长期认知功能下降跟外科手术和麻醉是否有关？

songhailong

长期认知功能下降跟外科手术和麻醉是否有关？
术后认知功能障碍涉及 神经心理学功能下降多个领域，包括记忆、执行功能、处理速度等，应该有别于术后谵妄，术后谵妄是注意力和意识改变一种急性精神混乱期。术语认知障碍文献有描述
，包括急性（1周），中级（3个月），以及长期（1-2年）手术后认知功能减退。认知障碍的发生率主要发生非心脏手术后，估计7％至26％发生。对于那些遭受认知障碍，认知功能减退的发病可能手术后不久发生，但这种情况可逆转，手术和麻醉是否进一步加快认知状态长期下滑？迹象表明后一种理论可能对老年性痴呆认知功能下降疾病的原因的认识特别重要，因为这种神经退行性病理生理学情况并不完全了解。特别是，如果有关手术诱发因素和/或可确定麻醉导致认知障碍，可以设计
干预措施，以尽量减少认知障碍发生。阿维丹等研究认知障碍于麻醉有关，这对时下流行的长期 认知障碍于手术事件有直接关系观念的挑战，


POSTOPERATIVE cognitive dysfunction or decline (POCD)
refers to decline in a variety of neuropsychological domains,
including memory, executive functioning, and speed of
processing, and should be distinguished from postoperative
delirium, which is an acute confusional state with
alterations in attention and consciousness.
The term
POCD has been described in the literature to include
acute (1 week), intermediate (3 months), and long-term
(1–2 yr) cognitive decline after surgery. The incidence of
POCD after major noncardiac surgery has been estimated
to be between 7% and 26%.For those who
experience POCD, the onset of cognitive decline likely
occurs soon after surgery, but is this condition reversible,
or does surgery and anesthesia accelerate further long-term
decline in cognitive status? Evidence for the
latter theory might be particularly important to the understanding
of the cause of cognitive decline in Alzheimer
disease, because the pathophysiology of this neurodegenerative
condition is not completely understood.
Specifically, if precipitating factors relating to surgery
and/or anesthesia can be identified that lead to POCD,
interventions can be designed to minimize the occurrence
of POCD. This issue of ANESTHESIOLOGY contains a
study by Avidan et al.5 providing a challenge to the
prevailing notion that long-term POCD is directly related
to the surgical event.

songhailong

共五段陆续翻译！

hermione_fang

期待楼主的下文呀！怎么停止了？加油加油

hermione_fang

要不把原文发给我好不？:loveliness: