首页 期刊 论文 学科刊群 资讯 加盟 关于
EN
image
Article(id=1198202428119154836, tenantId=1146029695717560320, journalId=1189873630562394117, issueId=1198202427301265552, articleNumber=null, orderNo=null, doi=10.11855/j.issn.0577-7402.1265.2024.0612, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=research-article, receivedDate=1694966400000, receivedDateStr=2023-09-18, revisedDate=null, revisedDateStr=null, acceptedDate=1711555200000, acceptedDateStr=2024-03-28, onlineDate=1763603320388, onlineDateStr=2025-11-20, pubDate=1730044800000, pubDateStr=2024-10-28, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1763603320388, onlineIssueDateStr=2025-11-20, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1763603320388, creator=13701087609, updateTime=1763603320388, updator=13701087609, issue=Issue{id=1198202427301265552, tenantId=1146029695717560320, journalId=1189873630562394117, year='2024', volume='49', issue='10', pageStart='1099', pageEnd='1220', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1763603320193, creator=13701087609, updateTime=1763603941762, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1198205034396746241, tenantId=1146029695717560320, journalId=1189873630562394117, issueId=1198202427301265552, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1198205034396746242, tenantId=1146029695717560320, journalId=1189873630562394117, issueId=1198202427301265552, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=1099, endPage=1104, ext={EN=ArticleExt(id=1198202428358230167, articleId=1198202428119154836, tenantId=1146029695717560320, journalId=1189873630562394117, language=EN, title=Sleep disorders and perioperative neurocognitive dysfunction, columnId=1198202428035268754, journalTitle=Medical Journal of Chinese People’s Liberation Army, columnName=Special Issue on Mechanisms and Protective Strategies of Perioperative Organ Injury Ⅱ, runingTitle=null, highlight=null, articleAbstract=

Perioperative neurocognitive disorder (PND) significantly threatens brain health, leading to prolonged hospitalization, increased patient mortality risk, and poor long-term prognosis. Sleep disorder may substantially elevate the risk of neurocognitive dysfunction. However, the specific role of sleep in PND development remains to be elucidated. In addition, controversy exists over whether interventions for perioperative sleep disorder can effectively prevent PND. Therefore, this review aims to explore the basic function and regulatory principles of sleep, the clinical characteristics of perioperative sleep disorder, its role and potential mechanisms in PND development. Furthermore, we also provide new evidence on the potential therapeutic strategies to modulate sleep disorder for PND management, to improve patient's neurocognitive prognosis and long-term outcomes.

, correspAuthors=Meng-Qiang Luo, authorNote=null, correspAuthorsNote=
E-mail:
, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, authorCompany=null, fund=null, authors=null, authorsList=Chao-Chao Zha, Shi-Lin Li, Ying-Wei Wang, Meng-Qiang Luo), CN=ArticleExt(id=1198202428765077661, articleId=1198202428119154836, tenantId=1146029695717560320, journalId=1189873630562394117, language=CN, title=围手术期睡眠紊乱与神经认知功能障碍, columnId=1198202428207235220, journalTitle=解放军医学杂志, columnName=围手术期器官损伤机制及保护策略专题Ⅱ, runingTitle=null, highlight=null, articleAbstract=

围手术期神经认知功能障碍(PND)可严重损害患者的神经认知功能，延长住院时间，导致病死率增高及远期预后不良。睡眠紊乱被认为是诱发PND的重要因素，但其在PND发生过程中的作用尚不明确，而围手术期积极干预睡眠紊乱能否有效预防PND亦存在争议。为此，本文阐述了睡眠的基本功能与调控，围手术期睡眠紊乱的临床特征及其在PND发生中的作用，并进一步探讨了调控睡眠紊乱干预PND的潜在治疗策略，以指导临床改善患者的神经功能预后及远期转归。

, correspAuthors=罗猛强, authorNote=null, correspAuthorsNote=
罗猛强，E-mail：
, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=qkEhXkeeIqYg+IaAqHYeQA==, magXml=xtR5lC3WpqWGl/tmnxit+g==, pdfUrl=null, pdf=hO+9OVVQHZZpvR7z84xqWQ==, pdfFileSize=1052014, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=MSu6V4Ip68SDRxunlICO+w==, mapNumber=null, authorCompany=null, fund=null, authors=

查超超，硕士研究生，主要从事围手术期脑功能保护方面的研究

罗猛强，复旦大学附属华山医院麻醉科副主任医师、副教授、主任助理、硕士研究生导师；担任中华医学会麻醉学分会青年学组委员、上海市医学会麻醉专科分会青委副主任委员、中国神经科学学会麻醉与脑功能分会委员兼秘书、Anesthesiology杂志中文版青年编委、《国际麻醉学与复苏杂志》通信编委；主要研究方向为全麻机制，应用活体单细胞钙成像技术揭示全身麻醉与睡眠对促睡眠核团VLPO特异类型神经元异质性的调节机制；以第一或通信作者在Advanced Science、eLife、Anesthesiology、Journal of Clinical Anesthesia等期刊发表论文16篇，主持国家自然科学基金面上项目及青年基金，并获上海市抗击新冠疫情先进个人等荣誉。

, authorsList=查超超, 李峙林, 王英伟, 罗猛强)}, authors=[Author(id=1198319029174763782, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, orderNo=0, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1198319029317370123, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, authorId=1198319029174763782, language=EN, stringName=Chao-Chao Zha, firstName=Chao-Chao, middleName=null, lastName=Zha, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=Department of Anesthesiology, Huashan Hospital Affiliated to Fudan University, Shanghai 200040, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1198319029422227726, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, authorId=1198319029174763782, language=CN, stringName=查超超, firstName=超超, middleName=null, lastName=查, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=复旦大学附属华山医院麻醉科，上海 200040, bio={"content":"

查超超，硕士研究生，主要从事围手术期脑功能保护方面的研究

"}, bioImg=null, bioContent=

查超超，硕士研究生，主要从事围手术期脑功能保护方面的研究

, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1198319029057323264, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, xref=null, ext=[AuthorCompanyExt(id=1198319029069906177, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, companyId=1198319029057323264, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Anesthesiology, Huashan Hospital Affiliated to Fudan University, Shanghai 200040, China), AuthorCompanyExt(id=1198319029082489090, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, companyId=1198319029057323264, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=复旦大学附属华山医院麻醉科，上海 200040)])]), Author(id=1198319029510308113, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, orderNo=1, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1198319029623554324, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, authorId=1198319029510308113, language=EN, stringName=Shi-Lin Li, firstName=Shi-Lin, middleName=null, lastName=Li, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=Department of Anesthesiology, Huashan Hospital Affiliated to Fudan University, Shanghai 200040, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1198319029724217622, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, authorId=1198319029510308113, language=CN, stringName=李峙林, firstName=峙林, middleName=null, lastName=李, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=复旦大学附属华山医院麻醉科，上海 200040, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1198319029057323264, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, xref=null, ext=[AuthorCompanyExt(id=1198319029069906177, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, companyId=1198319029057323264, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Anesthesiology, Huashan Hospital Affiliated to Fudan University, Shanghai 200040, China), AuthorCompanyExt(id=1198319029082489090, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, companyId=1198319029057323264, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=复旦大学附属华山医院麻醉科，上海 200040)])]), Author(id=1198319029875212573, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, orderNo=2, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1198319029971681567, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, authorId=1198319029875212573, language=EN, stringName=Ying-Wei Wang, firstName=Ying-Wei, middleName=null, lastName=Wang, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=Department of Anesthesiology, Huashan Hospital Affiliated to Fudan University, Shanghai 200040, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1198319030059761956, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, authorId=1198319029875212573, language=CN, stringName=王英伟, firstName=英伟, middleName=null, lastName=王, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=复旦大学附属华山医院麻醉科，上海 200040, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1198319029057323264, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, xref=null, ext=[AuthorCompanyExt(id=1198319029069906177, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, companyId=1198319029057323264, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Anesthesiology, Huashan Hospital Affiliated to Fudan University, Shanghai 200040, China), AuthorCompanyExt(id=1198319029082489090, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, companyId=1198319029057323264, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=复旦大学附属华山医院麻醉科，上海 200040)])]), Author(id=1198319030164619561, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, orderNo=3, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=luomq16@fudan.edu.cn, emailSecond=null, emailThird=null, correspondingAuthor=1, authorType=1, ext={EN=AuthorExt(id=1198319030261088561, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, authorId=1198319030164619561, language=EN, stringName=Meng-Qiang Luo, firstName=Meng-Qiang, middleName=null, lastName=Luo, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=*, address=Department of Anesthesiology, Huashan Hospital Affiliated to Fudan University, Shanghai 200040, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1198319030361751866, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, authorId=1198319030164619561, language=CN, stringName=罗猛强, firstName=猛强, middleName=null, lastName=罗, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=*, address=复旦大学附属华山医院麻醉科，上海 200040, bio={"content":"

罗猛强，复旦大学附属华山医院麻醉科副主任医师、副教授、主任助理、硕士研究生导师；担任中华医学会麻醉学分会青年学组委员、上海市医学会麻醉专科分会青委副主任委员、中国神经科学学会麻醉与脑功能分会委员兼秘书、Anesthesiology杂志中文版青年编委、《国际麻醉学与复苏杂志》通信编委；主要研究方向为全麻机制，应用活体单细胞钙成像技术揭示全身麻醉与睡眠对促睡眠核团VLPO特异类型神经元异质性的调节机制；以第一或通信作者在Advanced Science、eLife、Anesthesiology、Journal of Clinical Anesthesia等期刊发表论文16篇，主持国家自然科学基金面上项目及青年基金，并获上海市抗击新冠疫情先进个人等荣誉。

"}, bioImg=null, bioContent=

罗猛强，复旦大学附属华山医院麻醉科副主任医师、副教授、主任助理、硕士研究生导师；担任中华医学会麻醉学分会青年学组委员、上海市医学会麻醉专科分会青委副主任委员、中国神经科学学会麻醉与脑功能分会委员兼秘书、Anesthesiology杂志中文版青年编委、《国际麻醉学与复苏杂志》通信编委；主要研究方向为全麻机制，应用活体单细胞钙成像技术揭示全身麻醉与睡眠对促睡眠核团VLPO特异类型神经元异质性的调节机制；以第一或通信作者在Advanced Science、eLife、Anesthesiology、Journal of Clinical Anesthesia等期刊发表论文16篇，主持国家自然科学基金面上项目及青年基金，并获上海市抗击新冠疫情先进个人等荣誉。

, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1198319029057323264, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, xref=null, ext=[AuthorCompanyExt(id=1198319029069906177, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, companyId=1198319029057323264, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Anesthesiology, Huashan Hospital Affiliated to Fudan University, Shanghai 200040, China), AuthorCompanyExt(id=1198319029082489090, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, companyId=1198319029057323264, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=复旦大学附属华山医院麻醉科，上海 200040)])])], keywords=[Keyword(id=1198319030558884169, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, language=EN, orderNo=1, keyword=sleep disorders), Keyword(id=1198319030655353169, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, language=EN, orderNo=2, keyword=general anesthesia), Keyword(id=1198319030743433559, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, language=EN, orderNo=3, keyword=perioperative neurocognitive disorder), Keyword(id=1198319030818931036, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, language=EN, orderNo=4, keyword=sleep modulation), Keyword(id=1198319030898622818, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, language=CN, orderNo=1, keyword=睡眠紊乱), Keyword(id=1198319031099949421, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, language=CN, orderNo=2, keyword=全身麻醉), Keyword(id=1198319031192224115, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, language=CN, orderNo=3, keyword=围手术期神经认知功能障碍), Keyword(id=1198319031292887418, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, language=CN, orderNo=4, keyword=睡眠调控)], refs=[Reference(id=1198319033478119884, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, doi=null, pmid=null, pmcid=null, year=2021, volume=126, issue=2, pageStart=423, pageEnd=432, url=null, language=null, rfNumber=[1], rfOrder=0, authorNames=Peden CJ, Miller TR, Deiner SG, journalName=Br J Anaesth, refType=null, unstructuredReference=Peden CJ, Miller TR, Deiner SG, et al. Improving perioperative brain health: an expert consensus review of key actions for the perioperative care team[J]. Br J Anaesth, 2021, 126(2): 423-432., articleTitle=Improving perioperative brain health: an expert consensus review of key actions for the perioperative care team, refAbstract=null), Reference(id=1198319033578783187, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, doi=null, pmid=null, pmcid=null, year=2019, volume=366, issue=6465, pageStart=628, pageEnd=631, url=null, language=null, rfNumber=[2], rfOrder=1, authorNames=Fultz NE, Bonmassar G, Setsompop K, journalName=Science, refType=null, unstructuredReference=Fultz NE, Bonmassar G, Setsompop K, et al. Coupled electrophysiological, hemodynamic, and cerebrospinal fluid oscillations in human sleep[J]. Science, 2019, 366(6465): 628-631., articleTitle=Coupled electrophysiological, hemodynamic, and cerebrospinal fluid oscillations in human sleep, refAbstract=null), Reference(id=1198319033675252184, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, doi=null, pmid=null, pmcid=null, year=2020, volume=11, issue=1, pageStart=4411, pageEnd=null, url=null, language=null, rfNumber=[3], rfOrder=2, authorNames=Hablitz LM, Plá V, Giannetto M, journalName=Nat Commun, refType=null, unstructuredReference=Hablitz LM, Plá V, Giannetto M, et al. Circadian control of brain glymphatic and lymphatic fluid flow[J]. Nat Commun, 2020, 11(1): 4411., articleTitle=Circadian control of brain glymphatic and lymphatic fluid flow, refAbstract=null), Reference(id=1198319033796887006, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, doi=null, pmid=null, pmcid=null, year=2020, volume=369, issue=6508, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[4], rfOrder=3, authorNames=Peng W, Wu Z, Song K, journalName=Science, refType=null, unstructuredReference=Peng W, Wu Z, Song K, et al. Regulation of sleep homeostasis mediator adenosine by basal forebrain glutamatergic neurons[J]. Science, 2020, 369(6508): eabb0556., articleTitle=Regulation of sleep homeostasis mediator adenosine by basal forebrain glutamatergic neurons, refAbstract=null), Reference(id=1198319033926910433, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, doi=null, pmid=null, pmcid=null, year=2021, volume=44, issue=9, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[5], rfOrder=4, authorNames=Skorucak J, Weber N, Carskadon MA, journalName=Sleep, refType=null, unstructuredReference=Skorucak J, Weber N, Carskadon MA, et al. Homeostatic response to sleep restriction in adolescents[J]. Sleep, 2021, 44(9): zsab106., articleTitle=Homeostatic response to sleep restriction in adolescents, refAbstract=null), Reference(id=1198319034128237029, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, doi=null, pmid=null, pmcid=null, year=2019, volume=66, issue=3, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[6], rfOrder=5, authorNames=Jilg A, Bechstein P, Saade A, journalName=J Pineal Res, refType=null, unstructuredReference=Jilg A, Bechstein P, Saade A, et al. Melatonin modulates daytime‐dependent synaptic plasticity and learning efficiency[J]. J Pineal Res, 2019, 66(3): e12553., articleTitle=Melatonin modulates daytime‐dependent synaptic plasticity and learning efficiency, refAbstract=null), Reference(id=1198319034249871852, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, doi=null, pmid=null, pmcid=null, year=2020, volume=11, issue=null, pageStart=540759, pageEnd=null, url=null, language=null, rfNumber=[7], rfOrder=6, authorNames=Luo M, Song B, Zhu J, journalName=Front Neurol, refType=null, unstructuredReference=Luo M, Song B, Zhu J. Sleep disturbances after general anesthesia: current perspectives[J]. Front Neurol, 2020, 11: 540759., articleTitle=Sleep disturbances after general anesthesia: current perspectives, refAbstract=null), Reference(id=1198319034392478192, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, doi=null, pmid=null, pmcid=null, year=2020, volume=1, issue=3, pageStart=e96, pageEnd=e105, url=null, language=null, rfNumber=[8], rfOrder=7, authorNames=Li P, Gao L, Gaba A, journalName=Lancet Healthy Longev, refType=null, unstructuredReference=Li P, Gao L, Gaba A, et al. Circadian disturbances in Alzheimer's disease progression: a prospective observational cohort study of community-based older adults[J]. Lancet Healthy Longev, 2020, 1(3): e96-e105., articleTitle=Circadian disturbances in Alzheimer's disease progression: a prospective observational cohort study of community-based older adults, refAbstract=null), Reference(id=1198319034497335796, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, doi=null, pmid=null, pmcid=null, year=2019, volume=18, issue=3, pageStart=307, pageEnd=318, url=null, language=null, rfNumber=[9], rfOrder=8, authorNames=Leng Y, Musiek ES, Hu K, journalName=Lancet Neurol, refType=null, unstructuredReference=Leng Y, Musiek ES, Hu K, et al. Association between circadian rhythms and neurodegenerative diseases[J]. Lancet Neurol, 2019, 18(3): 307-318., articleTitle=Association between circadian rhythms and neurodegenerative diseases, refAbstract=null), Reference(id=1198319034614776316, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, doi=null, pmid=null, pmcid=null, year=2022, volume=11, issue=2, pageStart=445, pageEnd=null, url=null, language=null, rfNumber=[10], rfOrder=9, authorNames=Ishizawa Y, journalName=J Clin Med, refType=null, unstructuredReference=Ishizawa Y. Does preoperative cognitive optimization improve postoperative outcomes in the elderly?[J]. J Clin Med, 2022, 11(2): 445., articleTitle=Does preoperative cognitive optimization improve postoperative outcomes in the elderly?, refAbstract=null), Reference(id=1198319034757382656, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, doi=null, pmid=null, pmcid=null, year=2023, volume=23, issue=10, pageStart=4881, pageEnd=null, url=null, language=null, rfNumber=[11], rfOrder=10, authorNames=Bate GL, Kirk C, Rehman RZU, journalName=Sensors (Basel), refType=null, unstructuredReference=Bate GL, Kirk C, Rehman RZU, et al. The role of wearable sensors to monitor physical activity and sleep patterns in older adult inpatients: a structured review[J]. Sensors (Basel), 2023, 23(10): 4881., articleTitle=The role of wearable sensors to monitor physical activity and sleep patterns in older adult inpatients: a structured review, refAbstract=null), Reference(id=1198319034883211782, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, doi=null, pmid=null, pmcid=null, year=2018, volume=46, issue=12, pageStart=e1204, pageEnd=e1212, url=null, language=null, rfNumber=[12], rfOrder=11, authorNames=Fadayomi AB, Ibala R, Bilotta F, journalName=Crit Care Med, refType=null, unstructuredReference=Fadayomi AB, Ibala R, Bilotta F, et al. A systematic review and meta-analysis examining the impact of sleep disturbance on post-operative delirium[J]. Crit Care Med, 2018, 46(12): e1204-e1212., articleTitle=A systematic review and meta-analysis examining the impact of sleep disturbance on post-operative delirium, refAbstract=null), Reference(id=1198319035059372555, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, doi=null, pmid=null, pmcid=null, year=2022, volume=4, issue=null, pageStart=100043, pageEnd=null, url=null, language=null, rfNumber=[13], rfOrder=12, authorNames=Pennings N, Golden L, Yashi K, journalName=Obes Pillars, refType=null, unstructuredReference=Pennings N, Golden L, Yashi K, et al. Sleep-disordered breathing, sleep apnea, and other obesity-related sleep disorders: an Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) 2022[J]. Obes Pillars, 2022, 4: 100043., articleTitle=Sleep-disordered breathing, sleep apnea, and other obesity-related sleep disorders: an Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) 2022, refAbstract=null), Reference(id=1198319035147452943, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, doi=null, pmid=null, pmcid=null, year=2020, volume=77, issue=6, pageStart=716, pageEnd=724, url=null, language=null, rfNumber=[14], rfOrder=13, authorNames=André C, Rehel S, Kuhn E, journalName=JAMA Neurol, refType=null, unstructuredReference=André C, Rehel S, Kuhn E, et al. Association of sleep-disordered breathing with Alzheimer disease biomarkers in community-dwelling older adults: a secondary analysis of a randomized clinical trial[J]. JAMA Neurol, 2020, 77(6): 716-724., articleTitle=Association of sleep-disordered breathing with Alzheimer disease biomarkers in community-dwelling older adults: a secondary analysis of a randomized clinical trial, refAbstract=null), Reference(id=1198319035277476373, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, doi=null, pmid=null, pmcid=null, year=2014, volume=18, issue=5, pageStart=477, pageEnd=null, url=null, language=null, rfNumber=[15], rfOrder=14, authorNames=Roggenbach J, Klamann M, von Haken R, journalName=Crit Care, refType=null, unstructuredReference=Roggenbach J, Klamann M, von Haken R, et al. Sleep-disordered breathing is a risk factor for delirium after cardiac surgery: a prospective cohort study[J]. Crit Care, 2014, 18(5): 477., articleTitle=Sleep-disordered breathing is a risk factor for delirium after cardiac surgery: a prospective cohort study, refAbstract=null), Reference(id=1198319035411694109, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, doi=null, pmid=null, pmcid=null, year=2021, volume=32, issue=null, pageStart=103, pageEnd=111, url=null, language=null, rfNumber=[16], rfOrder=15, authorNames=Chew D, Sethi E, Sim YE, journalName=Knee, refType=null, unstructuredReference=Chew D, Sethi E, Sim YE, et al. Postoperative delirium following total joint arthroplasties in a multi-ethnic population–a prospective