CAJ | 학술논문

背景随着社会老龄化,老年手术患者增多,术后认知功能障碍(postoperative cognitive dysfunction,POCD)越来越受到关注.POCD的诊断是一个排除性诊断,而麻醉医师对其相关神经心理学的概念了解有限. 目的比较全面地介绍POCD相关的神经心理学概念,加深对诊断POCD的理解,为其临床研究提供参考. 内容根据《精神疾病诊断与统计手册》第4版(DSM-Ⅳ)的分类,POCD是轻度认知障碍(mild cognitive impairment,MCI)的一种特殊类型.诊断POCD除了要排除阿尔茨海默病(alzheimer's disease,AD)、谵妄这类明显的神经精神疾病,还要鉴别抑郁及血管性认知功能损伤等其他轻度认知功能损害.对MCI、正常老化、谵妄、抑郁及阿尔茨海默病等神经心理学概念的研究现状及与POCD的相互关系进行综述. 趋向 POCD的研究需要神经心理学等跨专业的学科知识,寻求相关专业同仁的支持,加强学科间的交流合作,共同研究POCD十分必要.
배경 수착사회노령화,노년수술환자증다,술후인지공능장애(postoperative cognitive dysfunction,POCD)월래월수도관주.POCD적진단시일개배제성진단,이마취의사대기상관신경심이학적개념료해유한. 목적 비교전면지개소POCD상관적신경심이학개념,가심대진단POCD적리해,위기림상연구제공삼고. 내용 근거《정신질병진단여통계수책》제4판(DSM-Ⅳ)적분류,POCD시경도인지장애(mild cognitive impairment,MCI)적일충특수류형.진단POCD제료요배제아이자해묵병(alzheimer's disease,AD)、섬망저류명현적신경정신질병,환요감별억욱급혈관성인지공능손상등기타경도인지공능손해.대MCI、정상노화、섬망、억욱급아이자해묵병등신경심이학개념적연구현상급여POCD적상호관계진행종술. 추향 POCD적연구수요신경심이학등과전업적학과지식,심구상관전업동인적지지,가강학과간적교류합작,공동연구POCD십분필요.
Background The elderly are the fastest growing segment of the population.In the aging society,elderly surgical patients are increasing,and postoperative cognitive dysfunction (POCD) gains intensive attention of anesthesiologists.The POCD diagnosis is a diagnosis of exclusion,while the anesthesiologists have limited understanding about the neuropsychological concepts concerning POCD.Objective To comprehensively introduce the neuropsychological concepts concerning POCD,deepen the understanding of the diagnosis of POCD and to provide references for its clinical research.Content According to diagnosis and statistical manual of mental disorders,4th edition (DSM-Ⅳ),POCD is a special type of mild cognitive impairment (MCI).To diagnosis the POCD,we need not only to exclude obvious neurological and psychiatric disorders,such as alzheimer's disease(AD),delirium,but also to identify other mild cognitive impairment,like depression,vascular cognitive impairment and so on.In this article,the research progress of neuropsychological concepts associated with POCD,such as MCI,normal aging,delirium,depression and AD were reviewed.Trend POCD research needs neuropsychology and multi-disciplinary subject knowledge.Different expertise's collaborations between neuropsychiatrists and anesthesiologists are urgently needed.