术后谵妄(POD)指术后严重的注意力及神经认知障碍,其发病率高,且可致多种术后并发症的发生率增加,老年患者为其高危人群之一。相关研究显示:心率变异性(HRV)作为反映自主神经系统(ANS)功能的生物电指标,与老年患者POD的发生相关。本文综述了近年HRV指数与老年患者POD关系的研究,描述了老年患者POD的流行病学规律、ANS功能异常引发POD的可能机制以及HRV与神经认知功能及POD的可能联系,以期为POD的防治提供新的思路。

Postoperative delirium (POD) is a syndrome of severe postoperative attention and neurocognitive impairment, which has a high incidence and can lead to an increased incidence of various postoperative complications. Elderly patients are one of the high-risk groups for POD. Relevant studies have shown that heart rate variability (HRV), as a bioelectrical indicator reflecting the function of the autonomic nervous system (ANS), is associated with the occurrence of POD in elderly patients. This paper reviewed the recent studies on the relationship between HRV index and POD in elderly patients, described the epidemiological regularity of POD in elderly patients, the possible mechanism of POD caused by abnormal ANS function, and the possible connection between HRV and neurocognitive function or POD, in order to provide new evidence for the prevention and treatment of POD.