observational study[J]. Knee, 2021, 32: 103-111., articleTitle=Postoperative delirium following total joint arthroplasties in a multi-ethnic population–a prospective observational study, refAbstract=null), Reference(id=1198319035571077665, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, doi=null, pmid=null, pmcid=null, year=2014, volume=18, issue=1, pageStart=19, pageEnd=29, url=null, language=null, rfNumber=[17], rfOrder=16, authorNames=Mirrakhimov AE, Brewbaker CL, Krystal AD, journalName=Sleep Breath, refType=null, unstructuredReference=Mirrakhimov AE, Brewbaker CL, Krystal AD, et al. Obstructive sleep apnea and delirium: exploring possible mechanisms[J]. Sleep Breath, 2014, 18(1): 19-29., articleTitle=Obstructive sleep apnea and delirium: exploring possible mechanisms, refAbstract=null), Reference(id=1198319035701101094, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, doi=null, pmid=null, pmcid=null, year=2020, volume=3, issue=4, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[18], rfOrder=17, authorNames=King CR, Fritz BA, Escallier K, journalName=JAMA Netw Open, refType=null, unstructuredReference=King CR, Fritz BA, Escallier K, et al. Association between preoperative obstructive sleep apnea and preoperative positive airway pressure with postoperative intensive care unit delirium[J]. JAMA Netw Open, 2020, 3(4): e203125., articleTitle=Association between preoperative obstructive sleep apnea and preoperative positive airway pressure with postoperative intensive care unit delirium, refAbstract=null), Reference(id=1198319035822735914, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, doi=null, pmid=null, pmcid=null, year=2020, volume=12, issue=null, pageStart=299, pageEnd=307, url=null, language=null, rfNumber=[19], rfOrder=18, authorNames=Gao L, Lim AS, Wong PM, journalName=Nat Sci Sleep, refType=null, unstructuredReference=Gao L, Lim AS, Wong PM, et al. Fragmentation of rest/activity patterns in community-based elderly individuals predicts incident heart failure[J]. Nat Sci Sleep, 2020, 12: 299-307., articleTitle=Fragmentation of rest/activity patterns in community-based elderly individuals predicts incident heart failure, refAbstract=null), Reference(id=1198319036951003694, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, doi=null, pmid=null, pmcid=null, year=2019, volume=19, issue=1, pageStart=272, pageEnd=null, url=null, language=null, rfNumber=[20], rfOrder=19, authorNames=Campbell AM, Axon DR, Martin JR, journalName=BMC Geriatr, refType=null, unstructuredReference=Campbell AM, Axon DR, Martin JR, et al. Melatonin for the prevention of postoperative delirium in older adults: a systematic review and meta-analysis[J]. BMC Geriatr, 2019, 19(1): 272., articleTitle=Melatonin for the prevention of postoperative delirium in older adults: a systematic review and meta-analysis, refAbstract=null), Reference(id=1198319037085221425, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, doi=null, pmid=null, pmcid=null, year=2019, volume=92, issue=12, pageStart=e1387, pageEnd=e1394, url=null, language=null, rfNumber=[21], rfOrder=20, authorNames=Bowman K, Jones L, Pilling LC, journalName=Neurology, refType=null, unstructuredReference=Bowman K, Jones L, Pilling LC, et al. Vitamin D levels and risk of delirium: a mendelian randomization study in the UK Biobank[J]. Neurology, 2019, 92(12): e1387-e1394., articleTitle=Vitamin D levels and risk of delirium: a mendelian randomization study in the UK Biobank, refAbstract=null), Reference(id=1198319037236216375, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, doi=null, pmid=null, pmcid=null, year=2021, volume=69, issue=2, pageStart=365, pageEnd=372, url=null, language=null, rfNumber=[22], rfOrder=21, authorNames=Pilling LC, Jones LC, Masoli JAH, journalName=J Am Geriatr Soc, refType=null, unstructuredReference=Pilling LC, Jones LC, Masoli JAH, et al. Low vitamin D levels and risk of incident delirium in 351,000 older UK biobank participants[J]. J Am Geriatr Soc, 2021, 69(2): 365-372., articleTitle=Low vitamin D levels and risk of incident delirium in 351,000 older UK biobank participants, refAbstract=null), Reference(id=1198319037336879672, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, doi=null, pmid=null, pmcid=null, year=2021, volume=132, issue=5, pageStart=1254, pageEnd=1264, url=null, language=null, rfNumber=[23], rfOrder=22, authorNames=Moody OA, Zhang ER, Vincent KF, journalName=Anesth Analg, refType=null, unstructuredReference=Moody OA, Zhang ER, Vincent KF, et al. The neural circuits underlying general anesthesia and sleep[J]. Anesth Analg, 2021, 132(5): 1254-1264., articleTitle=The neural circuits underlying general anesthesia and sleep, refAbstract=null), Reference(id=1198319037450125882, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, doi=null, pmid=null, pmcid=null, year=2023, volume=10, issue=2, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[24], rfOrder=23, authorNames=Luo M, Fei X, Liu X, journalName=Adv Sci (Weinh), refType=null, unstructuredReference=Luo M, Fei X, Liu X, et al. Divergent neural activity in the VLPO during anesthesia and sleep[J]. Adv Sci (Weinh), 2023, 10(2): e2203395., articleTitle=Divergent neural activity in the VLPO during anesthesia and sleep, refAbstract=null), Reference(id=1198319037542400574, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, doi=null, pmid=null, pmcid=null, year=2022, volume=20, issue=1, pageStart=72, pageEnd=84, url=null, language=null, rfNumber=[25], rfOrder=24, authorNames=Yang Q, Zhou F, Li A, journalName=Curr Neuropharmacol, refType=null, unstructuredReference=Yang Q, Zhou F, Li A, et al. Neural substrates for the regulation of sleep and general anesthesia[J]. Curr Neuropharmacol, 2022, 20(1): 72-84., articleTitle=Neural substrates for the regulation of sleep and general anesthesia, refAbstract=null), Reference(id=1198319037680812609, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, doi=null, pmid=null, pmcid=null, year=2016, volume=32, issue=6, pageStart=302, pageEnd=305, url=null, language=null, rfNumber=[26], rfOrder=25, authorNames=Ocmen E, Erdost HA, Duru LS, journalName=Kaohsiung J Med Sci, refType=null, unstructuredReference=Ocmen E, Erdost HA, Duru LS, et al. Effect of day/night administration of three different inhalational anesthetics on melatonin levels in rats[J]. Kaohsiung J Med Sci, 2016, 32(6): 302-305., articleTitle=Effect of day/night administration of three different inhalational anesthetics on melatonin levels in rats, refAbstract=null), Reference(id=1198319037785670216, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, doi=null, pmid=null, pmcid=null, year=2002, volume=46, issue=1, pageStart=30, pageEnd=36, url=null, language=null, rfNumber=[27], rfOrder=26, authorNames=Kärkelä J, Vakkuri O, Kaukinen S, journalName=Acta Anaesthesiol Scand, refType=null, unstructuredReference=Kärkelä J, Vakkuri O, Kaukinen S, et al. The influence of anaesthesia and surgery on the circadian rhythm of melatonin[J]. Acta Anaesthesiol Scand, 2002, 46(1): 30-36., articleTitle=The influence of anaesthesia and surgery on the circadian rhythm of melatonin, refAbstract=null), Reference(id=1198319037936665168, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, doi=null, pmid=null, pmcid=null, year=2022, volume=77, issue=1, pageStart=73, pageEnd=81, url=null, language=null, rfNumber=[28], rfOrder=27, authorNames=van Zuylen ML, Meewisse AJG, Ten Hoope W, journalName=Anaesthesia, refType=null, unstructuredReference=van Zuylen ML, Meewisse AJG, Ten Hoope W, et al. Effects of surgery and general anaesthesia on sleep-wake timing: CLOCKS observational study[J]. Anaesthesia, 2022, 77(1): 73-81., articleTitle=Effects of surgery and general anaesthesia on sleep-wake timing: CLOCKS observational study, refAbstract=null), Reference(id=1198319038171546196, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, doi=null, pmid=null, pmcid=null, year=2023, volume=44, issue=1, pageStart=1, pageEnd=27, url=null, language=null, rfNumber=[29], rfOrder=28, authorNames=中国老年医学学会麻醉学分会, journalName=国际麻醉学与复苏杂志, refType=null, unstructuredReference=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(1): 1-27., articleTitle=中国老年患者术后谵妄防治专家共识, refAbstract=null), Reference(id=1198319038351901274, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, doi=null, pmid=null, pmcid=null, year=2020, volume=41, issue=11, pageStart=1116, pageEnd=1120, url=null, language=null, rfNumber=[30], rfOrder=29, authorNames=罗猛强, 姜思琦, 邓萌, journalName=国际麻醉学与复苏杂志, refType=null, unstructuredReference=罗猛强, 姜思琦, 邓萌, 等. 右美托咪定镇静催眠作用机制研究进展[J]. 国际麻醉学与复苏杂志, 2020, 41(11): 1116-1120., articleTitle=右美托咪定镇静催眠作用机制研究进展, refAbstract=null), Reference(id=1198319038481924706, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, doi=null, pmid=null, pmcid=null, year=2023, volume=48, issue=11, pageStart=1267, pageEnd=1275, url=null, language=null, rfNumber=[31], rfOrder=30, authorNames=丁允莹, 嵇富海, 彭科, journalName=解放军医学杂志, refType=null, unstructuredReference=丁允莹, 嵇富海, 彭科. 右美托咪定的器官保护作用及其机制[J]. 解放军医学杂志, 2023, 48(11): 1267-1275., articleTitle=右美托咪定的器官保护作用及其机制, refAbstract=null), Reference(id=1198319038578393703, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, doi=null, pmid=null, pmcid=null, year=2019, volume=74, issue=3, pageStart=380, pageEnd=392, url=null, language=null, rfNumber=[32], rfOrder=31, authorNames=Ng K, Shubash C, Chong J, journalName=Anaesthesia, refType=null, unstructuredReference=Ng K, Shubash C, Chong J. The effect of dexmedetomidine on delirium and agitation in patients in intensive care: systematic review and meta-analysis with trial sequential analysis[J]. Anaesthesia, 2019, 74(3): 380-392., articleTitle=The effect of dexmedetomidine on delirium and agitation in patients in intensive care: systematic review and meta-analysis with trial sequential analysis, refAbstract=null), Reference(id=1198319038653891178, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, doi=null, pmid=null, pmcid=null, year=2016, volume=388, issue=10054, pageStart=1893, pageEnd=1902, url=null, language=null, rfNumber=[33], rfOrder=32, authorNames=Su X, Meng ZT, Wu XH, journalName=Lancet, refType=null, unstructuredReference=Su X, Meng ZT, Wu XH, et al. Dexmedetomidine for prevention of delirium in elderly patients after non-cardiac surgery: a randomised, double-blind, placebo-controlled trial[J]. Lancet, 2016, 388(10054): 1893-1902., articleTitle=Dexmedetomidine for prevention of delirium in elderly patients after non-cardiac surgery: a randomised, double-blind, placebo-controlled trial, refAbstract=null), Reference(id=1198319038746165868, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, doi=null, pmid=null, pmcid=null, year=2021, volume=49, issue=5, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[34], rfOrder=33, authorNames=Bi X, Wei J, Zhang X, journalName=J Int Med Res, refType=null, unstructuredReference=Bi X, Wei J, Zhang X. Effects of dexmedetomidine on neurocognitive disturbance after elective non-cardiac surgery in senile patients: a systematic review and meta-analysis[J]. J Int Med Res, 2021, 49(5): 03000605211014294., articleTitle=Effects of dexmedetomidine on neurocognitive disturbance after elective non-cardiac surgery in senile patients: a systematic review and meta-analysis, refAbstract=null), Reference(id=1198319038867800689, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, doi=null, pmid=null, pmcid=null, year=2020, volume=133, issue=6, pageStart=1234, pageEnd=1243, url=null, language=null, rfNumber=[35], rfOrder=34, authorNames=Chamadia S, Hobbs L, Marota S, journalName=Anesthesiology, refType=null, unstructuredReference=Chamadia S, Hobbs L, Marota S, et al. Oral dexmedetomidine promotes non-rapid eye movement stage 2 sleep in humans[J]. Anesthesiology, 