非依赖肺通气应用现状及进展

Current research status and prospects of independent lung ventilation

单肺通气(one-lung ventilation,OLV)是把双刃剑,在便于手术操作的同时又会造成通气/血流比例(ventilation-perfusion ratio,V/Q)失调和不同程度肺损伤。文章从OLV所导致V/Q失调和肺损伤的病理生理基础角度出发,重点探讨了肺隔离过程中实施非依赖肺适度通气的益处。通过综述相关文献,分别阐述了非依赖肺通气(independent lung ventilation,ILV)的理论基础、实施意义和相关临床应用,同时介绍了基于潮气量分流并共用呼吸回路的ILV方法。这种方法相对较为简便易行,在实施保护性肺隔离通气方面具有一定的优势和应用前景。

One-lung ventilation(OLV)is a"double-edged sword",which causes imbalanced ventilation-perfusion ratio(V/Q)and may result in lung injury to different extent.This review mainly discusses the benefits of moderate independent lung ventilation(ILV)during lung isolation,from the point of view of the pathophysiological basis of V/Q imbalance and lung injury caused by OLV.Based on relevant literature,the theoretical basis,rationale of implementation and clinical application of ILV were discussed.In addition,the method of ILV based on dividing of tidal volume and sharing of single respiratory circuit was introduced.This method is relatively simple,easy-to-use and with some advantages and application prospects in the implementation of protective lung isolation ventilation.