术后肺部并发症围手术期风险因素及防治策略

Research progress on perioperative risk factors and prevention and treatment strategies of postoperative pulmonary complications

术后肺部并发症(postoperative pulmonary complications,PPCs)发生率高,增加医疗费用,并且增加患者围手术期的死亡率,是影响外科患者术后康复和预后的重要因素。全身麻醉诱导后,呼吸动力和肌肉功能改变,肺容量减少,使用肌肉松弛药的患者更易出现肺不张。在全身麻醉下行大手术的患者,呼吸系统可能需要6周时间才能恢复到术前状态。虽然PPCs的防治取得了很大进展,但目前诸多诊断、防治措施等仍存在争议。本文对患者围手术期易发生PPCs的危险因素以及防治策略的研究现状等进行概述,为临床医生更好地了解术后肺部并发症的防治措施提供依据。

Postoperative pulmonary complications(PPCs)occur commonly,which affect the recovery and prognosis of surgical patients;and increases medical costs and perioperative mortality of patients.In patients undergoing major surgeries the respiratory dynamics and muscle function are degraded,and lung capacity is decreased following induction of general anesthesia;additionally,patients receiving neuromuscular agents are more likely to develop atelectasis;and the respiratory system may take 6 weeks to return to its preoperative state.Although much progress has been made in PPCs prevention and treatment,there are still many controversies about diagnosis and prevention measures.This article reviews the risk factors of PPCs and the research progress of management strategies,so that to provide information for clinical prevention and treatment of PPCs.