术后睡眠障碍的危险因素及防治措施研究进展
Research Progress on Risk Factors and Prevention Measures of Postoperative Sleep Disturbances
DOI: 10.12677/jcpm.2026.51007, PDF,    科研立项经费支持
作者: 宋文静, 肖 晓：重庆医科大学第五临床学院，重庆；重庆医科大学附属永川医院麻醉科，重庆；税春玲*：重庆医科大学附属永川医院麻醉科，重庆；唐 璐：成都市金牛区人民医院康复科，四川 成都
关键词: 术后睡眠障碍；睡眠评估；围手术期；危险因素；干预措施；Postoperative Sleep Disturbance； Sleep Assessment； Perioperative Period； Risk Factors； Interventions
摘要: 随着快速康复外科的理念普及，研究员们越来越重视术后睡眠障碍(PSD)这一术后并发症。PSD影响着患者术后康复和生活质量，和多种术后并发症相关。本文从PSD的定义、评估、危险因素和干预措施进行描述，以期给大家介绍PSD的研究现状，帮助大家进行下一步研究。
Abstract: With the widespread adoption of the concept of Enhanced Recovery After Surgery (ERAS), researchers are increasingly focusing on postoperative sleep disturbance (PSD) as a common surgical complication. PSD adversely affects patients’ postoperative recovery and quality of life and is associated with various other postoperative complications. This article delineates the definition, assessment, risk factors, and interventions related to PSD, aiming to present the current research landscape and facilitate further investigation in this field.
文章引用：宋文静, 税春玲, 肖晓, 唐璐. 术后睡眠障碍的危险因素及防治措施研究进展 [J]. 临床个性化医学, 2026, 5(1): 41-48. https://doi.org/10.12677/jcpm.2026.51007

参考文献

[1] Liu, D. and Dan, Y. (2019) A Motor Theory of Sleep-Wake Control: Arousal-Action Circuit. Annual Review of Neuroscience, 42, 27-46. [Google Scholar] [CrossRef] [PubMed]
[2] Lyckenvik, T., Olsson, M., Forsberg, M., Wasling, P., Zetterberg, H., Hedner, J., et al. (2025) Sleep Reduces CSF Concentrations of Beta-Amyloid and Tau: A Randomized Crossover Study in Healthy Adults. Fluids and Barriers of the CNS, 22, Article No. 84. [Google Scholar] [CrossRef] [PubMed]
[3] Voss, U. and Klimke, A. (2019) Dreaming during REM Sleep: Autobiographically Meaningful or a Simple Reflection of a Hebb’ian-Based Memory Consolidation Process? Archives Italiennes de Biologie, 156, 99-111. [Google Scholar] [CrossRef] [PubMed]
[4] 华谟敏, 洪洪, 王东信. 老年患者术后睡眠障碍[J]. 老年医学与保健, 2023, 29(4): 661-664.
[5] 樊丽萍, 胡晶辉, 嵇富海. 老年患者全麻术后睡眠障碍的研究进展[J]. 国际麻醉学与复苏杂志, 2025, 46(5): 506-510.
[6] Chen, Z., Tang, R., Zhang, R., Jiang, Y. and Liu, Y. (2017) Effects of Dexmedetomidine Administered for Postoperative Analgesia on Sleep Quality in Patients Undergoing Abdominal Hysterectomy. Journal of Clinical Anesthesia, 36, 118-122. [Google Scholar] [CrossRef] [PubMed]
[7] 唐润栋, 徐晓林, 姜彦, 刘英志, 陈作雷. 右美托咪定复合舒芬太尼术后镇痛对经腹子宫切除术患者睡眠质量的影响[J]. 临床麻醉学杂志. 2017, 33(3): 222-225.
[8] 吴昱, 陈旭真, 苗玉花, 汪国基, 郝书航. 右美托咪定对鼻内镜手术术后早期睡眠质量的影响[J]. 临床麻醉学杂志, 2022, 38(4): 440-442.
[9] 王晓秋, 吴文忠, 刘成勇, 等. 体动记录仪与睡眠评价[J]. 世界睡眠医学杂志. 2020, 7(4): 733-737.
