呼气末正压通气在腹腔镜手术中的应用进展  

The Progress of Application of Positive End-expiratory Pressure in the Laparoscopic Surgery

作　　者：骆丹[1] 刘新伟[1] 

机构地区：[1]重庆医科大学附属第一医院麻醉科,重庆400016

出　　处：《医学综述》2015年第12期2234-2236,共3页Medical Recapitulate

基　　金：卫生部国家临床重点专科建设基金资助项目(财社〔2011〕170号);重庆市医学重点学科计划项目(渝卫科教〔2007〕2号)

摘　　要：腹腔镜应用于临床已有近40年的历史,现已广泛开展于多学科手术,为患者术后恢复带来很大益处。但在使用腹腔镜手术建立人工气腹时产生的高腹压和高碳酸血症对人体的呼吸系统、循环系统有很大影响,从而引起人体内环境紊乱,产生特有的并发症,因此对麻醉的实施及管理要求高于一般手术。近年来,有研究使用呼气末正压(PEEP)通气以减少腹腔镜手术中的不良反应及术后肺部并发症。该文将阐述PEEP在腹腔镜手术中应用的原因及进展。The application of laparoscopic has been almost 40 years in clinical,which has been widely carried out in multidisciplinary surgeries,bringing great benefit to rapid recovery. But hypercapnia and high intraperitoneal pressure resulted from the pneumoperitoneum laparoscopic surgery which adversely affect the respiratory and circulation system and cause internal environment disorder and specific complications. Therefore the requirement for implementation and management of anesthesia is higher than general surgery. There are studies in recent years of using the positive end-expiratory pressure（ PEEP） to reduce adverse reactions and the postoperative pulmonary complications of laparoscopic surgery. Here describes the reasons and progress of the PEEP application in laparoscopic surgery.

关 键 词：腹腔镜手术 呼气末正压通气 临床应用 

分 类 号：R614.2[医药卫生—麻醉学]