电阻抗断层成像技术在肥胖患者麻醉中的 应用进展
Advances in the Application of Electrical Impedance Tomography in Anesthesia for Obese Patients
摘要: 肥胖患者因其呼吸生理的特殊性，成为术后肺部并发症的高危人群。传统的呼吸监测手段难以实时、可视化地评估肺通气的空间异质性。电阻抗断层成像(electrical impedance tomography, EIT)作为一种无创、无辐射的床旁功能成像技术，能够动态地监测肺通气分布，辅助实施个体化肺保护通气策略。本文重点阐述了EIT在术前评估(量化通气基线异质性)、术中管理(核心为基于塌陷/过度膨胀权衡法指导个体化PEEP滴定与肺复张操作)以及术后复苏(评估拔管风险与指导呼吸支持)中的具体应用，同时分析了EIT在技术标准化、临床解读等方面面临的挑战，并展望了其与人工智能、多模态监测融合的未来发展方向。结论认为，EIT是实现肥胖患者麻醉与围术期中精准肺保护性通气管理的新兴技术，具有广阔的临床应用前景。
Abstract: Due to their unique respiratory physiology, obese patients are at high risk for postoperative pulmonary complications. Traditional respiratory monitoring methods struggle to assess the spatial heterogeneity of lung ventilation in real-time and visually. Electrical impedance tomography (EIT), a non-invasive, radiation-free bedside functional imaging technique, enables dynamic monitoring of lung ventilation distribution, assisting in the implementation of individualized lung-protective ventilation strategies. This article focuses on the specific applications of EIT in preoperative assessment (quantifying baseline ventilation heterogeneity), intraoperative management (centered on guiding individualized positive end-expiratory pressure (PEEP) titration and recruitment maneuvers based on the collapse/overdistension trade-off method), and postoperative recovery (assessing extubation risk and guiding respiratory support). It also analyzes the challenges EIT faces in terms of technical standardization and clinical interpretation, and discusses its future development direction involving integration with artificial intelligence and multimodal monitoring. The conclusion is that EIT is an emerging technology for achieving precise, lung-protective ventilation management in the anesthesia and perioperative period for obese patients, with broad prospects for clinical application.
文章引用：彭卓, 王昊. 电阻抗断层成像技术在肥胖患者麻醉中的 应用进展[J]. 临床医学进展, 2026, 16(2): 2303-2311. https://doi.org/10.12677/acm.2026.162632

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