2020, 133(6): 1234-1243., articleTitle=Oral dexmedetomidine promotes non-rapid eye movement stage 2 sleep in humans, refAbstract=null), Reference(id=1198319038947492469, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, doi=null, pmid=null, pmcid=null, year=2015, volume=12, issue=2, pageStart=126, pageEnd=133, url=null, language=null, rfNumber=[36], rfOrder=35, authorNames=Artemiou P, Bily B, Bilecova-Rabajdova M, journalName=Kardiochir Torakochirurgia Pol, refType=null, unstructuredReference=Artemiou P, Bily B, Bilecova-Rabajdova M, et al. Melatonin treatment in the prevention of postoperative delirium in cardiac surgery patients[J]. Kardiochir Torakochirurgia Pol, 2015, 12(2): 126-133., articleTitle=Melatonin treatment in the prevention of postoperative delirium in cardiac surgery patients, refAbstract=null), Reference(id=1198319039043961463, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, doi=null, pmid=null, pmcid=null, year=2023, volume=31, issue=12, pageStart=1178, pageEnd=1189, url=null, language=null, rfNumber=[37], rfOrder=36, authorNames=Kinouchi M, Mihara T, Taguri M, journalName=Am J Geriatr Psychiatry, refType=null, unstructuredReference=Kinouchi M, Mihara T, Taguri M, et al. The efficacy of ramelteon to prevent postoperative delirium after general anesthesia in the elderly: a double-blind, randomized, placebo-controlled trial[J]. Am J Geriatr Psychiatry, 2023, 31(12): 1178-1189., articleTitle=The efficacy of ramelteon to prevent postoperative delirium after general anesthesia in the elderly: a double-blind, randomized, placebo-controlled trial, refAbstract=null), Reference(id=1198319039140430458, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, doi=null, pmid=null, pmcid=null, year=2019, volume=47, issue=12, pageStart=1751, pageEnd=1758, url=null, language=null, rfNumber=[38], rfOrder=37, authorNames=Jaiswal SJ, Vyas AD, Heisel A, journalName=Crit Care Med, refType=null, unstructuredReference=Jaiswal SJ, Vyas AD, Heisel A, et al. Ramelteon for prevention of post-operative delirium: a randomized controlled trial in patients undergoing elective pulmonary thromboendarterectomy[J]. Crit Care Med, 2019, 47(12): 1751-1758., articleTitle=Ramelteon for prevention of post-operative delirium: a randomized controlled trial in patients undergoing elective pulmonary thromboendarterectomy, refAbstract=null), Reference(id=1198319039215927935, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, doi=null, pmid=null, pmcid=null, year=2020, volume=68, issue=4, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[39], rfOrder=38, authorNames=Han Y, Wu J, Qin Z, journalName=J Pineal Res, refType=null, unstructuredReference=Han Y, Wu J, Qin Z, et al. Melatonin and its analogues for the prevention of postoperative delirium: a systematic review and meta-analysis[J]. J Pineal Res, 2020, 68(4): e12644., articleTitle=Melatonin and its analogues for the prevention of postoperative delirium: a systematic review and meta-analysis, refAbstract=null), Reference(id=1198319039329174147, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, doi=null, pmid=null, pmcid=null, year=2020, volume=59, issue=null, pageStart=74, pageEnd=81, url=null, language=null, rfNumber=[40], rfOrder=39, authorNames=Ng KT, Teoh WY, Khor AJ, journalName=J Clin Anesth, refType=null, unstructuredReference=Ng KT, Teoh WY, Khor AJ. The effect of melatonin on delirium in hospitalised patients: a systematic review and meta-analyses with trial sequential analysis[J]. J Clin Anesth, 2020, 59: 74-81., articleTitle=The effect of melatonin on delirium in hospitalised patients: a systematic review and meta-analyses with trial sequential analysis, refAbstract=null), Reference(id=1198319039429837449, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, doi=null, pmid=null, pmcid=null, year=2021, volume=133, issue=3, pageStart=765, pageEnd=771, url=null, language=null, rfNumber=[41], rfOrder=40, authorNames=Wang ML, Min J, Sands LP, journalName=Anesth Analg, refType=null, unstructuredReference=Wang ML, Min J, Sands LP, et al. Midazolam premedication immediately before surgery is not associated with early postoperative delirium[J]. Anesth Analg, 2021, 133(3): 765-771., articleTitle=Midazolam premedication immediately before surgery is not associated with early postoperative delirium, refAbstract=null), Reference(id=1198319039517917835, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, doi=null, pmid=null, pmcid=null, year=2022, volume=134, issue=6, pageStart=1154, pageEnd=1163, url=null, language=null, rfNumber=[42], rfOrder=41, authorNames=Duprey MS, Devlin JW, Griffith JL, journalName=Anesth Analg, refType=null, unstructuredReference=Duprey MS, Devlin JW, Griffith JL, et al. Association between perioperative medication use and postoperative delirium and cognition in older adults undergoing elective noncardiac surgery[J]. Anesth Analg, 2022, 134(6): 1154-1163., articleTitle=Association between perioperative medication use and postoperative delirium and cognition in older adults undergoing elective noncardiac surgery, refAbstract=null), Reference(id=1198319039639552654, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, doi=null, pmid=null, pmcid=null, year=2024, volume=41, issue=2, pageStart=81, pageEnd=108, url=null, language=null, rfNumber=[43], rfOrder=42, authorNames=Aldecoa C, Bettelli G, Bilotta F, journalName=Eur J Anaesthesiol, refType=null, unstructuredReference=Aldecoa C, Bettelli G, Bilotta F, et al. Update of the European Society of Anaesthesiology and Intensive Care Medicine evidence-based and consensus-based guideline on postoperative delirium in adult patients[J]. Eur J Anaesthesiol, 2024, 41(2): 81-108., articleTitle=Update of the European Society of Anaesthesiology and Intensive Care Medicine evidence-based and consensus-based guideline on postoperative delirium in adult patients, refAbstract=null), Reference(id=1198319039765381778, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, doi=null, pmid=null, pmcid=null, year=2021, volume=38, issue=9, pageStart=943, pageEnd=956, url=null, language=null, rfNumber=[44], rfOrder=43, authorNames=Spies CD, Knaak C, Mertens M, journalName=Eur J Anaesthesiol, refType=null, unstructuredReference=Spies CD, Knaak C, Mertens M, et al. Physostigmine for prevention of postoperative delirium and long-term cognitive dysfunction in liver surgery: a double-blinded randomised controlled trial[J]. Eur J Anaesthesiol, 2021, 38(9): 943-956., articleTitle=Physostigmine for prevention of postoperative delirium and long-term cognitive dysfunction in liver surgery: a double-blinded randomised controlled trial, refAbstract=null), Reference(id=1198319039907988119, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, doi=null, pmid=null, pmcid=null, year=2019, volume=321, issue=7, pageStart=686, pageEnd=696, url=null, language=null, rfNumber=[45], rfOrder=44, authorNames=Subramaniam B, Shankar P, Shaefi S, journalName=JAMA, refType=null, unstructuredReference=Subramaniam B, Shankar P, Shaefi S, et al. Effect of intravenous acetaminophen vs. placebo combined with propofol or dexmedetomidine on postoperative delirium among older patients following cardiac surgery: the DEXACET randomized clinical trial[J]. JAMA, 2019, 321(7): 686-696., articleTitle=Effect of intravenous acetaminophen vs. placebo combined with propofol or dexmedetomidine on postoperative delirium among older patients following cardiac surgery: the DEXACET randomized clinical trial, refAbstract=null), Reference(id=1198319040100926109, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, doi=null, pmid=null, pmcid=null, year=2017, volume=124, issue=6, pageStart=1992, pageEnd=2000, url=null, language=null, rfNumber=[46], rfOrder=45, authorNames=Mu DL, Zhang DZ, Wang DX, journalName=Anesth Analg, refType=null, unstructuredReference=Mu DL, Zhang DZ, Wang DX, et al. Parecoxib supplementation to morphine analgesia decreases incidence of delirium in elderly patients after hip or knee replacement surgery: a randomized controlled trial[J]. Anesth Analg, 2017, 124(6): 1992-2000., articleTitle=Parecoxib supplementation to morphine analgesia decreases incidence of delirium in elderly patients after hip or knee replacement surgery: a randomized controlled trial, refAbstract=null), Reference(id=1198319040197395105, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, doi=null, pmid=null, pmcid=null, year=2019, volume=9, issue=6, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[47], rfOrder=46, authorNames=Wang X, Wang Y, Hu Y, journalName=Brain Behav, refType=null, unstructuredReference=Wang X, Wang Y, Hu Y, et al. Effect of flurbiprofen axetil on postoperative delirium for elderly patients[J]. Brain Behav, 2019, 9(6): e01290., articleTitle=Effect of flurbiprofen axetil on postoperative delirium for elderly patients, refAbstract=null), Reference(id=1198319040293864100, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, doi=null, pmid=null, pmcid=null, year=2021, volume=58, issue=null, pageStart=101446, pageEnd=null, url=null, language=null, rfNumber=[48], rfOrder=47, authorNames=Labarca G, Schmidt A, Dreyse J, journalName=Sleep Med Rev, refType=null, unstructuredReference=Labarca G, Schmidt A, Dreyse J, et al. Efficacy of continuous positive airway pressure (CPAP) in patients with obstructive sleep apnea (OSA) and resistant hypertension (RH): systematic review and meta-analysis[J]. Sleep Med Rev, 2021, 58: 101446., articleTitle=Efficacy of continuous positive airway pressure (CPAP) in patients with obstructive sleep apnea (OSA) and resistant hypertension (RH): systematic review and meta-analysis, refAbstract=null), Reference(id=1198319041438909096, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, doi=null, pmid=null, pmcid=null, year=2019, volume=67, issue=4, pageStart=794, pageEnd=798, url=null, language=null, rfNumber=[49], rfOrder=48, authorNames=Berger M, Oyeyemi D, Olurinde MO, journalName=J Am Geriatr Soc, refType=null, unstructuredReference=Berger M, Oyeyemi D, Olurinde MO, et al. The INTUIT study: investigating neuroinflammation underlying postoperative cognitive dysfunction[J]. J Am Geriatr Soc, 2019, 67(4): 794-798., articleTitle=The INTUIT study: investigating neuroinflammation underlying postoperative cognitive dysfunction, refAbstract=null), Reference(id=1198319041535378093, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, doi=null, pmid=null, pmcid=null, year=2020, volume=180, issue=1, pageStart=17, pageEnd=25, url=null, language=null, rfNumber=[50], rfOrder=49, authorNames=Wang YY, Yue JR, Xie DM, journalName=JAMA Intern Med, refType=null, unstructuredReference=Wang YY, Yue JR, Xie DM, et al. Effect of the tailored, family-involved hospital elder life program on postoperative delirium and function in older adults: a randomized clinical trial[J]. JAMA Intern Med, 2020, 180(1): 17-25., articleTitle=Effect of the tailored, family-involved hospital elder life program on postoperative delirium and function in older adults: a randomized clinical trial, refAbstract=null)], funds=[Fund(id=1198319032546984337, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, awardId=82371286, language=EN, fundingSource=National Natural Science Foundation of China(82371286), fundOrder=null, country=null), Fund(id=1198319032639259029, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, awardId=82371286, language=CN, fundingSource=国家自然科学基金(82371286), fundOrder=null, country=null), Fund(id=1198319032773476764, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, awardId=82101350, language=EN, fundingSource=National Natural Science Foundation of