慢性阻塞性肺疾病患者围术期的呼吸和呼吸道管理

慢性阻塞性肺疾病是日渐流行、危害俱增的常见慢性疾病之一,此类患者围术期的呼吸和气道管理也备受重视。术前要做好充分的药物治疗、呼吸训练等准备工作、测定肺功能、评估呼吸和气道的困难程度;选择合适的麻醉方式和麻醉药物,加强对呼吸和循环的监测;术后要注意CO2蓄积、低氧血症、肺部感染、支气管痉挛、呼吸衰竭等并发症,根据患者具体病情,可选择常规治疗,机械通气等不同方法,严格掌握拔管指征。

Management of Breath and Airway of COPD Patients During Perioperative Stage

Chronic obstructive pulmonary disease, one of the common chronic diseases, is more prevalent and more harmful. More importance is attached to the perioperative management in respiration and airway. The preoperative management includes medication, respiratory training, the lung function testing, the evalua- tion of degrees of difficulty in airway, and so on. The anesthetists should choose the appropriate method of an- esthetic technique,and then focus on the monitoring on circulation and respiration. Attentions should be paid to the postoperative complication following surgery such as hypercapnia, hypoxemia, pneumonia, bronchos- pasta, respiratory failure. According to the individual condition, the anesthetists can select routine therapy or mechanical ventilation and must abide by the indication for extubation strictly.