合并呼吸功能不全病人行腔镜手术时应注意的问题

随着腹腔镜技术的发展，腹腔镜微创手术已经成为当前外科的主流术式，越来越多的病人接受微创手术治疗，包括合并呼吸功能不全的病人。而腹腔镜手术时，CO2气腹、腹腔压力、手术体位、肥胖和麻醉方式等因素对病人呼吸功能均产生不良影响，严重时导致呼吸功能衰竭。因此，了解腹腔镜微创手术时上述各因素对病人呼吸功能产生的病理生理变化，是预防术后肺功能衰竭的基础。术前进行病人肺功能的正确评估、术中监测及处理呼吸功能变化，病人体位、麻醉方式的选择和术后镇痛及无创呼吸机的使用是降低术后并发症的重要手段。

Main problems about patients with pulmonary dysfunction during laparoscopic surgery

Because expertise and equipment have improved,laparoscopy has become one of the most common surgical procedures performed on an outpatient basis and to sicker patients,rendering managements of patients for laparoscopy technically difficult and challenging.Some factors impact the outcomes of patients after laparoscopic procedure,including carbon dioxide pneumoperitoneum,abdominal pressure,extremes of patient positioning,morbidly obese and type of anesthesia,even leading to pathophysiological changes of patie...