肺部手术患者围手术期咳嗽的研究进展

Research progress on perioperative cough in patients undergoing lung surgery

咳嗽是肺部手术患者常见症状及围手术期常见并发症之一,其对患者术后的恢复过程及生活质量往往会产生很大影响。早期识别肺部手术患者围手术期咳嗽的危险因素并加以管理是有效干预策略的基础。目前国内外已有很多临床及基础研究试图提出对于围手术期患者咳嗽的系统性管理方案,但成效不佳。本文通过检索近年来肺部手术围手术期咳嗽症状的相关文献报道,发现女性、右侧肺癌、困难气道、急性咳嗽、慢性阻塞性肺疾病病史、纵隔淋巴结清扫、支气管残端长度、麻醉、术后胸腔积液及支气管扭结均与肺部手术围手术期咳嗽相关,且转化受体电位阳离子通道亚家族V成员1通路可能是其潜在的分子机制。对于肺部手术围手术期咳嗽的管理包括药物治疗、淋巴结残腔填补、术中神经监测、支气管假体置入、针灸、术后呼吸锻炼等。这些发现可为临床早期识别肺部手术围手术期咳嗽的高危患者及咳嗽症状的预防和管理提供参考,并为进一步研究提供方向。

Cough is one of the common symptoms and complications of patients undergoing lung surgery,which often has a great impact on the recovery process and quality of life of patients after surgery.Early identification and management of the risk factors of perioperative cough in patients undergoing lung surgery are the basis of effective intervention strategies.At present,many clinical and basic studies at home and abroad have tried to put forward a systematic management plan for patients with cough during perioperative period,but the results are not satisfactory.Through searching the relevant literature reports of cough symptoms during the perioperative period of lung surgery in recent years,this article found that women,right lung cancer,difficult airway,acute cough,history of chronic obstructive pulmonary disease,mediastinal lymph node dissection,length of bronchial stump,anesthesia,postoperative pleural effusion,and bronchial kink are all related to the perioperative cough of lung surgery,and the conversion receptor potential cation channel subfamily V member 1 pathway may be its potential molecular mechanism.The management of perioperative cough during lung surgery includes drug treatment,lymph node residual cavity filling,intraoperative nerve monitoring,bronchial prosthesis placement,acupuncture,postoperative respiratory exercise,etc.These findings can provide reference for clinical early identification of high-risk patients with cough during the perioperative period of lung surgery,as well as the prevention and management of cough symptoms,and provide direction for further research.