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围手术期高血糖对术后认知功能的影响:一项综述

The impact of perioperative hyperglycemia on postoperative cognitive function: A comprehensive review.

作者信息

Song Jiale, Li Shuqin, Zhao Heng, Hao Qian, Sui Hongyuan, Zhou Hongmei, Lu Jian

机构信息

Jiaxing University Master Degree Cultivation Base, Zhejiang Chinese Medical University, Hangzhou City, China.

Department of Anesthesiology, The Second Hospital of Jiaxing, The Second Affiliated Hospital of Jiaxing University, Jiaxing Key Laboratory of Basic Research and Clinical Transformation of Perioperative Precision Anesthesia, Jiaxing City, China.

出版信息

IBRO Neurosci Rep. 2025 Apr 25;18:698-704. doi: 10.1016/j.ibneur.2025.04.010. eCollection 2025 Jun.

Abstract

Hyperglycemia, commonly triggered by the physiological stress of surgery, is exacerbated by counter-regulatory hormonal responses and can lead to significant complications including Postoperative Cognitive Dysfunction (POCD) and delirium. These conditions not only extend hospitalization and increase healthcare costs but also negatively impact long-term patient well-being. This review addresses multiple objectives by conducting a comprehensive literature review that synthesizes existing research across various surgical disciplines to assess the impact of hyperglycemia on cognitive outcomes. This involves integrating findings from both observational studies and clinical trials to offer a nuanced perspective on the current knowledge landscape. Secondly, it identifies significant gaps in research, including inconsistencies in outcomes and methodological shortcomings. Highlighting these gaps emphasizes the need for a more standardized approach to understanding hyperglycemia's cognitive effects post-surgery. Lastly, the review proposes future research directions, advocating for innovative research methodologies and clinical interventions aimed at mitigating the cognitive impairments associated with perioperative hyperglycemia. By providing an exhaustive examination of these aspects, the review seeks to enhance scholarly discourse and inform clinical practice, ultimately aiming to refine perioperative care protocols. This will protect cognitive functions and improve overall patient outcomes, bridging the gap between theoretical research and practical application, thereby setting the stage for advancements that could transform perioperative management standards.

摘要

高血糖通常由手术的生理应激引发,反调节激素反应会使其加剧,并可能导致包括术后认知功能障碍(POCD)和谵妄在内的重大并发症。这些情况不仅会延长住院时间、增加医疗成本,还会对患者的长期健康产生负面影响。本综述通过进行全面的文献综述来实现多个目标,该综述综合了各个外科领域的现有研究,以评估高血糖对认知结果的影响。这包括整合观察性研究和临床试验的结果,以对当前的知识状况提供细致入微的观点。其次,它确定了研究中的重大差距,包括结果的不一致性和方法学上的缺陷。强调这些差距凸显了采用更标准化方法来理解术后高血糖对认知影响的必要性。最后,该综述提出了未来的研究方向,倡导采用创新的研究方法和临床干预措施,以减轻围手术期高血糖相关的认知障碍。通过对这些方面进行详尽的审视,该综述旨在加强学术讨论并为临床实践提供信息,最终目标是完善围手术期护理方案。这将保护认知功能并改善患者的总体结局,弥合理论研究与实际应用之间的差距,从而为可能改变围手术期管理标准的进展奠定基础。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/367f/12434691/dc2a58b7f557/gr1.jpg

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