[10] Chen, D., Yin, Z. and Fang, B. (2017) Measurements and Status of Sleep Quality in Patients with Cancers. Supportive Care in Cancer, 26, 405-414. [Google Scholar] [CrossRef] [PubMed]
[11] 马卫兰, 邓立琴, 马晶晶, 武淑晶, 陈岗. 盐酸戊乙奎醚对全麻老年患者全膝关节置换术后早期睡眠的影响[J]. 临床麻醉学杂志, 2019, 35(3): 260-265.
[12] 罗婵, 王雅麒, 季静, 陈鹏. 脑电双频指数在临床上的应用进展[J]. 中国实验诊断学, 2020, 24(1): 153-156.
[13] Wang, Y., Zhao, X., Ren, J., Xue, S., Liu, Y., Zhang, L., et al. (2024) The Effect of Light Therapy on Insomnia: A Systematic Review and Meta-Analysis. Sleep and Breathing, 29, Article No. 66. [Google Scholar] [CrossRef] [PubMed]
[14] Zhu, Y.X., Zhang, Y.Y. and Jiang, X.J. (2025) Impact of Baseline Nutritional Status, Psychological Health, Fatigue, and Insomnia on Outcomes of Immune Checkpoint Inhibitors in Advanced Non‐Small Cell Lung Cancer: A Retrospective Cohort Study. The Kaohsiung Journal of Medical Sciences, e70097. [Google Scholar] [CrossRef] [PubMed]
[15] Ortiz, L.E., Morse, A.M., Thorpy, M.J., Kushida, C.A., Harsh, J., Roth, T., et al. (2025) Once‐Nightly Sodium Oxybate Meets American Academy of Sleep Medicine Criteria for Treatment of Narcolepsy. Journal of Sleep Research, e70189. [Google Scholar] [CrossRef] [PubMed]
[16] Youn, S., Kim, C., Lee, J., Yeo, S., Suh, S. and Chung, S. (2019) Development of Dysfunctional Beliefs and Attitude about Sleep Scale for Cancer Patients. Behavioral Sleep Medicine, 18, 287-297. [Google Scholar] [CrossRef] [PubMed]
[17] Natarajan, J., Joseph, M.A., Al-Asmi, A., Seshan, V., Al Balushi, L.D., Al Junaibi, S.M., et al. (2025) Quality of Life, Depression, Daytime Sleepiness and Fatigue in Omani People with Epilepsy: A Cross-Sectional Study. BMC Neurology, 25, Article No. 366. [Google Scholar] [CrossRef] 
[18] Krueger, B., Rajcsanyi, L.S., Hundertmark, K., Stutz, B., Hinney, A. and Buyken, A. (2025) Morning Clock Gene Expression in Young Adults of Early and Late Chronotypes. Scientific Reports, 15, Article No. 26709. [Google Scholar] [CrossRef] [PubMed]
[19] 程敏, 张驰, 董乃夫, 仇金鹏. 老年人术后睡眠障碍与术后谵妄的研究进展[J]. 中国实验诊断学, 2020, 24(12): 2076-2078.
[20] 邓亚琼, 王红霞. 老年髋部骨折患者术后睡眠障碍的影响因素及护理对策分析[J]. 母婴世界, 2020(30): 197.
[21] 黄道礼, 陈鸿, 肖庆华, 邱卫东. 右美托咪定联合舒芬太尼对老年脊柱手术患者术后睡眠障碍的影响[J]. 国际医药卫生导报, 2021, 27(23): 3707-3710.
[22] 张伟, 王若涵, 刘瑶, 等. 老年病人胸科手术后睡眠障碍的危险因素[J]. 中华麻醉学杂志, 2021, 41(3): 278-281.
[23] 庞瑞. 老年膝骨关节炎患者术后睡眠障碍的危险因素分析及防范措施[J]. 当代护士(下旬刊), 2022, 29(6): 44-46.
[24] 宋丽, 姚兰. 胶质瘤切除术后患者睡眠障碍的危险因素[J]. 中华麻醉学杂志, 2020, 40(12): 1440-1442.
[25] 马福国, 刘延莉, 王倩, 孙立新. 丙泊酚全凭静脉麻醉与七氟醚静吸复合麻醉对老年女性患者术后睡眠质量影响的比较[J]. 中华麻醉学杂志, 2019, 39(10): 1168-1171.