China(82101350), fundOrder=null, country=null), Fund(id=1198319032895111591, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, awardId=82101350, language=CN, fundingSource=国家自然科学基金(82101350), fundOrder=null, country=null), Fund(id=1198319032999969196, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, awardId=82271292, language=EN, fundingSource=National Natural Science Foundation of China(82271292), fundOrder=null, country=null), Fund(id=1198319033079660977, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, awardId=82271292, language=CN, fundingSource=国家自然科学基金(82271292), fundOrder=null, country=null), Fund(id=1198319033192907195, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, awardId=23Y2190600, language=EN, fundingSource=Medical Innovation Research Project of Shanghai "Science and Technology Innovation Action Plan"(23Y2190600), fundOrder=null, country=null), Fund(id=1198319033285181887, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, awardId=23Y2190600, language=CN, fundingSource=上海市“科技创新行动计划”医学创新研究专项(23Y2190600), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1198319029057323264, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, xref=null, ext=[AuthorCompanyExt(id=1198319029069906177, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, companyId=1198319029057323264, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Anesthesiology, Huashan Hospital Affiliated to Fudan University, Shanghai 200040, China), AuthorCompanyExt(id=1198319029082489090, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198202428119154836, companyId=1198319029057323264, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=复旦大学附属华山医院麻醉科，上海 200040)])], figs=null, attaches=null, journal=Journal(id=1146441329971666965, delFlag=0, nameCn=解放军医学杂志, nameEn=Medical Journal of Chinese People’s Liberation Army, nameHistory1=null, nameHistory2=null, issn=0577-7402, eissn=null, cn=11-1056/R, coden=null, periodic=0, language=CN, oaType=是, ccby=CC BY-NC-ND, superviseOffice=null, ownerOffice=null, pubOffice=null, editorOffice=null, officeType=null, aims=null, clcCode=null, officeProv=null, officeCity=null, officeAddr=null, officeZip=null, officeEmail=null, officePhone=null, editDirector=null, officeDirector=null, officeDirectorPhone=null, officeStaffNum=null, officeEmpNum=null, coverPicUrl=6srot5PcoYX30Oa4xeTmeg==, journalPrice=null, startedYear=null, abbrevIsoEn=null, journalRemark=null, publicationField=null, createdTime=1751262512917, updatedTime=1761735725513, createdBy=18614031015, updatedBy=13701087609, firstLetterCn=M, firstLetterEn=M, subjectCode=Life Sciences, subjectName=Life Sciences, subjectCodeEn=Life Sciences, subjectNameEn=null, picCn=6srot5PcoYX30Oa4xeTmeg==, picEn=ELwBh5xqrSTlIs7HmSNt2Q==, jcr=null, cjcr=null, exts=[JournalExt(id=1190369167564968109, language=CN, name=解放军医学杂志, nameHistory1=null, nameHistory2=null, managedBy=, sponsoredBy=, publishedBy=, editorOffice=, officeProv=null, officeCity=null, officeAddr=, officeZip=, editDirector=, officeDirector=null, officePhone=null, coverPicUrl=null, journalRemark=, submitArticleUrl=null, websiteUrl=, createdTime=1761735725537, updatedTime=1761735725537, createdBy=13701087609, updatedBy=13701087609, submissionGuidelinesUrl=, submissionAuthorUrl=#, submissionEditorUrl=#, submissionReviewUrl=#, submissionCeEditorUrl=, submissionAeEditorUrl=, option={"copyright":""}), JournalExt(id=1190369167615299758, language=EN, name=Medical Journal of Chinese People’s Liberation Army, nameHistory1=null, nameHistory2=null, managedBy=, sponsoredBy=, publishedBy=, editorOffice=, officeProv=null, officeCity=null, officeAddr=, officeZip=, editDirector=, officeDirector=null, officePhone=null, coverPicUrl=null, journalRemark=, submitArticleUrl=null, websiteUrl=, createdTime=1761735725549, updatedTime=1761735725549, createdBy=13701087609, updatedBy=13701087609, submissionGuidelinesUrl=, submissionAuthorUrl=#, submissionEditorUrl=#, submissionReviewUrl=#, submissionCeEditorUrl=, submissionAeEditorUrl=, option={"copyright":""})], databaseList=null, tenantJournalId=1189873630562394117, websiteList=[Website(id=1189873845923287108, webName=null, webTitle=null, webDomain=null, webCopyrigh=null, webIpcNo=null, seoTitle=null, seoKeywords=null, seoDescription=null, tenantJournalId=null, journalId=1189873630562394117, journalNameCn=null, journalNameEn=null, grayFlag=null, tenantId=1146029695717560320, platformId=null, journalGroupId=null, journalGroupNameCn=null, journalGroupNameEn=null, type=1, domain=https://castjournals.cast.org.cn/joweb/jfjyxzz/CN, language=CN, createTime=1761617631655, createBy=18614031015, updateTime=1761622010471, updateBy=18614031015, name=解放军医学杂志-中文, tplId=1146099689490845704, title=解放军医学杂志, delFlag=0, indexPage=/home, props=[WebsiteProps(id=1189924939378520839, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873845923287108, code=articleTextType, value=kx, createTime=1761629813284, updateTime=1761629813284, creator=18614031015, updator=18614031015), WebsiteProps(id=1189924939353355012, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873845923287108, code=banner, value=null, createTime=1761629813278, updateTime=1761629813278, creator=18614031015, updator=18614031015), WebsiteProps(id=1189924939399492362, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873845923287108, code=grayFlag, value=0, createTime=1761629813289, updateTime=1761629813289, creator=18614031015, updator=18614031015), WebsiteProps(id=1189924939344966403, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873845923287108, code=logo, value=https://castjournals.cast.org.cn/joweb/jfjyxzz/CN/file/pic?fileId=+zXjYVhun8ZOAA6+aKx2hw==, createTime=1761629813276, updateTime=1761629813276, creator=18614031015, updator=18614031015), WebsiteProps(id=1189924939412075276, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873845923287108, code=minRunFlag, value=0, createTime=1761629813292, updateTime=1761629813292, creator=18614031015, updator=18614031015), WebsiteProps(id=1189924939374326534, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873845923287108, code=picServerUrl, value=https://castjournals.cast.org.cn/joweb/jfjyxzz/CN/file/pic, createTime=1761629813283, updateTime=1761629813283, creator=18614031015, updator=18614031015), WebsiteProps(id=1189924939407880971, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873845923287108, code=silenceFlag, value=0, createTime=1761629813291, updateTime=1761629813291, creator=18614031015, updator=18614031015), WebsiteProps(id=1189924939361743621, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873845923287108, code=staticResourcePath, value=https://castjournals.cast.org.cn/joweb/cast_kjdb_cn_619/, createTime=1761629813280, updateTime=1761629813280, creator=18614031015, updator=18614031015), WebsiteProps(id=1189924939386909448, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873845923287108, code=themeColor, value=null, createTime=1761629813286, updateTime=1761629813286, creator=18614031015, updator=18614031015), WebsiteProps(id=1189924939395298057, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873845923287108, code=themeStyle, value=null, createTime=1761629813288, updateTime=1761629813288, creator=18614031015, updator=18614031015)]), Website(id=1189873846057504839, webName=null, webTitle=null, webDomain=null, webCopyrigh=null, webIpcNo=null, seoTitle=null, seoKeywords=null, seoDescription=null, tenantJournalId=null, journalId=1189873630562394117, journalNameCn=null, journalNameEn=null, grayFlag=null, tenantId=1146029695717560320, platformId=null, journalGroupId=null, journalGroupNameCn=null, journalGroupNameEn=null, type=1, domain=https://castjournals.cast.org.cn/joweb/jfjyxzz/EN, language=EN, createTime=1761617631687, createBy=18614031015, updateTime=1761622030030, updateBy=18614031015, name=解放军医学杂志-英文, tplId=1146101810881728533, title=Medical Journal of Chinese People’s Liberation Army, delFlag=0, indexPage=/home, props=[WebsiteProps(id=1189924968168223505, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873846057504839, code=articleTextType, value=kx, createTime=1761629820148, updateTime=1761629820148, creator=18614031015, updator=18614031015), WebsiteProps(id=1189924968147251982, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873846057504839, code=banner, value=null, createTime=1761629820143, updateTime=1761629820143, creator=18614031015, updator=18614031015), WebsiteProps(id=1189924968185000724, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873846057504839, code=grayFlag, value=0, createTime=1761629820152, updateTime=1761629820152, creator=18614031015, updator=18614031015), WebsiteProps(id=1189924968138863373, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873846057504839, code=logo, value=https://castjournals.cast.org.cn/joweb/jfjyxzz/EN/file/pic?fileId=+zXjYVhun8ZOAA6+aKx2hw==, createTime=1761629820141, updateTime=1761629820141, creator=18614031015, updator=18614031015), WebsiteProps(id=1189924968197583638, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873846057504839, code=minRunFlag, value=0, createTime=1761629820155, updateTime=1761629820155, creator=18614031015, updator=18614031015), WebsiteProps(id=1189924968159834896, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873846057504839, code=picServerUrl, value=https://castjournals.cast.org.cn/joweb/jfjyxzz/EN/file/pic, createTime=1761629820146, updateTime=1761629820146, creator=18614031015, updator=18614031015), WebsiteProps(id=1189924968193389333, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873846057504839, code=silenceFlag, value=0, createTime=1761629820154, updateTime=1761629820154, creator=18614031015, updator=18614031015), WebsiteProps(id=1189924968155640591, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873846057504839, code=staticResourcePath, value=https://castjournals.cast.org.cn/joweb/cast_kjdb_en_623/, createTime=1761629820145, updateTime=1761629820145, creator=18614031015, updator=18614031015), WebsiteProps(id=1189924968172417810, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873846057504839, code=themeColor, value=null, createTime=1761629820149, updateTime=1761629820149, creator=18614031015, updator=18614031015), WebsiteProps(id=1189924968180806419, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873846057504839, code=themeStyle, value=null, createTime=1761629820151, updateTime=1761629820151, creator=18614031015, updator=18614031015)])], journalTitle=解放军医学杂志, weixinUrl=null, journalUrl=http://zh.jfjyxzz.org.cn/, iacademicId=null, status=1, seqNo=null, journalTitleEn=Medical Journal of Chinese People’s Liberation Army, journalPhotoCn=6srot5PcoYX30Oa4xeTmeg==, journalPhotoEn=ELwBh5xqrSTlIs7HmSNt2Q==, journalFirstLetter=M, journalRecommend=null, journalNew=null, journalCollection=null, jcrJf=null, cjcrJf=null, jcrJfStr=null, cjcrJfStr=null, submissionFirstDecision=null, sciSubjectClassification=null, casSubjectClassification=null, citeScore=null, totalCitationFrequency=null, icpCode=null, psCode=null, advertisingLicenseCode=null, copyrightInformation=null, country=null, option=, provinceCode=null, provinceName=null, collectFlag=false), detailUrlCn=https://castjournals.cast.org.cn/joweb/jfjyxzz/CN/10.11855/j.issn.0577-7402.1265.2024.0612, detailUrlEn=https://castjournals.cast.org.cn/joweb/jfjyxzz/EN/10.11855/j.issn.0577-7402.1265.2024.0612, pdfUrlCn=https://castjournals.cast.org.cn/joweb/jfjyxzz/CN/PDF/10.11855/j.issn.0577-7402.1265.2024.0612, pdfUrlEn=https://castjournals.cast.org.cn/joweb/jfjyxzz/EN/PDF/10.11855/j.issn.0577-7402.1265.2024.0612, aliStartDate=null, aliEndDate=null, collectionFlag=false, citedCount=null, citedUrl=null, reference=null)
收藏切换
围手术期睡眠紊乱与神经认知功能障碍
收藏切换
PDF下载
查超超 , 李峙林 , 王英伟 , 罗猛强 *
解放军医学杂志 | 围手术期器官损伤机制及保护策略专题Ⅱ 2024,49(10): 1099-1104
收起
收藏切换
解放军医学杂志 | 围手术期器官损伤机制及保护策略专题Ⅱ 2024, 49(10): 1099-1104
围手术期睡眠紊乱与神经认知功能障碍
全屏
查超超, 李峙林, 王英伟, 罗猛强*
作者信息
  • 复旦大学附属华山医院麻醉科，上海 200040

