允许性高碳酸血症对腹腔镜手术老年患者术后认知功能的影响及研究进展

Impact and Research Progress of Permissible Hypercapnia on Postoperative Cognitive Dysfunctiol in Elderly Patients Undergoing Laparoscopic Surgery/MIN Xue， LYU Zhijian， LI Kongbing， JIA Yujie WANG Dongmei. //Medical Innovation of China， 2025， 22（10）： 183-188

基金项目：青海大学附属医院（临床医学院）科学创新基金项目（FYXC-2024-06）

通信作者：吕志坚

[Abstract]In current medical practice， with the extensive application of laparoscopic technology in elderly patients， postoperative cognitive dysfunction （POCD）has become a key problem affecting the rehabilitation and quality of life of elderly patients. Permissible hypercapnia （PHC）is an acceptable respiratory acidosis resulting from theuse of low tidalvolume protective ventilationstrategies.Clinical studieshave shownthat theapplication of PHC in laparoscopic surgery can improve postoperative cognitive function in elderly patients through various mechanisms.It is important to note that although PHChas shown potential benefits in multiple studies， several key issues regarding its use inelderly patients remainunclear：first， the mechanismof overall effect of PHC on the physiological status ofelderly patients hasnot been fully elucidated； secondly，the specificrole of PHC strategy in postoperativepain managementand itspotentialimpact onpostoperativecognitive function stillneed tobe further verified；finally，thereis stillalackofclear clinicalconsensus onkeyparameterssuchasallowablelimitsandsafe limits for CO during PHC therapy. In this paper， we reviewed the influence of PHC ventilation strategy on elderly patients undergoing laparoscopic surgery and the related mechanisms.

[Key words] Permissible hypercapnia Postoperative cognitive dysfunction Laparoscopic surgery Elderly patients

First-author's address： Surgical Anesthesia Center， Afliated Hospital of Qinghai University， Xining 810001， China

doi：10.3969/j.issn.1674-4985.2025.10.043

术后认知功能障碍（POCD）是术后常见的并发症之一，在老年患者中尤其普遍。（剩余11079字）