therapeuticЮжно-Российский журнал терапевтической практикиSouth Russian Journal of Therapeutic Practice2712-81563033-8344РостГМУ10.21886/2712-8156-2026-7-3-17-22therapeutic-762Research ArticleОБЗОРЫREVIEWSИнтегративная роль нейровоспаления, церебральной гипоперфузии и анестезиологического стресса в патогенезе послеоперационной когнитивной дисфункцииThe integrative role of neuroinflammation, cerebral hypoperfusion, and anesthetic stress in the pathogenesis of postoperative cognitive dysfunctionhttps://orcid.org/0009-0002-1304-2202СалтановаВ. А.SaltanovaV. A.

Салтанова Валентина Анатольевна, аспирант кафедры неврологии; врач-невролог 

Тюмень

Valentina A. Saltanova, Postgraduate student at the Department of Neurology, Neurologist

Tyumen

valentinaslt72@gmail.comhttps://orcid.org/0009-0007-1871-6540БорисенкоВ. Р.BorisenkoV. R.

Борисенко Валерия Романовна, ординатор кафедры неврологии

Тюмень

Valeriya R. Borisenko, Resident at the Department of Neurology

Tyumen

lera.borisenko.020601@gmail.comhttps://orcid.org/0009-0002-7289-4587МазуровН. А.MazurovN. A.

Мазуров Никита Александрович, аспирант кафедры неврологии

Тюмень

Nikita A. Mazurov, Postgraduate student at the Department of Neurology

Tyumen

nikita_banzay@mail.ruhttps://orcid.org/0000-0002-7598-7757КичероваО. А.KicherovaO. A.

Кичерова Оксана Альбертовна, д. м. н., доц., заведующий кафедрой неврологии

Тюмень

Oksana A. Kicherova, Dr. Sci. (Med.), Associate Professor, Head of the Department of Neurology 

Tyumen

pan1912@mail.ruhttps://orcid.org/0000-0003-4313-0836РейхертЛ. И.ReikherL. I.

Рейхерт Людмила Ивановна, д. м. н., профессор кафедры неврологии

Тюмень

Lyudmila I. Reikhert, Dr. Sci. (Med.), Professor at the Department of Neurology

Tyumen

lir0806@gmail.comФГБОУ ВО «Тюменский государственный медицинский университет» Минздрава России; ГБУЗ Тюменской области «Областная клиническая больница №2»РоссияTyumen State Medical University; Regional clinical hospital No. 2Russian FederationФГБОУ ВО «Тюменский государственный медицинский университет» Минздрава РоссииРоссияTyumen State Medical UniversityRussian Federation202627092026731722Copyright © Салтанова В.А., Борисенко В.Р., Мазуров Н.А., Кичерова О.А., Рейхерт Л.И., 20262026Салтанова В.А., Борисенко В.Р., Мазуров Н.А., Кичерова О.А., Рейхерт Л.И.Saltanova V.A., Borisenko V.R., Mazurov N.A., Kicherova O.A., Reikher L.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.therapeutic-j.ru/jour/article/view/762

Послеоперационные нейрокогнитивные расстройства (ПОНР) представляют собой одно из наиболее частых и клинически значимых осложнений в послеоперационном периоде, ассоциированных с увеличением сроков госпитализации, снижением качества жизни пациентов и повышением риска долгосрочных когнитивных нарушений, особенно среди пациентов пожилого возраста. Современная научная парадигма отвергает упрощенное представление о ПОНР как о прямом и исключительном следствии фармакологического воздействия общих анестетиков на головной мозг. Цель обзора — детализировать патофизиологические звенья ПОНР, представив их как последовательные этапы единого патогенетического процесса. Для написания литературного обзора были использованы базы данных «PubMed», «Google Scholar», «eLIBRARY.RU». В настоящем обзоре представлен анализ наиболее обоснованной интегративной модели патогенеза данных нарушений, согласно которой длительное воздействие общей анестезии выступает в роли фактора, снижающего функциональную устойчивость и адаптационный резерв нервной системы.

Postoperative neurocognitive disorders (POND) are one of the most common and clinically significant complications in the postoperative period, associated with prolonged hospitalization, decreased quality of life, and an increased risk of longterm cognitive impairment, especially among elderly patients. The current scientific paradigm rejects the simplistic notion of POND as a direct and exclusive consequence of the pharmacological effects of general anesthetics on the brain. The aim of this review is to detail the pathophysiological components of POND, presenting them as sequential stages of a single pathogenetic process. PubMed, Google Scholar, and eLIBRARY.RU were used for this literature review. This review presents an analysis of the most substantiated integrative model for the pathogenesis of these disorders, according to which prolonged exposure to general anesthesia acts as a factor reducing the functional stability and adaptive reserve of the nervous system.

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The authors declare that there are no conflicts of interest present.