[26] 李京京, 吕晓晴, 刘杉杉, 等. 围手术期肺癌患者症状群与生活质量相关性的纵向研究[J]. 中华护理杂志, 2020, 55(11): 1635-1641.
[27] 王开, 段光友, 赵鹏, 吴卓熙, 李洪. 右美托咪定术中持续泵注对脊柱手术患者术后睡眠质量的改善作用[J]. 第三军医大学学报, 2020, 42(10): 1002-1007.
[28] 李仁华, 陈娜, 王锷, 唐朝辉. 老年患者术前睡眠障碍与术后神经认知恢复延迟的相关性[J]. 中南大学学报(医学版), 2021, 46(11): 1251-1259.
[29] 王彤, 董佳岐, 宋艳, 吴玥. 老年睡眠障碍相关影响因素的研究进展[J]. 老年医学与保健, 2021, 27(1): 197-199.
[30] 王思思, 曹杨, 张艳芳, 王浩然. 老年急性心肌梗死患者PCI术后睡眠障碍影响因素分析[J]. 临床心身疾病杂志, 2025, 31(1): 93-96.
[31] 王晶, 李玲利, 赵春林, 杨雪, 袁邻雁. 基于Logistic回归的关节置换术患者术后睡眠障碍风险预测模型构建研究[J]. 四川大学学报(医学版), 2023, 54(4): 759-764.
[32] Brennan, L., Kirkham, F.J. and Gavlak, J.C. (2020) Sleep-Disordered Breathing and Comorbidities: Role of the Upper Airway and Craniofacial Skeleton. Nature and Science of Sleep, 12, 907-936. [Google Scholar] [CrossRef] [PubMed]
[33] 王恒, 万小健. 全身麻醉后睡眠障碍的研究进展[J]. 国际麻醉学与复苏杂志, 2022, 43(12): 1316-1322.
[34] 陶玉竹, 王祯, 李依泽, 张麟临, 王国林. 麻醉药物对术后睡眠障碍的影响及其研究进展[J]. 国际麻醉学与复苏杂志, 2019, 40(11): 1056-1060.
[35] 隆巧玉, 葛亚丽. 麻醉管理对术后睡眠障碍的影响研究进展[J]. 大连医科大学学报, 2022, 44(3): 244-248.
[36] 冯振鑫, 张卫. 术后睡眠障碍——值得关注的围手术期并发症[J]. 国际麻醉学与复苏杂志, 2018, 39(1): 61-65.
[37] Song, Y., Liu, Y., Yuan, Y., Jia, X., Zhang, W., Wang, G., et al. (2021) Effects of General versus Subarachnoid Anaesthesia on Circadian Melatonin Rhythm and Postoperative Delirium in Elderly Patients Undergoing Hip Fracture Surgery: A Prospective Cohort Clinical Trial. EBioMedicine, 70, Article ID: 103490. [Google Scholar] [CrossRef] [PubMed]
[38] 旷雪怡, 史宏伟. 术后睡眠障碍: 评估、危险因素和防治[J]. 国际麻醉学与复苏杂志, 2025, 46(6): 632-637.
[39] 宋明华. 开胸术后患者疼痛与睡眠障碍双向干预效果研究[J]. 中国药物与临床, 2020, 20(15): 2638-2639.
[40] 李辉波, 苏钰淇, 曾志文. 术后急性疼痛与睡眠障碍相互影响的研究进展[J]. 临床麻醉学杂志, 2024, 40(5): 553-556.
[41] 吴占澄, 陈长凤, 黄慧. 疼痛+睡眠多维度强化干预联合渐进性肌肉放松训练在急腹症术后睡眠障碍患者中的应用效果[J]. 世界睡眠医学杂志, 2024, 11(4): 749-751.
[42] 刘清梅, 李英豪, 梁霞, 张庆利. 抑郁伴睡眠障碍患者术后PSQI评分变化及与认知功能损害的关系[J]. 国际精神病学杂志, 2020, 47(5): 1057-1059, 1078.
[43] 田海燕. 患者术后睡眠障碍及护理干预效果[J]. 世界睡眠医学杂志, 2019, 6(1): 76-78.
[44] 于淼, 杨延章, 宋健楠, 等. 术前血浆下丘脑泌素-1、黑色素聚集激素水平对老年患者术后睡眠障碍的预测价值[J]. 国际麻醉学与复苏杂志, 2024, 45(10): 1016-1022.
