肺电阻抗成像技术的临床应用新进展

New Advances in the Clinical Application of Electrical Impedance Tomography of the Lung

摘要: 肺电阻抗成像(Electrical Impedance Tomography, EIT)是一种非侵入、无辐射的床旁实时成像技术，通过在胸壁放置电极并注入微小电流，测量体表电压变化来重建肺内阻抗分布图像，从而反映肺通气和血流灌注等生理病理信息。相较于传统影像学(如X光、CT、MRI等)，EIT具有便携、连续动态监测的独特优势，可在床旁实时提供肺功能信息，弥补了传统影像无法连续床边监测的不足。自20世纪70年代末提出将EIT用于肺通气监测的设想以来，经过数十年的发展，EIT设备不断改进并逐步应用于临床。特别是近五年来，随着EIT设备的普及和便携化，其临床应用场景已从重症监护扩展到慢性疾病管理和健康筛查等领域。本文核心旨在解决三大关键问题：一是系统梳理近五年EIT设备在硬件小型化与软件算法优化方面的核心突破，明确技术进步对临床应用的支撑作用；二是聚焦EIT从重症监护向新生儿/儿科、肺灌注及心血管评估等新兴领域拓展的临床证据链，分析不同场景下技术应用的适配性与价值差异；三是探讨AI融合、可穿戴设备等新技术方向面临的实际瓶颈，为后续研究与临床转化提供明确方向。

Abstract: Electrical Impedance Tomography (EIT) of the lung is a non-invasive and radiation-free bedside real-time imaging technique. By placing electrodes on the chest wall and injecting a tiny current, it measures the changes in surface voltage to reconstruct the impedance distribution image within the lungs, thereby reflecting physiological and pathological information such as pulmonary ventilation and blood perfusion. Compared with traditional imaging techniques (such as X-ray, CT, and MRI), EIT has the unique advantages of portability and continuous dynamic monitoring, providing real-time lung function information at the bedside and making up for the inability of traditional imaging to continuously monitor at the bedside. Since the concept of using EIT for lung ventilation monitoring was proposed in the late 1970s, after decades of development, EIT devices have been continuously improved and gradually applied in clinical practice. Especially in the past five years, with the popularization and portability of EIT devices, their clinical application scenarios have expanded from intensive care to chronic disease management and health screening, among others. The core of this article aims to address three key issues: first, systematically review the core breakthroughs in hardware miniaturization and software algorithm optimization of EIT devices in the past five years, and clarify the supporting role of technological progress in clinical applications; second, focus on the clinical evidence chain of EIT's expansion from intensive care to emerging fields such as neonatology/pediatrics, lung perfusion, and cardiovascular assessment, and analyze the adaptability and value differences of technology application in different scenarios; third, explore the practical bottlenecks faced by new technology directions such as AI integration and wearable devices, and provide clear directions for subsequent research and clinical transformation.