急性呼吸窘迫综合征肺损伤动态评估技术的研究进展
Advances in Dynamic Assessment Techniques for Lung Injury in Acute Respiratory Distress Syndrome
DOI: 10.12677/acm.2026.1682876, PDF,    科研立项经费支持
作者: 高丽娟, 赵中春, 张永刚*：潍坊市坊子区人民医院呼吸与危重症医学科，山东 潍坊
关键词: 急性呼吸窘迫综合征；肺损伤；动态评估；机械通气；精准治疗；Acute Respiratory Distress Syndrome； Lung Injury； Dynamic Assessment； Mechanical Ventilation； Precision Medicine
摘要: 急性呼吸窘迫综合征(acute respiratory distress syndrome, ARDS)是重症医学中常见的一种疾病，它引起的肺损伤具有明显的异质性和动态变化特点。随着病情的发展以及各种治疗方法的影响下，肺可复张性、肺水肿程度和通气分布都发生了改变，所以对肺损伤情况进行正确的判断就成为调节机械通气、控制液体输入量并提高患者生存率的前提条件。传统的氧合指数、胸片、呼吸力学参数可以反映出整个肺的功能情况，但是不能够很好地体现出来肺损伤的不同部位以及变化的过程，并且不能够满足现在精确治疗的要求。近年来，肺部超声、电阻抗断层成像、定量肺CT、功能磁共振成像以及肺损伤相关的生物标志物等各种技术不断发展，使得ARDS肺损伤诊断从静态指标向动态、多层次检测转变，从而给个体化的治疗提供了更多的依据。本文主要对ARDS肺损伤动态评估的新技术及其临床应用进展进行综述，以期为ARDS精准诊疗提供参考。
Abstract: Acute respiratory distress syndrome (ARDS) is a common condition in critical care medicine, characterized by marked heterogeneity and dynamic progression of lung injury. As the disease evolves and various therapeutic interventions are implemented, lung recruitability, the degree of pulmonary edema, and regional ventilation distribution continuously change. Therefore, accurate assessment of lung injury is a prerequisite for optimizing mechanical ventilation, guiding fluid management, and improving patient survival. Conventional assessment tools, including the oxygenation index, chest radiography, and respiratory mechanics, reflect global lung function but fail to adequately characterize regional lung injury and its dynamic changes, limiting their ability to meet the demands of precision medicine. In recent years, advances in lung ultrasound, electrical impedance tomography (EIT), quantitative computed tomography (qCT), functional magnetic resonance imaging (fMRI), and lung injury-related biomarkers have shifted the evaluation of ARDS from static measurements to dynamic, multidimensional monitoring, thereby providing a stronger basis for individualized treatment strategies. This review summarizes emerging technologies for the dynamic assessment of lung injury in ARDS and discusses their current clinical applications, with the aim of providing references for precision diagnosis and treatment of ARDS.
文章引用：高丽娟, 赵中春, 张永刚. 急性呼吸窘迫综合征肺损伤动态评估技术的研究进展[J]. 临床医学进展, 2026, 16(8): 1019-1031. https://doi.org/10.12677/acm.2026.1682876

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