2025 年第 7 期 第 20 卷

Stanford A型主动脉夹层围手术期抑郁的研究现状

Research status of perioperative depression in Stanford type A aortic dissection

作者：韩雨晴齐择优林多茂崔博群马骏

英文作者：Han Yuqing Qi Zeyou Lin Duomao Cui Boqun Ma Jun

单位：首都医科大学附属北京安贞医院麻醉手术中心，北京100029

英文单位：Anesthesia and Surgery Center Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

关键词：StanfordA型主动脉夹层；抑郁；研究现状

英文关键词：StanfordtypeAaorticdissection;Depression;Researchstatus

• 摘要：

• 通过检索PubMed、Web of Science、EMbase等数据库相关文献，分析Stanford A型主动脉夹层术后抑郁的流行病学特征、发病机制、防治现状和治疗方式，并探讨艾司氯胺酮在该领域的应用前景。Stanford A型主动脉夹层术后抑郁发生率为35%~50%，严重影响患者预后，手术应激、炎症反应、神经-体液失调等因素在其发病中起关键作用，且较普通心脏手术更为显著。目前治疗以药物和心理干预为主，但效果欠佳。艾司氯胺酮具有起效快、疗效好等优势，有望成为该领域新的治疗选择。Stanford A型主动脉夹层术后抑郁发生率高，机制复杂。深入探索其病因，完善综合防治体系，有望改善患者预后，艾司氯胺酮在该领域具有良好应用前景，值得深入研究。

• By searching PubMed, Web of Science, EMbase and other databases, the epidemiological characteristics, pathogenesis, prevention and treatment of postoperative depression of Stanford type A aortic dissection were analyzed, and the application prospect of esketamine in this field was discussed. The incidence of depression after surgery for Stanford type A aortic dissection is 35%-50%, which seriously affects the prognosis of patients. Surgical stress, inflammatory response, neurohumoral imbalance and other factors play a key role in its pathogenesis, and it is more significant than that of common cardiac surgery. At present, the main treatment is drug and psychological intervention, but the effect is not good. Esmketamine has the advantages of rapid onset and good efficacy, which is expected to become a new treatment option in this field. The incidence of depression after surgery for Stanford type A aortic dissection is high and the mechanism is complex. Further exploration of its etiology and improvement of comprehensive prevention and treatment system are expected to improve the prognosis of patients. Esketamine has a good application prospect in this field and is worthy of further study.