    • 查超超，硕士研究生，主要从事围手术期脑功能保护方面的研究

    罗猛强，复旦大学附属华山医院麻醉科副主任医师、副教授、主任助理、硕士研究生导师；担任中华医学会麻醉学分会青年学组委员、上海市医学会麻醉专科分会青委副主任委员、中国神经科学学会麻醉与脑功能分会委员兼秘书、Anesthesiology杂志中文版青年编委、《国际麻醉学与复苏杂志》通信编委；主要研究方向为全麻机制，应用活体单细胞钙成像技术揭示全身麻醉与睡眠对促睡眠核团VLPO特异类型神经元异质性的调节机制；以第一或通信作者在Advanced Science、eLife、Anesthesiology、Journal of Clinical Anesthesia等期刊发表论文16篇，主持国家自然科学基金面上项目及青年基金，并获上海市抗击新冠疫情先进个人等荣誉。

通讯作者:

罗猛强，E-mail：
Sleep disorders and perioperative neurocognitive dysfunction
Chao-Chao Zha, Shi-Lin Li, Ying-Wei Wang, Meng-Qiang Luo*
Affiliations
  • Department of Anesthesiology, Huashan Hospital Affiliated to Fudan University, Shanghai 200040, China
出版时间: 2024-10-28 doi: 10.11855/j.issn.0577-7402.1265.2024.0612
文章导航
收藏切换
摘要
收起

围手术期神经认知功能障碍(PND)可严重损害患者的神经认知功能，延长住院时间，导致病死率增高及远期预后不良。睡眠紊乱被认为是诱发PND的重要因素，但其在PND发生过程中的作用尚不明确，而围手术期积极干预睡眠紊乱能否有效预防PND亦存在争议。为此，本文阐述了睡眠的基本功能与调控，围手术期睡眠紊乱的临床特征及其在PND发生中的作用，并进一步探讨了调控睡眠紊乱干预PND的潜在治疗策略，以指导临床改善患者的神经功能预后及远期转归。

睡眠紊乱  /  全身麻醉  /  围手术期神经认知功能障碍  /  睡眠调控

Perioperative neurocognitive disorder (PND) significantly threatens brain health, leading to prolonged hospitalization, increased patient mortality risk, and poor long-term prognosis. Sleep disorder may substantially elevate the risk of neurocognitive dysfunction. However, the specific role of sleep in PND development remains to be elucidated. In addition, controversy exists over whether interventions for perioperative sleep disorder can effectively prevent PND. Therefore, this review aims to explore the basic function and regulatory principles of sleep, the clinical characteristics of perioperative sleep disorder, its role and potential mechanisms in PND development. Furthermore, we also provide new evidence on the potential therapeutic strategies to modulate sleep disorder for PND management, to improve patient's neurocognitive prognosis and long-term outcomes.

