外科危重患者急性呼吸衰竭的预防和治疗

Prevention and treatment of acute respiratory failure in surgical patients

急性肺功能损伤或衰竭（ＡＲＦ）是外科疾患和外科治疗操作的危险并发症之一。外科医师对本病的充分了解和及时、正确的处理，是预防、治疗本并发症以及提高外科病最终疗效的关键之一。作者结合复兴医院综合ＩＣＵ的４５例ＡＲＦ患者对外科急性呼吸损伤或衰竭的诊断标准、治疗时机、常用的通气方式以及ＰＣ－ＩＲＶ、ＰＨＶ等通气模式进行一些探讨。作者认为，这些新的通气方式能够降低气道峰压，提高氧合，减少肺损伤。

Abstract Acute respiratory failure(ARF) is one of the lethal complications of surgical disease and surgical procedures.A well understanding,aswell a prompt and proper management to this syndrome, willbe the access to the successful prevention and desire outcome of this problem. It is true not only to the ICU physicians but also to the surgeons. This paper also had a discussion on the application of the PC-IRV and PHV modes in the ARDS patients.These new approaches to ventilation canmaintain a mean airway pressure high enough to recruit unstable alveoli and improve gas exchange whlist avoiding high peak inflation pressures.