老年患者心脏手术后谵妄的危险因素与干预策略现状^*

Postoperative delirium in elderly patients following cardiac surgery: current evidence on risk factors and preventive interventions

摘要

术后谵妄(POD)是老年患者心脏手术后常见的急性神经认知障碍,可导致术后并发症增多、住院时间延长、死亡率升高及生活质量下降等不良结局。该研究从患者相关、手术相关及术后管理相关三个方面对POD的危险因素进行分析,同时也综述了药物和非药物两种干预措施的临床应用要点。为老年患者心脏POD的早期识别、风险分层及精准干预提供循证依据,对改善患者预后具有重要临床意义。

Abstract

Postoperative delirium (POD) is a prevalent acute neurocognitive disease following heart surgery in elderly patients, potentially resulting in unfavorable outcomes including heightened postoperative complications, extended hospital stays, higher mortality, and diminished quality of life. This review examines postoperative risk factors from three perspectives: patient-related, surgery-related, and postoperative management, while also elucidating the essential aspects of clinical application for pharmaceutical and non-pharmacological interventions. Consequently, it offers an evidence-based foundation for the early detection, risk stratification, and targeted intervention of POD in elderly patients, which holds substantial therapeutic importance for enhancing patient outcomes.

关键词

老年患者 / 心脏手术 / 术后谵妄 / 危险因素 / 干预策略

Key words

Elderly patients / Cardiac surgery / Postoperative delirium / Risk factors / Intervention strategy

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基金资助

^*新疆维吾尔自治区自然科学基金(2019D01C293)