sleep disorders  /  general anesthesia  /  perioperative neurocognitive disorder  /  sleep modulation
查超超, 李峙林, 王英伟, 罗猛强. 围手术期睡眠紊乱与神经认知功能障碍. 解放军医学杂志, 2024 , 49 (10) : 1099 -1104 . DOI: 10.11855/j.issn.0577-7402.1265.2024.0612
Chao-Chao Zha, Shi-Lin Li, Ying-Wei Wang, Meng-Qiang Luo. Sleep disorders and perioperative neurocognitive dysfunction[J]. Medical Journal of Chinese People’s Liberation Army, 2024 , 49 (10) : 1099 -1104 . DOI: 10.11855/j.issn.0577-7402.1265.2024.0612
正文
收起
围手术期神经认知功能障碍(perioperative neurocognitive disorder，PND)可严重损害患者的神经认知功能，延长住院时间，导致病死率增高及远期预后不良，尤其老年人由于其器官功能显著下降，在手术与麻醉的双重作用下更易诱发PND，如术后谵妄(postoperative delirium，POD)、术后认知功能障碍(postoperative cognitive dysfunction，POCD)等中枢神经系统并发症，严重影响患者的临床安全与预后转归。近年来美国麻醉医师协会(American Society of Anesthesiologists，ASA)与我国老年医师协会均针对性地推出了专家意见以指导临床实践，但关于PND的高危因素及围手术期管理策略尚未达成共识[1]。睡眠具有重要的生理功能，能够促进人体代谢废物的清除，维持脑内微环境稳态，保障大脑处于健康的认知状态；反之，睡眠紊乱可严重损害大脑结构与认知功能，显著增高围手术期PND的发生率，导致患者术后远期认知功能下降[2]。鉴于PND存在诸多诱发因素，越来越多的学者认为单因素干预措施预防PND的临床效果并不可靠，更倾向于采取多模式策略降低PND的发生率。由于睡眠紊乱被认为是诱发PND的重要因素，但其在PND发生过程中的作用尚不明确，而且围手术期积极干预睡眠紊乱能否有效预防PND亦存在争议。因此，本文就围手术期睡眠紊乱的临床特征及其在PND发生中的作用，以及睡眠紊乱调控策略等进行探讨，以期为PND的防治提供潜在的靶点，从而改善患者的临床预后及转归。
1 睡眠对机体神经认知功能的影响
收起
1.1 睡眠的基本功能
睡眠是人类各年龄段均存在的重要生理状态，自然发生且具有复杂性，对人类的生存与健康至关重要。机体通过睡眠能够保存能量、清除代谢废物、增强免疫、促进神经发育及巩固记忆等，以调节免疫与激素水平，提升学习效率，维持良好的神经认知功能状态。睡眠与心血管疾病、代谢免疫、认知功能、精神健康等密切相关，睡眠紊乱可能导致抑郁、焦虑，使人群罹患糖尿病、心脑血管疾病的风险显著增加；临床中常见的睡眠紊乱如睡眠相关的呼吸与运动障碍、失眠、嗜睡症、昼夜节律紊乱、睡眠时异常活动等均会影响睡眠质量及时长，严重损害患者的心血管功能和神经认知功能[2]。
1.2 健康睡眠的基本特征
目前认为健康的睡眠主要包括以下5个维度：(1)睡眠时长，多数人每天最佳睡眠时长为7~8 h；(2)睡眠效率，容易入睡并在醒来后重新入睡；(3)睡眠规律性与时机，规律性是指每天大致在同一时间入睡与起床，昼夜节律系统驱动睡眠主要发生在所谓的“生物钟之夜”(即处于每天24 h内的特定时间段)，有助于睡眠主导大脑及身体机能的恢复；(4)警觉/困倦，保持注意力觉醒的能力；(5)睡眠满意度，主观睡眠满意度是睡眠健康的重要指标，能够反映难以检测的睡眠紊乱如皮质下特定脑区的激活或局部大脑的觉醒。
2 睡眠稳态的调控
收起
自然界的哺乳动物具有相似的睡眠周期，觉醒、非快动眼睡眠(non-rapid eye movement sleep，NREM)及快动眼睡眠(rapid eye movement sleep，REM)三者呈周期性变化，时程可各不相同，其中NREM是整个睡眠周期的基础，在清醒后首先出现且维持时间最长，受脑内觉醒发生系统、NREM发生系统、REM发生系统的调控，是脑内各系统相互作用、动态平衡的结果，同时接受24 h昼夜节律的调控。
2.1 觉醒与睡眠发生系统
觉醒状态的维持与网状结构上行激活系统及其他脑内觉醒系统活动相关，如蓝斑去甲肾上腺素能、黑质多巴胺能、中缝核群的血清素能、结节乳头体组胺能、外侧下丘脑的食欲素能、基底前脑的乙酰胆碱能神经元系统等。NREM发生系统主要包括下丘脑视前区(preoptic area，POA)、下丘脑内侧视前核、丘脑、基底神经节、脑干背内侧网状核、孤束核及大脑皮质等。
2.2 睡眠昼夜节律调控系统
昼夜节律参与记忆形成、调节脑脊液的分布等诸多生理过程[3]，并接受时钟基因调控，其内部生物钟过程以反馈机制为特点，主要受下丘脑视交叉上核(suprachiasmatic nucleus，SCN)调控。SCN神经元含有丰富的N-甲基-D-天冬氨酸(N-methyl-D-aspartic acid，NMDA)和γ-氨基丁酸(γ-aminobutyric acid，GABA)受体，受体激活可影响生物钟基因的表达，在接收来自视网膜的光信号后，SCN能够同步控制外周细胞及数千个下游基因调控昼夜节律，该过程中可通过自主转录与SCN内的翻译反馈环路适应外部环境，如光线、进食与温度等。
睡眠是昼夜节律的重要组成部分，通过睡眠稳态驱动调节；睡眠不足时腺苷诱导机体进入睡眠的驱动力将增强，从而维持稳态平衡，促进机体进入NREM[4]，因此睡眠剥夺后NREM时程更深、更长，但在长期睡眠紊乱时这种稳态调节作用会减弱[5]。褪黑素周期性释放的昼夜节律也在睡眠调节中发挥着重要作用。血浆褪黑素水平与SCN一致，呈夜间高白天低的状态。褪黑素规律释放不仅能够巩固海马时钟基因的表达模式，且在日间能够通过调节突触可塑性提高学习效率[6]，而夜间光照可抑制褪黑素分泌，导致睡眠紊乱，可能是住院患者睡眠紊乱的主要原因；昼夜节律紊乱可导致海马依赖性认知障碍，损害神经认知功能，但现阶段关于昼夜节律紊乱对围手术期患者神经认知功能恢复的影响仍关注较少。
3 围手术期睡眠紊乱与PND
收起
3.1 围手术期睡眠紊乱的临床特征
睡眠紊乱主要表现为启动与维持睡眠的功能发生异常，总睡眠时长减少、觉醒次数增加、睡眠质量下降及节律紊乱，其中术后睡眠紊乱呈特征性的睡眠结构改变，表现为碎片化及慢波睡眠与REM的比例明显降低[7]。围手术期睡眠紊乱非常普遍，在手术人群中的总体发生率为15%~72%，未及时治疗可进展为慢性睡眠紊乱，特别是术后转入ICU的患者睡眠紊乱发生率可高达80%，且在转出ICU后仍有30%的患者存在持续睡眠紊乱[8]。流行病学调查显示，围手术期睡眠紊乱的高危因素包括高龄、基础病史(如危重症及神经退行性疾病)[8-9]、手术类型与时间、疼痛、环境噪声及心理因素等，均可加重对患者神经认知功能的损害。因此，睡眠紊乱是威胁患者安全与预后转归的重要临床问题，但与之相关的危险因素及围手术期管理策略仍未达成共识。
3.2 围手术期睡眠紊乱与神经认知功能转归
围手术期睡眠紊乱与PND等并发症密切相关，包括POD、痛觉敏化、发作性低氧、神经认知障碍及恢复延迟，其中老年患者PND发生率高达50%，可导致远期认知功能明显下降，已成为阻碍老年患者术后快速康复的主要危险因素[10]。根据美国精神障碍第5版诊断标准，POD被定义为注意力和意识的急性、波动性障碍，而POCD是指患者在术后30 d至1年内存在的认知功能损害。睡眠紊乱与PND之间潜在的联系已被越来越多的研究证实，使用可穿戴活动记录仪客观评估睡眠模式发现POD患者术前睡眠碎片化的比例更高，术后苏醒所需时间更长，表明术前的睡眠紊乱与POD具有明显相关性[11]。最近一项纳入1199例患者的荟萃分析亦得出了相似的结论，发现术前睡眠紊乱的患者发生POD的风险明显增加，风险比值比为5.24[12]。
睡眠呼吸障碍综合征尤其是伴有呼吸暂停的阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome，OSAS)与肥胖、困难气道、心脏不良事件及PND风险增加具有明显相关性[13]。OSAS可使患者认知储备下降及执行能力恶化，导致大脑关键结构淀粉样蛋白沉积[14]。使用多导睡眠图监测发现，术前存在OSAS的患者发生POD的风险可升高超过6倍[15]。同时有研究显示行择期膝关节置换术的老年OSAS患者发生POD的风险显著增高[16]。上述研究结果均提示OSAS与PND的发生具有明显相关性[17]，但最近一项回顾性队列研究在调整围手术期混杂因素后并未显示术前OSAS与POD之间存在关联[18]。因此，OSAS是否是神经功能恢复延迟或PND的高危因素仍有待进一步探究。
3.3 围手术期睡眠紊乱与PND可能的共病机制
睡眠紊乱可与影响神经认知功能及PND相关的疾病共存，如心力衰竭、疼痛等[19]，两者共有的病理机制可能包括神经递质失衡、褪黑素代谢改变及重要神经保护因子(如维生素D)缺失等[20-22]，而OSAS诱发PND的机制可能涉及睡眠结构异常导致节律紊乱、缺氧、血管损伤、全身炎症与氧化应激等[17]。
越来越多的证据提示，全身麻醉是导致围手术期睡眠紊乱的重要因素，不同分子靶点的全麻药物[如NMDA受体拮抗剂或γ-氨基丁酸A型(GABAA)受体激动剂]可通过作用于不同睡眠-觉醒核团发挥麻醉作用，包括促睡眠核团如经典腹外侧视前区(ventrolateral preoptic area，VLPO)、下丘脑室上核、丘脑网状核、外侧缰核等均参与了全麻引起的意识消失作用，而促觉醒核团如臂旁核、丘脑室旁核、蓝斑核、中缝背核、伏隔核、腹侧被盖区、外侧下丘脑、外侧隔核等在全麻后的苏醒过程中具有重要作用[23-24]。但睡眠与全身麻醉的核心机制存在差异，全身麻醉时脑电图虽与生理性睡眠具有相似性，但不尽相同；全身麻醉的脑电特征为随着麻醉的加深，低频、高振幅活动逐渐增加，而NREM的脑电特征为振幅增高、频率减慢同时伴肌张力减低。最近有研究发现，全身麻醉与睡眠对神经元活性的调控亦存在明显差异[25]，笔者团队采用在体单细胞钙成像技术长期记录同一群VLPO的抑制性GABA与兴奋性谷氨酸能神经元在全身麻醉与睡眠时的活动模式，发现全身麻醉与睡眠对VLPO神经元活性的调控存在明显差异[24]，提示全身麻醉可能通过调控睡眠神经网络的可塑性，进而干扰脑内抑制与兴奋性神经递质的释放与平衡，最终导致睡眠紊乱的发生。
全身麻醉也能够影响昼夜节律，如七氟烷可通过刺激交感神经增加日间褪黑素的分泌，而日间使用异氟烷却会明显抑制昼夜节律基因如芳香烃受体核转位蛋白样1基因(brain and muscle Arnt-like protein 1，BMAL1)、时钟基因(circadian locomotor output cycles kaput，CLOCK)等的表达，但临床常用吸入麻醉药均不影响夜间褪黑素的分泌[26]。因此，与日间相比，在夜间接受手术对昼夜节律的影响可能较小。褪黑素水平常在术后第1晚降低，导致REM明显减少，直至术后第3晚才能恢复至基线水平[27]，提示褪黑素可能具有预防围手术期睡眠紊乱的作用。综上，全身麻醉与手术的叠加效应可使患者术后睡眠紊乱的发生风险明显增高，干扰昼夜节律，使主观睡眠质量与效率下降，日间疲劳加重[28]。因此，对围手术期睡眠进行调控时不仅需改善睡眠质量与时长，同时还应更多地关注昼夜节律的调节。
4 围手术期睡眠紊乱所致PND的干预措施
收起
近年来，PND防治已成为临床研究的焦点并取得了显著进展。ASA围手术期脑健康专家组针对PND提出了6条指导意见，涵盖提升教育水平、认知评估、加强谵妄筛查、推广非药物干预、优化疼痛管理及避免不必要地使用抗精神病药物等；同时强调了成立PND多学科管理团队的重要性，并指出麻醉医师在团队中应发挥核心作用[1]。2023年，中国老年医学会麻醉学分会针对POD发布专家共识，建议围手术期应在术前评估与准备、术中监测与干预、术后管理与治疗等方面进行系统管理；对于围手术期睡眠的调控，建议提高重视程度并采取药物或非药物干预方式积极地通过镇静催眠、调节昼夜节律及缓解焦虑、抑郁情绪等改善老年患者的睡眠质量，并辅以心理干预等方法，以降低POD的发生率[29]。
4.1 右美托咪定
右美托咪定是高选择性α2受体激动剂，具有镇静、催眠、抗焦虑、镇痛作用，目前已广泛应用于临床麻醉和ICU镇静[30-31]。与其他全麻药相比，右美托咪定最有可能保留生理性睡眠结构。在健康受试者中，右美托咪定能够剂量依赖性地诱导N3期NREM，脑电改变与自然睡眠类似，且不影响受试者次日的精神状态[32]。与苯二氮䓬类药物或丙泊酚相比，右美托咪定镇静能够有效降低ICU机械通气患者的POD发生率。一项纳入700例老年非心脏手术患者的随机对照试验研究显示，低剂量右美托咪定可明显降低入住ICU患者术后发生POD的风险[33]，另有荟萃分析结果表明右美托咪定有助于降低危重患者POD的发生率及持续时间[32,34]，但目前对于右美托咪定是否能够降低POD发生风险的结论并不完全一致，其原因可能与不必要的持续镇静及药物相关的低血压有关。值得注意的是，目前正在尝试通过口服途径给予右美托咪定以改善睡眠。口服右美托咪定与静脉使用的效果类似，均可在改善睡眠的同时模拟生理性睡眠结构，虽然现阶段尚无法明确最佳剂量，且尚未获得美国食品药品管理局(Food and Drug Administration，FDA)批准，但通过口服的方式给予右美托咪定调控睡眠具有广阔的临床应用前景[35]。
4.2 褪黑素
褪黑素是由松果体分泌的内源性激素，具有抗氧化与抗炎作用，能够对夜间黑暗环境做出应答，调节睡眠-觉醒周期，发挥促睡眠的作用，现已被ICU作为促睡眠药物。POD患者血清褪黑素水平降低，因此，褪黑素对缓解POD所致的炎症有益，可能作为预防POD潜在的干预药物。在一项纳入500例心脏手术患者的前瞻性试验中，术前当晚预防性给予褪黑素可明显降低POD的发生率[36]；另有研究表明，预防性使用褪黑素受体激动剂雷美替胺可有效预防老年内科患者发生POD[37]，但也有研究显示褪黑素并不能预防择期肺动脉血栓内膜剥脱手术患者POD的发生[38]。一项临床荟萃分析结果显示，术前5个半衰期内给予褪黑素及其类似物雷美替胺，可明显降低成年患者围手术期POD的发生率[39]。但另一项纳入16项临床试验的荟萃分析结果既不支持也不否定使用褪黑素能够预防住院患者发生POD，值得注意的是荟萃分析所纳入的试验均存在高度异质性[40]。因此，未来仍需通过多中心、大样本的随机对照临床试验加以验证。
4.3 苯二氮䓬类与拟胆碱能药物
苯二氮䓬类药物具有镇静、催眠、抗焦虑的作用，临床中常用于治疗焦虑、失眠及作为术前用药。现阶段虽有研究提示苯二氮䓬类药物的使用与POD发生率增高无关[41]，但多数研究表明术前使用咪达唑仑对降低POD的发生率无益，甚至可导致POD发生风险增高[42]。因此，2024年欧洲麻醉与重症医学会成人POD防治专家共识推荐，除非患者术前存在严重焦虑症状，否则应避免术前常规使用苯二氮䓬类药物，且应尽量使用最低有效剂量，以降低POD的发生风险[43]。抗胆碱能药物长期以来被认为是导致POD的重要危险因素，因此在临床医疗中对于POD高危患者应避免使用；目前的研究证据也不支持使用拟胆碱能药物如毒扁豆碱以降低POD的发生率[44]。
4.4 非甾体抗炎药与其他药物性干预措施
疼痛是诱发术后睡眠紊乱的重要因素，同时伴随手术引起的炎症反应，导致POD发生风险增高。研究显示，非甾体抗炎药如对乙酰氨基酚可明显减轻手术所致的炎症反应，降低老年患者心脏手术后POD的发生率[45]；同样地，帕瑞昔布联合吗啡、氟比洛芬酯等均有助于降低老年患者POD的发生风险[46-47]。其他药物如抗精神类药物氟哌啶醇，目前推荐仅在非药物及常规药物治疗无效时，考虑短期小剂量使用以控制POD症状，而普瑞巴林、加巴喷丁、瑞舒伐他汀现阶段亦不推荐用于POD的治疗[43]。总之，目前临床上对POD仍缺乏有效的药物干预措施，仅限于对症处理，且难以避免相关的不良反应。
4.5 围手术期睡眠紊乱所致PND的非药物干预措施
既往研究证实，持续气道正压通气(continuous positive airway pressure，CPAP)可显著改善非手术OSAS患者的睡眠、神经认知功能及情绪恶化[48]，但迄今为止，对于需要接受手术的OSAS患者，CPAP是否能够通过改善睡眠降低PND的发生率尚缺乏足够证据支持。有研究显示，围手术期OSAS患者接受CPAP治疗与标准治疗组相比，虽然呼吸暂停-低通气指数所定义的OSAS分级与POD严重程度明显相关，但未发现使用CPAP能够降低POD发生率[49]。因此，对于术前患有OSAS的患者，围手术期是否应积极使用CPAP治疗，或将OSAS患者视为高危人群应用POD预防措施仍有待于未来探究。
由于总体上缺乏有效促进睡眠的药物，目前医务人员正在尝试非药物睡眠干预措施，包括改善患者住院环境相关因素(如耳塞、眼罩和舒缓的音乐)以减少夜间睡眠紊乱，促进日间维持觉醒状态以降低POD发生率；同时，越来越多的研究开始关注经颅电刺激、非侵入性经颅磁刺激、经颅超声深部脑区刺激、针灸等在围手术期睡眠紊乱治疗中的应用，但现有证据仍非常有限，缺乏必要的多中心临床研究支持及长期疗效随访用于明确其有效性与安全性。
5 总结与展望
收起
睡眠与昼夜节律紊乱是神经退行性疾病发生的重要危险因素，而后者是PND的重要易感因素。目前已明确睡眠紊乱与PND存在关联，二者之间具有诸多相似的病理生理机制，提示围手术期积极纠正睡眠紊乱可能成为防治PND的关键。右美托咪定、褪黑素、CPAP及多模式非药物干预措施等，如基于睡眠调控设计的多因素预防策略—老年住院患者生活计划(hospital elderly life program，HELP)，可能能够纠正围手术期睡眠紊乱，明显降低患者PND的发生率并改善临床预后[50]，但尚需更多基础研究及高质量的临床试验提供更多循证依据支持。
基金
收起
  • 国家自然科学基金(82371286)
  • 国家自然科学基金(82101350)
  • 国家自然科学基金(82271292)
  • 上海市“科技创新行动计划”医学创新研究专项(23Y2190600)
文献
收起
参考文献 引证文献
排序方式：
[1]
Peden CJ, Miller TR, Deiner SG, et al. Improving perioperative brain health: an expert consensus review of key actions for the perioperative care team[J]. Br J Anaesth, 2021, 126(2): 423-432.
[2]
Fultz NE, Bonmassar G, Setsompop K, et al. Coupled electrophysiological, hemodynamic, and cerebrospinal fluid oscillations in human sleep[J]. Science, 2019, 366(6465): 628-631.
[3]
Hablitz LM, Plá V, Giannetto M, et al. Circadian control of brain glymphatic and lymphatic fluid flow[J]. Nat Commun, 2020, 11(1): 4411.
[4]
Peng W, Wu Z, Song K, et al. Regulation of sleep homeostasis mediator adenosine by basal forebrain glutamatergic neurons[J]. Science, 2020, 369(6508): eabb0556.
[5]
Skorucak J, Weber N, Carskadon MA, et al. Homeostatic response to sleep restriction in adolescents[J]. Sleep, 2021, 44(9): zsab106.
[6]
Jilg A, Bechstein P, Saade A, et al. Melatonin modulates daytime‐dependent synaptic plasticity and learning efficiency[J]. J Pineal Res, 2019, 66(3): e12553.
[7]
Luo M, Song B, Zhu J. Sleep disturbances after general anesthesia: current perspectives[J]. Front Neurol, 2020, 11: 540759.
[8]
Li P, Gao L, Gaba A, et al. Circadian disturbances in Alzheimer's disease progression: a prospective observational cohort study of community-based older adults[J]. Lancet Healthy Longev, 2020, 1(3): e96-e105.
