肺保护性通气策略在非肺脏疾病患者全麻机械通气中的研究进展

Research progress of lung protective ventilation strategy in general anesthesia mechanical ventilation of patients with non-pulmonary diseases

机械通气(Mechanical ventilation,MV)是全麻插管患者必要的生命支持手段,具有不可替代的优势。但不恰当或过度使用MV可能诱发肺部疾病,引起术后肺部并发症(Postoperative pulmonary complications,PPCs)的发生,从而影响患者康复。肺保护性通气策略(Lung protective ventilation strategy,LPVS)是一种能有效减少MV时PPCs的发生率、降低术后死亡率的呼吸支持策略,在临床上被广泛应用。目前关于围术期中各LPVS的具体内容及相互之间的联系尚存争议。本文结合近年来国内外研究文献,从LPVS的肺保护作用机制、LPVS的具体实施方法以及各LPVS之间的联系3个方面进行综述。文献复习结果表明,LPVS能有效降低PPCs,从而提升患者预后水平。随着更多研究的开展,未来将有望进一步深入了解LPVS的肺保护作用机制,通过建立更加统一的指南和标准,医疗机构可以更加准确地实施LPVS,提高患者术后的康复率和生存率。

Mechanical ventilation(MV)is an essential life support measure for patients under general anesthesia with endotracheal intubation,and it possesses irreplaceable advantages.However,inappropriate or excessive use of MV may induce pulmonary diseases and result in the occurrence of postoperative pulmonary complications(PPCs),thereby affecting the recovery of patients.Lung protective ventilation strategy(LPVS)is a respiratory support approach that effectively reduces the incidence of PPCs during MV and reduces postoperative mortality.It is widely applied in clinical practice.Currently,there is controversy regarding the specific content and interconnections among various LPVS during the perioperative period.In this paper,a systematic review was made by integrating recent domestic and international research literature,focusing on three aspects:the mechanisms of lung protection provided by LPVS,the specific implementation methods of LPVS,and the interconnections among different LPVS.The results of the literature review showed that LPVS could effectively reduce PPCs and improve patient prognosis.With further research,it is expected that the mechanisms of lung protection provided by LPVS will be better understood,and by establishing more unified guidelines and standards,healthcare institutions can implement LPVS more accurately and enhance patients'postoperative recovery and survival rates.