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| 术前焦虑和抑郁与术后肺部并发症的研究进展 |
| Research progress in preoperative anxiety / depression and postoperative pulmonary complications |
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| DOI：10.12089/jca.2026.05.011 |
| 中文关键词: 术后肺部并发症 术前负性情绪 焦虑 抑郁 麻醉 |
| 英文关键词: Postoperative pulmonary complications Preoperative negative emotions Anxiety Depression Anesthesia |
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| 中文摘要: |
| 负性情绪是以情绪痛苦为特征的心理状态，临床表现为焦虑、抑郁、恐惧、愤怒等情感。焦虑、抑郁是常见的术前负性情绪，发生率较高且不同手术发生率存在差异。术后肺部并发症（PPCs）是指术后发生的呼吸系统并发症的复合结局，可影响手术患者住院时间和术后死亡率。术前焦虑和抑郁是术后肺部并发症重要且潜在的可干预的危险因素，其机制涉及下丘脑-垂体-肾上腺（HPA）轴亢进引发的免疫抑制与炎症反应失衡、呼吸肌功能减退、凝血功能紊乱以及肠道菌群失调等方面。焦虑、抑郁虽然在机制上存在交叉，但生理通路与临床表现存在差异。本综述系统阐述术前焦虑和抑郁与PPCs发生发展的临床依据，并分析影响PPCs的病理生理机制。 |
| 英文摘要: |
| Negative emotions are psychological states characterized by emotional distress and clinically manifest as anxiety, depression, fear, and anger. Anxiety and depression are common preoperative negative emotional states, with a high prevalence that varies across different types of surgery. Postoperative pulmonary complications (PPCs) refer to a composite outcome of respiratory complications occurring after surgery and are associated with prolonged hospital stay and increased postoperative mortality. Anxiety and depression represent important and potentially modifiable risk factors for PPCs. The underlying mechanisms involve hypothalamic-pituitary-adrenal (HPA) axis hyperactivation-induced immune suppression and inflammatory imbalance, respiratory muscle dysfunction, coagulation abnormalities, and alterations in the gut microbiota. Although anxiety and depression share overlapping mechanisms, they differ in physiological pathways and clinical manifestations. This review systematically summarizes the clinical evidence linking preoperative anxiety and depression to the occurrence and progression of PPCs and analyzes the pathophysiological mechanisms through which they influence PPCs. |
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