苯二氮类药物与老年股骨颈骨折患者围术期谵妄△

Benzodiazepines and perioperative delirium of femoral neck fractures in elderly

摘要:

谵妄是老年股骨颈骨折患者围术期的常见并发症。目前认为谵妄发病由多因素介导，与多种不良结局密切相关。有临床证据表明，苯二氮?类药物能够通过非特异性激活 GABAA受体诱发谵妄。然而，苯二氮?类药物常被不规范地应用在老年股骨颈骨折患者围手术期管理中，由此引发的谵妄未得到重视。本文从谵妄的病理生理机制、苯二氮?类药物与谵妄的关系、老年股骨颈骨折患者谵妄易发的原因及防治策略等方面进行综述，以期为老年股骨颈骨折患者围术期管理提供参考。

Abstract:

Delirium is a common perioperative complication in elderly patients with femoral neck fractures, which is currently be- lieved due to multiple factors and closely related to adverse outcomes. Many clinical evidences have showed that benzodiazepines induces delirium by non- specific activation of GABAA receptors, however, the perioperative delirium induced by benzodiazepines in elderly pa- tients with femoral neck fractures has not been paid enough attention. In order to provide a reference for perioperative management of elder- ly patients with femoral neck fractures, this paper reviews the pathophysiological mechanism of delirium, the relationship between benzodi- azepines and delirium, the causes of delirium in elderly patients with femoral neck fractures and prevention strategies.