[45] 宋亚男. 褪黑素昼夜节律紊乱对围术期认知功能障碍的研究进展[J]. 中国微创外科杂志, 2019, 19(6): 556-558.
[46] Fjell, A.M., Sederevicius, D., Sneve, M.H., de Lange, A.G., Bråthen, A.C., Idland, A., et al. (2019) Self-Reported Sleep Problems Related to Amyloid Deposition in Cortical Regions with High HOMER1 Gene Expression. Cerebral Cortex, 30, 2144-2156. [Google Scholar] [CrossRef] [PubMed]
[47] 隆巧玉, 高巨, 常明智, 汤颜鞠, 葛亚丽. BIS指导下全麻对腔镜胃肠肿瘤切除术老年患者术后睡眠质量的影响[J]. 中华麻醉学杂志, 2021, 41(4): 416-420.
[48] Zorrilla-Vaca, A., Healy, R., Grant, M.C., Joshi, B., Rivera-Lara, L., Brown, C., et al. (2018) Intraoperative Cerebral Oximetry-Based Management for Optimizing Perioperative Outcomes: A Meta-Analysis of Randomized Controlled Trials. Canadian Journal of Anesthesia, 65, 529-542. [Google Scholar] [CrossRef] [PubMed]
[49] 刘珊珊, 李佳馨, 李泽楠, 徐龙河. 右美托咪定对睡眠障碍治疗的研究进展[J]. 中华保健医学杂志, 2025, 27(4): 738-742.
[50] 李馨瑜, 邱迪, 王星明, 张广芬, 杨建军. 氯胺酮及S-氯胺酮对术后睡眠质量影响的研究进展[J]. 国际麻醉学与复苏杂志, 2025, 46(6): 626-631.
[51] 马晶晶, 武淑晶, 邓立琴, 侯海涛, 张俊霞, 王小梅. 老年患者髋部骨折手术麻醉的优化策略: 髂筋膜间隙阻滞联合单侧腰麻[J]. 中华麻醉学杂志, 2020, 40(9): 1109-1112.
[52] Shakya, H., Wang, D., Zhou, K., Luo, Z., Dahal, S. and Zhou, Z. (2019) Prospective Randomized Controlled Study on Improving Sleep Quality and Impact of Zolpidem after Total Hip Arthroplasty. Journal of Orthopaedic Surgery and Research, 14, Article No. 289. [Google Scholar] [CrossRef] [PubMed]
[53] Xiao, Z., Long, B. and Zhao, Z. (2022) The Effect of Improving Preoperative Sleep Quality on Perioperative Pain by Zolpidem in Patients Undergoing Laparoscopic Colorectal Surgery: A Prospective, Randomized Study. Pain Research and Management, 2022, Article ID: 3154780. [Google Scholar] [CrossRef] [PubMed]
[54] 吴新顺, 李劲草, 刘影, 等. 大麻二酚通过调节昼夜节律改善大鼠全麻术后的睡眠障碍[J]. 南方医科大学学报, 2025, 45(4): 744-750.
[55] 高一, 周琪, 宋健楠, 等. 褪黑素对患者术后睡眠质量影响的meta分析[J]. 中华麻醉学杂志, 2022, 42(9): 1043-1047.
[56] 邹叔骋, 王朝阳, 刘博, 等. 地西泮对胶质瘤术后睡眠障碍患者神经内分泌免疫因子表达水平的影响[J]. 中国医师杂志, 2018, 20(11): 1692-1694.
[57] 宋凤香, 武淑晶, 侯海涛, 马晶晶, 邓立琴. 地塞米松对全麻腹腔镜子宫手术患者术后早期睡眠质量的影响[J]. 中国医师杂志, 2024, 26(10): 1558-1561.
[58] 唐洁, 吕凯丽, 薛艳, 俞萍. 经皮穴位电刺激对术后睡眠质量影响的Meta分析[J]. 临床麻醉学杂志, 2025, 41(8): 844-850.
[59] 刘雨, 段光友, 但伶, 张亚梅. 星状神经节阻滞对全身麻醉手术患者术后睡眠质量影响的Meta分析[J]. 重庆医学, 2025, 54(1): 181-186.