经皮耳迷走神经刺激治疗术后谵妄的临床研究现状：机制、证据与挑战

王 晟昱1, 王春 光*2
1、承德医学院研究生学院
2、保定市第一中心医院麻醉科

摘要


术后谵妄（postoperative delirium，POD）是一种急性、波动性的脑功能障碍，是老年患者围手术期常见的并发症，与不良预后密切相关。其病理机制复杂，传统防治手段效果有限，亟需新的干预策略。经皮耳迷走神经刺激（transcutaneous auricular vagus nerve stimulation，taVNS）是一种新兴的非侵入性神经调节技术，通过激活迷走神经唯一的体表分支，发挥调节效应，近年来在POD防治领域展现出巨大潜力。本综述系统阐述taVNS的作用机制，总结近年研究证据，分析当前面临的挑战。

关键词


经皮耳迷走神经刺激；术后谵妄；神经炎症；胆碱能抗炎通路；非药物干预

全文:

PDF


参考


[1]中国老年医学学会麻醉学分会.中国老年患者术后谵妄防治专家共识[J].国际麻醉学与复苏杂志，2023，44（01）：1-27.

[2]Han B, Li X, Hao J. The cholinergic anti-inflammatory pathway: An innovative treatment strategy for neurological diseases. Neurosci Biobehav Rev. 2017;77:358-368.

[3]Farmer AD, Strzelczyk A, Finisguerra A, et al. International Consensus Based Review and Recommendations for Minimum Reporting Standards in Research on Transcutaneous Vagus Nerve Stimulation (Version 2020). Front Hum Neurosci. 2021;14:568051.

[4]Bonaz B, Sinniger V, Pellissier S. Vagus Nerve Stimulation at the Interface of Brain-Gut Interactions. Cold Spring Harb Perspect Med. 2019;9(8):a034199.

[5]Briand MM, Gosseries O, Staumont B, Laureys S, Thibaut A. Transcutaneous Auricular Vagal Nerve Stimulation and Disorders of Consciousness: A Hypothesis for Mechanisms of Action. Front Neurol. 2020;11:933.

[6]Sun J, Zhang Q, Lin B, et al. Association Between Postoperative Long-Term Heart Rate Variability and Postoperative Delirium in Elderly Patients Undergoing Orthopedic Surgery: A Prospective Cohort Study. Front Aging Neurosci. 2021;13:646253.

[7]Huang C, Mårtensson J, Gögenur I, Asghar MS. Exploring Postoperative Cognitive Dysfunction and Delirium in Noncardiac Surgery Using MRI: A Systematic Review. Neural Plast. 2018;2018:1281657.

[8]Suzuki T, Takizawa T, Kamio Y, et al. Noninvasive Vagus Nerve Stimulation Prevents Ruptures and Improves Outcomes in a Model of Intracranial Aneurysm in Mice. Stroke. 2019;50(5):1216-1223.

[9]Zhou Q, Zheng Z, Wang X, et al. taVNS Alleviates Sevoflurane-Induced Cognitive Dysfunction in Aged Rats Via Activating Basal Forebrain Cholinergic Neurons. Neurochem Res. 2023;48(6):1848-1863.

[10]Zhou Q, Yu L, Yin C, et al. Effect of transcutaneous auricular vagus nerve stimulation on delayed neurocognitive recovery in elderly patients. Aging Clin Exp Res. 2022;34(10):2421-2429.

[11]Kim AY, Marduy A, de Melo PS, et al. Safety of transcutaneous auricular vagus nerve stimulation (taVNS): a systematic review and meta-analysis. Sci Rep. 2022;12(1):22055.


Refbacks

  • 当前没有refback。