2023 年第 1 期 第 18 卷

围术期神经认知障碍及其防治策略研究进展

Research progress on perioperative neurocognitive disorder and its prevention and treatment strategies

作者：周丹宋晓阳程鹏飞秦明哲余胭黎笔熙

英文作者：Zhou Dan Song Xiaoyang Cheng Pengfei Qin Mingzhe Yu Yan Li Bixi

单位：中部战区总医院麻醉科，武汉430070

英文单位：Department of Anesthesiology General Hospital of Central Theater Command Wuhan 430070 China

关键词：围术期神经认知障碍；炎症机制；神经炎症；防治策略

英文关键词：Perioperativeneurocognitivedisorder;Inflammatorymechanism;Neuroinflammation;Preventionandtreatmentstrategy

• 摘要：

• 围术期神经认知障碍（PND）是患者术后出现的常见并发症之一。PND的病理生理机制尚不完全明确，既往大量研究集中在各种神经通路、药物因素、手术因素等方面的影响。近年来越来越多的研究报道指向炎症因素在PND中的作用。围术期的手术、麻醉、患者相关因素等都能够影响炎症因子在外周和中枢神经系统的分布，而全身炎症和神经炎症都是影响PND的重要因素。此外通过预防炎症反应能够改善PND等，种种结论  说明炎症机制是引起神经认知功能障碍的重要因素。本文就PND的“炎症假说”机制及其防治策略方面的研究进展进行综述。

• Perioperative neurocognitive disorder (PND) is one of the common postoperative complications in  patients. The pathophysiological mechanism of PND is not clear, and previous studies focused on the effects of various neural pathways, drug factors, surgical factors and other aspects. In recent years, a lot of studies reported the role of inflammatory factors in perioperative neurocognitive impairment. Perioperative surgery, anesthesia and patient factors can affect the distribution of inflammatory factors in the peripheral and central nervous system, while systemic inflammation and neuroinflammation are important factors affecting PND. In addition, the prevention of inflammatory reaction can improve PND. Various conclusions show that inflammatory mechanism is an important factor causing neurocognitive disorder. This article reviews the research progress in the mechanism of "inflammation hypothesis" of PND and its prevention and treatment strategies.