胸外科手术患者急性肺损伤的发生及预防研究进展

胸外科手术患者发生急性肺损伤的原因是多方面的，其中与机械通气相关的占很大比例，另外尚有输血相关性急性肺损伤、手术创伤等等。机械通气的目的是指通过使肺泡的反复扩张一萎陷来达到机体足够氧合的目的，但同时又要避免肺泡过度扩张，从而带来最大限度地减少肺损伤。保护性通气并不是简单低潮气量通气的代名词，尚包括呼气末正压（PEEP）、低氧浓度（FIO2）、低的气道压力等等；而输血又作为一种引起急性肺损伤的独立危险因素而存在。

The occurrence and prevention advances of lung injury in patients receiving thoracic surgery

There are numerous causes that result in acute lung injury in patients with thoracic surgeries, mechanical ventilation is one of the main significant causes for these patients. In addition transfusion-related acute lung injury, surgical trauma and many other matters also have strong relation with this disease. The goal of ventilation is to mini- mize lung trauma by avoiding overdistension and repetitive alveolar collapse, while providing adequate oxygenation. Protective ventilation is not simply synonymous of low tidal volume ventilation, but it also involves positive end-expi- ratory pressure, lower FiO2, recruitment maneuvers, and lower ventilatory pressures. Furthermore transfusion is a inde- pendent of acute lung iniury.