肺切除术中肺保护策略研究进展  

Advances in lung protection strategies during lung resection

作　　者：刘骐毓 王华娟 刘倩 宋俊杰[1] 王莹 LIU Qiyu;WANG Huajuan;LIU Qian;SONG Junjie;WANG Ying(Department of Anesthesia and Perioperative Medicine,The First Affiliated Hospital of He´nan University,Kaifeng,He´nan 475000,China;He´nan University Medical College,Kaifeng,He´nan 475000,China)

机构地区：[1]河南大学第一附属医院麻醉与围术期医学科,河南开封475000 [2]河南大学医学院,河南开封475000

出　　处：《安徽医药》2024年第7期1281-1286,共6页Anhui Medical and Pharmaceutical Journal

基　　金：河南省医学科技攻关联合共建项目(LHGJ20220658);河南省高等学校重点科研课题(22A320029)。

摘　　要：肺切除术中常使用双腔支气管导管或支气管封堵器实现双肺隔离通气,可保护非术侧肺不受污染,并提供清晰的手术视野。但因其为非生理性通气方式,常会造成双肺不同程度的损伤。术中非术侧肺持续通气,其损伤常与气道压、潮气量、吸入氧浓度(FiO_(2))等有关;术侧肺损伤与手术操作引起的炎症反应、反复萎陷复张导致的氧化应激以及缺血缺氧再灌注损伤等有关。肺损伤一旦发生,会影响病人转归,延长住院时间,影响生活质量。该文主要概述目前肺切除术中肺保护策略研究进展,旨在为临床工作提供参考,为进一步完善围术期肺保护策略提供思路。Double-lumen bronchial catheters or bronchial blockers are often used to achieve isolated ventilation of both lungs during lung resection,which can protect the non-operative side lung from contamination and provide a clear surgical view.But because it is a non-physiological ventilation method,it often causes different degrees of damage to both lungs.Intraoperatively,the non-operative side of the lung is continuously ventilated.Its damage is often related to airway pressure,tidal volume,inhaled oxygen concentration(FiO2),etc;the injury to the lung on the operative side is related to the inflammatory response caused by the surgical operation,oxidative stress due to repeated atrophy and reattachment,and ischemia-hypoxia-reperfusion injury,etc.Once lung injury occurs,it may affect patient transfer,prolong hospital stay,and affect quality of life.This article mainly outlines the current research progress of lung protection strategy in pneumonectomy,aiming to provide reference for further improvement of perioperative lung protection strategy.

关 键 词：肺切除术 单肺通气 炎症反应 氧化应激 肺保护 

分 类 号：R655.3[医药卫生—外科学]