围手术期肺功能保护

围手术期肺损伤和如何进行肺功能保护日益受到重视。虽然麻醉、机械通气、手术类型、吸烟等多种因素可诱发肺损伤,但肺损伤的转归各不相同,与手术期间的肺功能保护密切相关。炎症和凋亡是围手术期肺损伤的主要机制,核因子κB的激活是其中的关键环节。目前提倡联合用药、保护性通气策略、术后镇痛等综合性治疗措施。文章就近年来在围手术期肺损伤的发病机制、促发因素、早期评估指标及肺功能保护措施的研究进行综述。

Lung Function Protection During Perioperative Period

Lung injury and how to protect lung function during perioperative period are attracting more attention day by day. Although lung injury can be induced by many factors including anesthesia, me-chanical ventilation, operative type, smoking and so on, the outcomes of these lung injury are different, which have close relationship with lung function protection during operation. Inflammation and apoptosis axe the primary mechanism of lung injury. And NF-kB activation is the key point. At present, the compre-hensive therapies axe advocated including combined medication, lung protective ventilation strategies, post-operative analgesia and so on .This article reviews the study of perioperative lung injury about its pathogenesis, precipitating factors, early evaluative index and lung protective measures.