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中华老年病研究电子杂志 ›› 2024, Vol. 11 ›› Issue (03) : 45 -49. doi: 10.3877/cma.j.issn.2095-8757.2024.03.009

综述

围术期谵妄与应激的研究进展
王可涵1, 许涛1, 周全红2,()   
  1. 1.200030 上海,上海交通大学医学院附属第六人民医院麻醉科
    2.200030 上海,上海交通大学医学院附属第六人民医院重症医学科
  • 收稿日期:2024-07-19 出版日期:2024-08-28
  • 通信作者: 周全红

Research progress on perioperative delirium and stress

Kehan Wang1, Tao Xu1, Quanhong Zhou2,()   

  1. 1.Department of Anesthesiology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200030,China
    2.Department of Critical Care Medicine, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200030,China
  • Received:2024-07-19 Published:2024-08-28
  • Corresponding author: Quanhong Zhou
引用本文:

王可涵, 许涛, 周全红. 围术期谵妄与应激的研究进展[J/OL]. 中华老年病研究电子杂志, 2024, 11(03): 45-49.

Kehan Wang, Tao Xu, Quanhong Zhou. Research progress on perioperative delirium and stress[J/OL]. Chinese Journal of Geriatrics Research(Electronic Edition), 2024, 11(03): 45-49.

谵妄是围术期最常见的并发症之一,严重影响老年患者近远期预后,给患者家庭及社会带来沉重负担。应激反应在谵妄的病理生理发展过程中起到重要作用,当易感人群对围术期应激原应答失衡时,可能诱发谵妄。本文着重探讨围术期谵妄的研究现状以及谵妄与应激的相互联系,总结应激机制与谵妄神经炎症、神经递质失衡以及昼夜节律紊乱机制相关的临床与基础研究,分析高反应性的下丘脑-垂体-肾上腺轴与高水平的糖皮质激素介导谵妄发生可能的机制,为完善谵妄管理方案的未来研究提供参考。

Delirium is one of the most common perioperative complications, which affects short and long term outcomes of elderly patients, and brings burden to patients' families and society. Stress response plays an important role in the pathophysiological process of delirium. Acute brain dysfunction,namely delirium, is a failure of higher- risk individuals to show resilience in response to perioperative stressors. This review focuses on previous research of perioperative delirium and its connection to stress response. It aims to summarize the clinical and basic studies regarding the effect of stress on neuroinflammation, neurotransmitter imbalance, and circadian rhythm disorder. Furthermore, it analyzes how the highly reactive hypothalamic-pituitary-adrenal axis and elevated levels of glucocorticoids may mediate the occurrence of delirium. This review will offer new insights for exploring the mechanism of delirium, providing references for future research on improving delirium management plans.

表1 谵妄的分型及特点
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