[9]
Leng Y, Musiek ES, Hu K, et al. Association between circadian rhythms and neurodegenerative diseases[J]. Lancet Neurol, 2019, 18(3): 307-318.
[10]
Ishizawa Y. Does preoperative cognitive optimization improve postoperative outcomes in the elderly?[J]. J Clin Med, 2022, 11(2): 445.
[11]
Bate GL, Kirk C, Rehman RZU, et al. The role of wearable sensors to monitor physical activity and sleep patterns in older adult inpatients: a structured review[J]. Sensors (Basel), 2023, 23(10): 4881.
[12]
Fadayomi AB, Ibala R, Bilotta F, et al. A systematic review and meta-analysis examining the impact of sleep disturbance on post-operative delirium[J]. Crit Care Med, 2018, 46(12): e1204-e1212.
[13]
Pennings N, Golden L, Yashi K, et al. Sleep-disordered breathing, sleep apnea, and other obesity-related sleep disorders: an Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) 2022[J]. Obes Pillars, 2022, 4: 100043.
[14]
André C, Rehel S, Kuhn E, et al. Association of sleep-disordered breathing with Alzheimer disease biomarkers in community-dwelling older adults: a secondary analysis of a randomized clinical trial[J]. JAMA Neurol, 2020, 77(6): 716-724.
[15]
Roggenbach J, Klamann M, von Haken R, et al. Sleep-disordered breathing is a risk factor for delirium after cardiac surgery: a prospective cohort study[J]. Crit Care, 2014, 18(5): 477.
[16]
Chew D, Sethi E, Sim YE, et al. Postoperative delirium following total joint arthroplasties in a multi-ethnic population–a prospective observational study[J]. Knee, 2021, 32: 103-111.
[17]
Mirrakhimov AE, Brewbaker CL, Krystal AD, et al. Obstructive sleep apnea and delirium: exploring possible mechanisms[J]. Sleep Breath, 2014, 18(1): 19-29.
[18]
King CR, Fritz BA, Escallier K, et al. Association between preoperative obstructive sleep apnea and preoperative positive airway pressure with postoperative intensive care unit delirium[J]. JAMA Netw Open, 2020, 3(4): e203125.
[19]
Gao L, Lim AS, Wong PM, et al. Fragmentation of rest/activity patterns in community-based elderly individuals predicts incident heart failure[J]. Nat Sci Sleep, 2020, 12: 299-307.
[20]
Campbell AM, Axon DR, Martin JR, et al. Melatonin for the prevention of postoperative delirium in older adults: a systematic review and meta-analysis[J]. BMC Geriatr, 2019, 19(1): 272.
[21]
Bowman K, Jones L, Pilling LC, et al. Vitamin D levels and risk of delirium: a mendelian randomization study in the UK Biobank[J]. Neurology, 2019, 92(12): e1387-e1394.
[22]
Pilling LC, Jones LC, Masoli JAH, et al. Low vitamin D levels and risk of incident delirium in 351,000 older UK biobank participants[J]. J Am Geriatr Soc, 2021, 69(2): 365-372.
[23]
Moody OA, Zhang ER, Vincent KF, et al. The neural circuits underlying general anesthesia and sleep[J]. Anesth Analg, 2021, 132(5): 1254-1264.
[24]
Luo M, Fei X, Liu X, et al. Divergent neural activity in the VLPO during anesthesia and sleep[J]. Adv Sci (Weinh), 2023, 10(2): e2203395.
[25]
Yang Q, Zhou F, Li A, et al. Neural substrates for the regulation of sleep and general anesthesia[J]. Curr Neuropharmacol, 2022, 20(1): 72-84.
[26]
Ocmen E, Erdost HA, Duru LS, et al. Effect of day/night administration of three different inhalational anesthetics on melatonin levels in rats[J]. Kaohsiung J Med Sci, 2016, 32(6): 302-305.
[27]
Kärkelä J, Vakkuri O, Kaukinen S, et al. The influence of anaesthesia and surgery on the circadian rhythm of melatonin[J]. Acta Anaesthesiol Scand, 2002, 46(1): 30-36.
[28]
van Zuylen ML, Meewisse AJG, Ten Hoope W, et al. Effects of surgery and general anaesthesia on sleep-wake timing: CLOCKS observational study[J]. Anaesthesia, 2022, 77(1): 73-81.
[29]
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(1): 1-27.
[30]
罗猛强, 姜思琦, 邓萌, 等. 右美托咪定镇静催眠作用机制研究进展[J]. 国际麻醉学与复苏杂志, 2020, 41(11): 1116-1120.
[31]
丁允莹, 嵇富海, 彭科. 右美托咪定的器官保护作用及其机制[J]. 解放军医学杂志, 2023, 48(11): 1267-1275.
[32]
Ng K, Shubash C, Chong J. The effect of dexmedetomidine on delirium and agitation in patients in intensive care: systematic review and meta-analysis with trial sequential analysis[J]. Anaesthesia, 2019, 74(3): 380-392.
[33]
Su X, Meng ZT, Wu XH, et al. Dexmedetomidine for prevention of delirium in elderly patients after non-cardiac surgery: a randomised, double-blind, placebo-controlled trial[J]. Lancet, 2016, 388(10054): 1893-1902.
[34]
Bi X, Wei J, Zhang X. Effects of dexmedetomidine on neurocognitive disturbance after elective non-cardiac surgery in senile patients: a systematic review and meta-analysis[J]. J Int Med Res, 2021, 49(5): 03000605211014294.
[35]
Chamadia S, Hobbs L, Marota S, et al. Oral dexmedetomidine promotes non-rapid eye movement stage 2 sleep in humans[J]. Anesthesiology, 2020, 133(6): 1234-1243.
[36]
Artemiou P, Bily B, Bilecova-Rabajdova M, et al. Melatonin treatment in the prevention of postoperative delirium in cardiac surgery patients[J]. Kardiochir Torakochirurgia Pol, 2015, 12(2): 126-133.
[37]
Kinouchi M, Mihara T, Taguri M, et al. The efficacy of ramelteon to prevent postoperative delirium after general anesthesia in the elderly: a double-blind, randomized, placebo-controlled trial[J]. Am J Geriatr Psychiatry, 2023, 31(12): 1178-1189.
[38]
Jaiswal SJ, Vyas AD, Heisel A, et al. Ramelteon for prevention of post-operative delirium: a randomized controlled trial in patients undergoing elective pulmonary thromboendarterectomy[J]. Crit Care Med, 2019, 47(12): 1751-1758.
[39]
Han Y, Wu J, Qin Z, et al. Melatonin and its analogues for the prevention of postoperative delirium: a systematic review and meta-analysis[J]. J Pineal Res, 2020, 68(4): e12644.
[40]
Ng KT, Teoh WY, Khor AJ. The effect of melatonin on delirium in hospitalised patients: a systematic review and meta-analyses with trial sequential analysis[J]. J Clin Anesth, 2020, 59: 74-81.
[41]
Wang ML, Min J, Sands LP, et al. Midazolam premedication immediately before surgery is not associated with early postoperative delirium[J]. Anesth Analg, 2021, 133(3): 765-771.
[42]
Duprey MS, Devlin JW, Griffith JL, et al. Association between perioperative medication use and postoperative delirium and cognition in older adults undergoing elective noncardiac surgery[J]. Anesth Analg, 2022, 134(6): 1154-1163.
[43]
Aldecoa C, Bettelli G, Bilotta F, et al. Update of the European Society of Anaesthesiology and Intensive Care Medicine evidence-based and consensus-based guideline on postoperative delirium in adult patients[J]. Eur J Anaesthesiol, 2024, 41(2): 81-108.
[44]
Spies CD, Knaak C, Mertens M, et al. Physostigmine for prevention of postoperative delirium and long-term cognitive dysfunction in liver surgery: a double-blinded randomised controlled trial[J]. Eur J Anaesthesiol, 2021, 38(9): 943-956.
[45]
Subramaniam B, Shankar P, Shaefi S, et al. Effect of intravenous acetaminophen vs. placebo combined with propofol or dexmedetomidine on postoperative delirium among older patients following cardiac surgery: the DEXACET randomized clinical trial[J]. JAMA, 2019, 321(7): 686-696.
[46]
Mu DL, Zhang DZ, Wang DX, et al. Parecoxib supplementation to morphine analgesia decreases incidence of delirium in elderly patients after hip or knee replacement surgery: a randomized controlled trial[J]. Anesth Analg, 2017, 124(6): 1992-2000.
[47]
Wang X, Wang Y, Hu Y, et al. Effect of flurbiprofen axetil on postoperative delirium for elderly patients[J]. Brain Behav, 2019, 9(6): e01290.
[48]
Labarca G, Schmidt A, Dreyse J, et al. Efficacy of continuous positive airway pressure (CPAP) in patients with obstructive sleep apnea (OSA) and resistant hypertension (RH): systematic review and meta-analysis[J]. Sleep Med Rev, 2021, 58: 101446.
[49]
Berger M, Oyeyemi D, Olurinde MO, et al. The INTUIT study: investigating neuroinflammation underlying postoperative cognitive dysfunction[J]. J Am Geriatr Soc, 2019, 67(4): 794-798.
[50]
Wang YY, Yue JR, Xie DM, et al. Effect of the tailored, family-involved hospital elder life program on postoperative delirium and function in older adults: a randomized clinical trial[J]. JAMA Intern Med, 2020, 180(1): 17-25.
2024年第49卷第10期
PDF下载
263
113
引用本文
BibTeX
文章信息
doi: 10.11855/j.issn.0577-7402.1265.2024.0612
  • 接收时间：2023-09-18
  • 首发时间：2025-11-20
  • 出版时间：2024-10-28
补充材料
相关文章
文章信息
作者
出版历史
  • 收稿日期：2023-09-18
  • 录用日期：2024-03-28
基金
National Natural Science Foundation of China(82371286)
国家自然科学基金(82371286)
National Natural Science Foundation of China(82101350)
国家自然科学基金(82101350)
National Natural Science Foundation of China(82271292)
国家自然科学基金(82271292)
Medical Innovation Research Project of Shanghai "Science and Technology Innovation Action Plan"(23Y2190600)
上海市“科技创新行动计划”医学创新研究专项(23Y2190600)
作者信息
    复旦大学附属华山医院麻醉科，上海 200040

通讯作者:

罗猛强，E-mail：
参考文献
分享链接
https://castjournals.cast.org.cn/joweb/jfjyxzz/CN/10.11855/j.issn.0577-7402.1265.2024.0612
分享至
全文二维码

扫描看全文

引用本文
BibTeX
本文的引用情况
2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
关闭全屏
相关链接
论文
最新文章
热读文章
热点专题
内参
蓝皮书
产业发展报告
传播力报告
期刊分级目录
资讯
学术新闻
行业新闻
学术会议
行业会议
关于
关于我们
联系我们
北京市海淀区学院南路86号
100081
010-62199257
qkjq@cast.org.cn

中国科学技术协会版权所有 京ICP 备10216604号-4 海淀分局备案 1101084647
科技导报社主办 中国科协信息中心技术支持