肺复张策略在腹腔镜手术中的应用

Application of Lung Recruitment Strategy in Laparoscopic Surgery

摘要: 相关研究表明，全麻手术后患者出现围术期肺不张的概率可高达90%以上，肺不张的发生可对病人产生一系列的严重后果，导致肺部并发症的发生、住院时间的增加及死亡率的增加。腹腔镜技术因其创伤小、愈合快，在临床上广泛开展，但其也存在一定的缺点，术中体位的改变及气腹的建立，均可引起并加重围术期肺不张的发生，从而增加患者肺部不良事件的发生率。肺复张作为肺保护性通气策略的一部分，越来越多的被应用于腹腔镜手术中，本文通过查阅大量文献，就肺复张在腹腔镜手术中的应用进行总结，目的是为临床腹腔镜手术患者围术期如何选用更合适的肺复张策略提供一定的理论依据。

Abstract: Relevant research shows that the probability of perioperative atelectasis in patients after general anesthesia surgery can be as high as 90%, and the occurrence of atelectasis can have a series of se-rious consequences for patients, leading to the occurrence of pulmonary complications, the increase of hospitalization time and the increase of mortality. Laparoscopic technique is widely used in clinic because of its small trauma and quick healing, but it also has some shortcomings. The change of in-traoperative posture and the establishment of pneumoperitoneum can cause and aggravate the occurrence of perioperative atelectasis, thus increasing the incidence of pulmonary adverse events in patients. As a part of lung protective ventilation strategy, lung recruitment is more and more used in laparoscopic surgery. This paper summarizes the application of lung recruitment in laparo-scopic surgery by consulting a large number of literatures, in order to provide some theoretical ba-sis for clinical laparoscopic surgery patients to choose a more suitable lung recruitment strategy during perioperative period.