压力控制容量保证通气联合手法肺复张对妇科腹腔镜手术患者肺功能的相关研究进展
Research Progress on the Effects of Pressure-Controlled Ventilation-Volume Guaranteed Combined with Recruitment Maneuvers on Pulmonary Function in Patients Undergoing Gynecologic Laparoscopic Surgery
摘要: 妇科腹腔镜手术中气腹与头低脚高位(Trendelenburg体位)易导致肺不张和呼吸力学恶化，影响患者肺功能及术后恢复。压力控制容量保证通气(PCV-VG)和手法肺复张(RM)作为潜在的肺保护策略，其联合应用的价值日益受到关注。本文综述了PCV-VG与RM的作用机制、在妇科腹腔镜手术中对肺功能的影响(如氧合改善、肺复张效果、并发症减少)、当前存在的争议与问题(如临床效果差异、RM获益不确定性、个体化PEEP设定挑战)，以及未来的研究方向(如个体化策略优化、生理机制深入、长期结局评估)。
Abstract: Pneumoperitoneum and the Trendelenburg position during gynecologic laparoscopic surgery predispose patients to atelectasis and deterioration of respiratory mechanics, adversely affecting pulmonary function and postoperative recovery. As potential lung-protective strategies, pressure-controlled ventilation-volume guaranteed (PCV-VG) and recruitment maneuvers (RM) have garnered increasing attention for their combined application. This review synthesizes current knowledge on the mechanisms of PCV-VG and RM, their impacts on pulmonary function in gynecologic laparoscopic surgery (e.g., improved oxygenation, enhanced lung recruitment, reduced complications), existing controversies and challenges (e.g., inconsistent clinical efficacy, uncertain benefits of RM, difficulties in individualized PEEP titration), and future research directions (e.g., optimization of personalized strategies, in-depth physiological mechanisms, long-term outcome evaluation).
文章引用：焦鑫鑫, 宋凯阳, 郭润, 白延斌. 压力控制容量保证通气联合手法肺复张对妇科腹腔镜手术患者肺功能的相关研究进展[J]. 临床医学进展, 2025, 15(9): 1469-1476. https://doi.org/10.12677/acm.2025.1592646

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