腹腔镜手术中应用肺保护性通气策略对老年患者呼吸功能影响的研究进展

Research progress about effects of lung protective ventilation strategy on respiratory function in the elderly with laparoscopic surgery

随着对通气模式的深入研究,肺保护性通气策略现已被越来越多的学者所重视。研究表明,肺保护性通气策略已被证明可以改善氧合功能,减少术后肺部并发症的发生。老年人由于其特殊的生理功能状态,在行机械通气时更容易发生术后肺部并发症。本文综述老年人的生理功能,腹腔镜手术对老年人呼吸功能的影响,小潮气量、呼气末正压通气、肺复张策略及其他肺保护性策略的相关进展与争议,旨在探讨哪种通气模式更适用于接受腹腔镜手术的老年患者。

With the further study of the ventilation model, pulmonary protective ventilation has been paid increasing attention by more and more scholars. Recent studies have shown that lung protective ventilation strategy has been proved to improve oxygenation and reduce postoperative pulmonary complications. Due to the special physiological function of the elderly, they are more likely to have postoperative pulmonary complications after mechanical ventilation. The article discusses which ventilation mode is more suitable for elderly patients undergoing laparoscopic surgery. This article reviews some theories about the physiological function of the elderly, and the effect of laparoscopy on the respiratory function of the elderly. It also reviews the related progress and controversy of low tidal volume, positive end expiratory pressure, recruitment maneuvers and other pulmonary protective strategies.