Muñoz-Corsini L, Gómez-Arnau J, Porras M C, Galindo S, Jiménez R
Servicio de Anestesiología y Reanimación, Clínica Puerta de Hierro, Madrid.
Rev Esp Anestesiol Reanim. 1997 May;44(5):191-200.
Although postoperative behavioral anomalies were first reported more than one hundred years ago, only in the past ten years has the profile for postoperative cognitive dysfunction (POCD) been defined. POCD is reversible and it has been suggested that the disorder has implications for increased mortality and morbidity if it is not diagnosed and treated early. At present the clinical presentation of POCD is thought to be variable and fluctuating, ranging from slight disorientation to coma. POCD can develop soon after surgery or appear several days later and its incidence is unknown as a result of the methodological difficulties involved in studying this entity. Of the various etiological factors that have been named, many can be modified during the period surrounding surgery. Once symptoms have developed,whether in the recovery unit or later, it is important to eliminate organic factors and begin treating the cause. The most important drugs for treatment are neuroleptics and benzodiazepines. We review the definition, epidemiology, etiology, pathophysiology and treatment of POCD and include a list of diseases and drugs associated with its development, as well as a description of psychological tests used for diagnosis.
尽管术后行为异常早在一百多年前就有报道，但直到过去十年，术后认知功能障碍（POCD）的特征才得以明确。POCD是可逆的，有人认为如果不及早诊断和治疗，该病症会增加死亡率和发病率。目前，POCD的临床表现被认为是多变且波动的，从轻微的定向障碍到昏迷不等。POCD可在手术后很快出现，也可能在几天后出现，由于研究该病症存在方法学上的困难，其发病率尚不清楚。在已被提及的各种病因中，许多在手术前后这段时间是可以改变的。一旦出现症状，无论是在恢复病房还是之后，消除器质性因素并开始治疗病因都很重要。治疗POCD最重要的药物是抗精神病药和苯二氮䓬类药物。我们综述了POCD的定义、流行病学、病因、病理生理学和治疗方法，列出了与其发生相关的疾病和药物清单，并描述了用于诊断的心理测试。
