胰岛素鼻内给药对衰弱患者术后谵妄的影响

金 鑫1, 李月 丹2, 李晓 琳3, 高晓 增4
1.华北理工大学研究生院 2.华北理工大学研究生院 3.华北理工大学研究生院 4.华北理工大学附属医院

摘要

摘要:术后谵妄(post operative delirium，POD)是老年衰弱患者常见的术后并发症，主要表现为注意力不集中、认知功能受损等，由于POD的发病机制十分复杂，目前还没有明确的防治方法，严重地影响了患者术后生活质量，增加了家庭和社会的负担。脑内胰岛已被证实能够对学习、记忆、认知以及神经元再生产生正向作用。衰弱、疾病状态、麻醉、手术等相关的脑内胰岛素信号通路异常或胰岛素抵抗会增加POD的发生风险，其与微管相关蛋白过度磷酸化、β-淀粉样蛋白异常沉积、神经炎症反应、突触功能障碍等密切相关，而通过鼻内给予胰岛素可改善或减轻上述因素所导致的POD严重程度，经鼻腔将胰岛素直接送达脑内可能成为防治POD的有效方法。本文就脑内胰岛素对衰弱患者POD的影响作出综述，旨在探索降低POD发病率的新途径。

关键词

关键词:脑内胰岛素；术后谵妄；衰弱；鼻内给药；全身麻醉

参考

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