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俯卧位手术肺保护性通气策略应用
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Abstract:
机械通气是临床上全身麻醉和危重患者保持气道通畅，改善通气和氧合的重要手段，但也可能由于呼吸参数使用不当导致呼吸机相关性肺损伤(ventilator-induced lung injury, VILI)。俯卧位手术机械通气时，为维持通气，气道压力有不同程度的升高，引起肺损伤的可能性随之增加。目前VILI的防治重点仍以肺保护性通气策略为主。现就全身麻醉下俯卧位手术对患者循环呼吸系统的影响以及相关肺保护性通气策略的应用研究进展作一综述。
Mechanical ventilation is an important means to keep airway unobstructed and improve ventilation and oxygenation in clinical general anesthesia and critical patients. However, improper use of res-piratory parameters may also lead to ventilator-induced lung injury (VILI). During mechanical ven-tilation in prone position surgery, in order to maintain ventilation, the airway pressure increases in varying degrees, which increases the possibility of lung injury. At present, the prevention and treatment of VILI is still focused on lung protective ventilation strategy. This article reviews the ef-fects of prone hand on patients’ circulatory and respiratory systems under general anesthesia and the application of relevant lung protective ventilation strategies.
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