单肺通气中肺保护策略研究进展

Strategy of lung protection in one lung ventilation

目的通过对单肺通气中肺保护策略研究进展的分析，为临床工作提供理论指导，减少单肺通气术中低氧血症和术后肺部并发症的发生。方法应用计算机在Pubmed上检索2007年1月～2012年5月有关单肺通气的文章，检索词为：onelungventilation，hypoxemia，lungprotection，限定文章语言种类为English。对资料进行初审，并查找全文。纳入标准：①有关单肺通气的实验及临床研究；②有关肺保护的试验研究。排除标准：①综述文献；②重复研究。共收集到200多篇有关单肺通气方面的文献，纳入14篇。结果纳入的14篇文章中有关单肺通气术中管理方面的文献12篇，有关单肺通气时低氧血症方面的文献2篇。通过对人选文献进行分析、整理，将单肺通气术中管理从通气模式选择、潮气量与呼吸频率的设置、PEEP及CPAP的运用、吸入氧浓度及液体管理等5方面进行分析，归纳总结出目前在单肺通气时的肺保护策略和麻醉管理进展。结论随着对单肺通气中肺保护的深入研究，单肺通气的麻醉管理将更加有效、合理。

Objective To supply the theoretical reference to one lung ventilation （OLV） and to attenuate hypoxemia during OLV and postoperative pulmonary complications. Methods With the keywords ＂ one lung ventilation, hypoxemia, lung protection＂, a computer based on the search of Pubmed was undertaken to recognize the articles about OLV published from January 2007 to May 2012, the language was limited to English. The materials were selected firstly and free full texts were searched. Inclusion criteria：①the basic and clinical study on OLV; ②the study of lung protection. Exclusion criteria： reviews and repetitive study; Over 200 articles about OLV were searched, in which 14 were fitted for the inclusion criteria. Results In the 14 articles, 12 were about the study of the management during OLV, and 2 were the hypoxemia study of OLV. These literatures were analyzed including ventilation mode, the setting of tidal volume and respiratory frequency, the application of PEEP and CPAP, fraction of inspired oxygen and fluid management in order to summarize the strategy of lung protection and the development of management during OLV. Conclusion With the further study of lung protection in one - lung ventilation （ OLV）, anesthesia management of OLV will be more and more effective and reasonable.