缺氧性肺血管收缩在单肺通气中的研究进展  

Research Progress of Hypoxic Pulmonary Vasoconstriction in One-lung Ventilation

作　　者：王志瑶 方育[1] 杨文燕[1] WANG Zhiyao;FANG Yu;YANG Wenyan(Department of Anesthesiology,the First Affiliated Hospital of Kunming Medical University,Kunming 650032,China)

机构地区：[1]昆明医科大学第一附属医院麻醉科,昆明650032

出　　处：《医学综述》2021年第4期631-636,共6页Medical Recapitulate

基　　金：国家自然科学基金(81660456)。

摘　　要：缺氧性肺血管收缩(HPV)是一种自动调节反射机制,是肺血管系统对急性和持续肺泡缺氧的重要反应,在单肺通气过程中发挥重要作用。HPV可使非通气侧肺的通过血流减少,并将减少部分的血流转移至通气侧肺,从而减少非通气侧肺的肺内分流,优化通气血流比值,改善氧合。此外,HPV受到多种因素的影响,包括麻醉药物、麻醉方式、机械通气、心排血量、温度、酸碱平衡等。目前,对单肺通气患者氧合和肺内分流影响因素的研究较多,通过增强对HPV的认识,可为寻找新的研究方向提供参考。Hypoxic pulmonary vasoconstriction(HPV)is an automatic regulatory reflex mechanism,which is an important response of pulmonary vascular system to acute and persistent alveolar hypoxia,playing an important role in the process of one lung ventilation.HPV can reduce the blood flow through the non-ventilated lung,and transfer the reduced part of the blood flow to the ventilated lung,so as to reduce the intrapulmonary shunt of the non-ventilated lung,optimize the ventilation blood flow ratio and improve oxygenation.In addition,HPV is affected by many factors,including narcotic drugs,anesthesia methods,mechanical ventilation,cardiac output,temperature,acid-base balance,etc.At present,there are many studies on the influencing factors of oxygenation and intrapulmonary shunt in patients with one lung ventilation,and improving the understanding of HPV can provide reference for finding new research directions.

关 键 词：缺氧性肺血管收缩 单肺通气 氧合 肺内分流 

分 类 号：R614.2[医药卫生—麻醉学]