肺开放通气策略在患儿围术期肺不张的应用进展  

Application progress of open lung ventilation strategy in children with perioperative atelectasis

作　　者：郝伟 录亚鹏 张荣智[1] 张琰[1] 王迎斌[1] HAO Wei;LU Yapeng;ZHANG Rongzhi;ZHANG Yan;WANG Yingbing(Department of Anesthesiology,the Second Hospital of Lanzhou University,Lanzhou 730000,China)

机构地区：[1]兰州大学第二医院麻醉科,730000

出　　处：《临床麻醉学杂志》2023年第5期524-527,共4页Journal of Clinical Anesthesiology

基　　金：兰州大学第二医院“萃英科技创新”计划(CY2019-BJ07,CY2020-BJ10);甘肃省高等学校创新基金项目(2020B-049)。

摘　　要：随着患儿手术量的增加,全麻机械通气中呼吸管理成为了重点。患儿呼吸系统发育不完善,传统机械通气设置易发生容积伤、气压伤等呼吸机相关肺损伤和术后肺部并发症,不利于患儿预后。应用小潮气量进行机械通气,在降低肺损伤及术后肺部并发症的同时会引起肺不张的发生。肺开放通气策略的实施在改善肺顺应性和氧合功能的同时,亦能降低术后肺不张和术后肺部并发症的发生率。然而,患儿中应用此策略尚无统一共识,本文对近年来涉及肺开放通气策略在患儿中的应用现状做一综述,为患儿围术期实施此策略提供参考。With the increase in the number of operations in children,respiratory management during general anesthesia and mechanical ventilation has become a focus.The respiratory system development of children is not perfect,and traditional mechanical ventilation setting is prone to volutrauma,barotrauma and other ventilator-related lung injuries and postoperative pulmonary complications,which is not conducive to the prognosis of children.Mechanical ventilation with a small tidal volume can reduce lung injury and postoperative pulmonary complications while causing atelectasis.The implementation of open lung ventilation strategy can improve lung compliance and oxygenation function while reducing the incidence of postoperative atelectasis and pulmonary complications.However,there is no consensus on the application of this strategy in children.This article reviews the current status of the application of open lung ventilation strategy in children in recent years,and provides a reference for the implementation of this strategy in the children perioperative period.

关 键 词：肺开放 肺复张 呼气末正压 儿童 

分 类 号：R726.1[医药卫生—儿科]