肺部超声检查在围手术期麻醉管理中的应用进展  

Application progress on lung ultrasound in perioperative anesthesia management

作　　者：裴帅杰 夏海发 姚尚龙[1] Pei Shuaijie;Xia Haifa;Yao Shanglong(Department of Anesthesiology,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China;Department of Anesthesiology,the People's Hospital of Honghu,Honghu 433200,China)

机构地区：[1]华中科技大学同济医学院附属协和医院麻醉科,武汉430022 [2]洪湖市人民医院麻醉科,洪湖433200

出　　处：《国际麻醉学与复苏杂志》2023年第3期315-318,共4页International Journal of Anesthesiology and Resuscitation

基　　金：吴阶平医学基金会临床科研专项资助基金(320.6750.18178)。

摘　　要：肺部超声(lung ultrasound,LUS)检查是一种重要的影像学检查,它便捷、无辐射、准确性高、重复性好,可以用于围手术期麻醉管理,减少术后肺部并发症(postoperative pulmonary complications,PPC)。文章就近年来LUS在围手术期麻醉管理中的应用进行综述,包括LUS对常见肺部疾病(如肺不张、胸腔积液、气胸和肺水肿)的评估,利用肺部超声指导的液体管理(fluid administration limited by lung sonography,FALLS)方案、反FALLS方案来指导补液及利尿治疗,在LUS下进行肺复张及呼气末正压(positive end⁃expiratory pressure,PEEP)滴定,利用人工智能(artificial intelligence,AI)分析LUS图像。关于LUS的临床应用还需要进一步研究和探索,以充分发挥其巨大的医学价值。Lung ultrasound(LUS)is an important imaging examination which is convenient,radiation⁃free,and highly accurate and repeatable.It can be applied for perioperative anesthesia management and reducing postoperative pulmonary complications(PPC).This article reviews the application of LUS for perioperative anesthesia management in recent years.The content includes assessment of common lung diseases such as atelectasis,pleural effusion,pneumothorax and pulmonary edema;the use of fluid administration limited by lung sonography(FALLS)protocol and reverse⁃FALLS protocol to guide fluid replacement and diuresis;the use of LUS for recruit⁃ment maneuver and positive end⁃expiratory pressure(PEEP)titration;and analysis of LUS images by artificial intelligence(AI).Further research and exploration are needed to explore the clinical application of LUS to achieve its great medical potential.

关 键 词：肺 超声检查 围手术期 肺不张 胸腔积液 气胸 肺水肿 机械通气 

分 类 号：R614[医药卫生—麻醉学]