アブストラクト
Japanese
| Title | 術後せん妄の発生機序と予防 |
|---|---|
| Subtitle | 日本臨床麻酔学会第41回大会シンポジウム 開心術における術後認知機能障害について - 予防と対策 - |
| Authors | 櫛方哲也* |
| Authors (kana) | |
| Organization | *弘前大学大学院医学研究科麻酔科学講座 |
| Journal | 日本臨床麻酔学会誌 |
| Volume | 42 |
| Number | 5 |
| Page | 499-504 |
| Year/Month | 2022 / |
| Article | 報告 |
| Publisher | 日本臨床麻酔学会 |
| Abstract | [要旨] 術後せん妄 (POD) とは術後に急性に日内変動を示す意識, 注意, 知覚の障害が出現する症候群で, 通常は短期間で回復するが, 予後を悪化させるため術後の経過改善のためにも何らかの介入が必要な病態である. 一方, PODと比較して発症時期, 経過とも比較的長く, 難治性の術後認知機能障害 (POCD) という病態もよく知られている. 両者はおそらく違う病態であるが, 正確な鑑別が困難であるので包括的に周術期神経認知障害 (Perioperative Neurocognitive Disorder : PND) という概念で捉える考え方もある. いずれにせよ, 早期に発症を予見し, 必要な治療を開始することは重篤化を防ぐ方策である. PODは手術侵襲や麻酔に伴う脳内の炎症, 術後疼痛が契機となって発症するとも考えられている. 「発症機序」については現在のところ確実な機序は未解明であるが, 「脆弱な脳」という概念が知られてきた. 「予防」の面では確実な方法はないものの, 「脆弱な脳」をどのように保護するか, ということも考慮されるべきである. |
| Practice | 臨床医学：外科系 |
| Keywords | 術後せん妄, 術後認知機能障害, 麻酔, 外科手術, 脆弱な脳, Postoperative delirium, POCD, Anesthesia, Surgery, Vulnerable brain |
English
| Title | Mechanism and Prevention of Postoperative Delirium |
|---|---|
| Subtitle | |
| Authors | Tetsuya KUSHIKATA |
| Authors (kana) | |
| Organization | Department of Anesthesiology, Hirosaki University Graduate School of Medicine |
| Journal | The Journal of Japan Society for Clinical Anesthesia |
| Volume | 42 |
| Number | 5 |
| Page | 499-504 |
| Year/Month | 2022 / |
| Article | Report |
| Publisher | The Japan Society for Clinical Anesthesia |
| Abstract | Postoperative delirium (POD) is an acute disturbance of consciousness, attention, and perception. Its course is transient and reversible, but since POD aggravates postoperative course, some intervention is required. POD is similar to but different from Postoperative cognitive dysfunction (POCD). Recently, we recognized both of them as a Perioperative Neurocognitive Disorder (PND). Early detection and treatment are essential to prevent serious sequelae. Although we have not identified a confirmed mechanism of POD's development, we recognize that surgical stress, superabundant anesthetics, and postoperative pain are causative. POD is thought to develop when these factors affect the inflamed (vulnerable) brain, so we need to protect the vulnerable brain from these factors. |
| Practice | Clinical surgery |
| Keywords | Postoperative delirium, POCD, Anesthesia, Surgery, Vulnerable brain |
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