摘要
随着手术量和老年人口数量的增加,术后认知障碍(POCD)越来越受关注。POCD的诊断主要依靠神经心理测试组合(NTB),NTB通常需要全面评估受试者的各个认知领域,人类的认知领域包括:注意、执行功能和工作记忆、记忆、语言和感知等。常见的简易神经心理测试量表包括简易精神状态测试量表(MMSE)、蒙特利尔认知评估量表(MoCA)、修订版认知功能电话问卷(TICS-m)和电话版MoCA等,这些量表一般用于神经认知障碍的筛查。随着对POCD研究的逐步完善,在术前、术后对受试者进行复杂的NTB评估被大家认可。在不同的临床研究中,NTB包含的神经心理测试量表和个数不一样。NTB首先需要能全面评估受试者的各个认知领域,其次各个子测试需要具有良好的重测信度,最好有平行版本避免学习效应。但对于POCD的研究不应该仅限于NTB,同时还需要关注患者的主诉、医生或知情者的观察,以及工具性日常生活能力的下降。
As the number of operations and the number of elderly populations increases,the Postoperative cognitive dysfunction(POCD)has received more and more concerns.The diagnosis of POCD mainly relies on the Neuropsychological Test Battery(NTB),which generally requires a comprehensive assessment of the subject′s cognitive domains.Cognitive domains include attention,executive function,working memory,memory,language and perception.Brief neuropsychological tests,such as MMSE,MoCA,TICS m and telephone versions of MoCA,are commonly used to screen for neurocognitive disorders.With further study,complex NTB of subjects before and after surgery is adopted by researchers.In different clinical studies,NTB contains different sub tests and the number of sub tests is also inconsistent.The NTB first needs to be able to assess the subject′s cognitive domains comprehensively and each sub test need to have a good test retest reliability,and preferably has a parallel version to avoid learning effects.However,POCD should not be only focused on NTB,and researchers should also pay attention to the subjective complaint from the patient.Observations from the informed or clinician and the decline in the instrumental activities of daily activities.
作者
冉娇(综述)
李雪寒(审校)
RAN Jiao;LI Xuehan(Department of Anesthesiology,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,China)
出处
《重庆医学》
CAS
2022年第3期533-537,共5页
Chongqing medicine
基金
四川省科技厅重点研发项目(2017SZ0147)。
关键词
术后
认知功能
神经心理学测试
认知领域
postoperative
cognitive function
neuropsychological test
cognitive domains
