肺复张评估方法的研究进展

Research progress on methods of assessing effect of lung recuritment maneuver

肺复张作为急性呼吸窘迫综合征的重要干预措施,对改善氧合和降低病死率都有重要意义。虽然目前肺复张已广泛用于临床治疗,但复张效果的评估仍存在较多不确定性。已有多种手段可用于评估肺复张效果和预测复张能力,包括计算机X线断层扫描(CT)、超声、电阻抗层析成像技术(EIT),以及呼吸力学参数。每种方法都各有利弊,CT和EIT能更加准确地反映局部组织变化,但存在转运风险、量化过程复杂等缺点;肺部超声对复张效果的敏感性较高,但准确性不如CT;而各种呼吸力学参数可以用于总体肺功能的评估,但无法监测局部组织的变化。因此,为实现准确有效的肺复张评估,需要综合运用多种评估方法。

Lung recuritment maneuver(RM),serving as an important treatment for acute respiratory distress syndrome(ARDS),is significant for improving oxygenation and reducing mortality.Although RM has been widely applied in clinical practice,the evaluation on effect of RM remains uncertain.There are several methods for monitoring RM effect and evaluating the ability for recruitment,including computed tomography(CT),ultrasound,electrical impedance tomography(EIT),and other respiratory mechanics parameters.All the methods have respective advantages and disadvantages.CT and EIT are able to monitor the changes of regional tissue more accurately,while the risk of transportation exists and complicated quantification process required;ultrasound has a higher sensitivity but lower accuracy on effect of RM;the respiratory mechanic parameters are eligible for reflecting the general function of lung but less satisfactory for monitoring the regional changes.As a consequence,a comprehensive application of several methods is required to achieve an accurate assessment on RM.