开胸术后急性肺损伤研究进展

摘要

开胸术后急性肺损伤是围手术期死亡的主要原因之一,是涉及炎症反应的复杂病理生理过程,其特征是非心源性的低氧血症,影像学表现为肺部的急性渗出.术后急性肺损伤的治疗核心是对症支持,预防依然是目前急性肺损伤诊治的最有效策略.本文对开胸术后急性肺损伤的诊断、发病机制、危险因素、治疗进行综述,并对围手术期的预防策略进展进行讨论和总结.%Acute lung injury after thoracic surgery is the main cause of perioperative death.Acute lung injury is a complex pathophysiological process involving inflammation,characterized by non cardiogenic hypoxemia and acute exudation of the lungs in imaging.Intraoperative ventilation strategy is the most important factor of postoperative acute lung injury.The core of treatment for postoperative acute lung injury is symptomatic support,and prevention is still the most effective strategy for the management of acute lung injury.In this review,the diagnosis,pathogenesis,risk factors and treatment of post-thoracic acute lung injury are introduced,and the progress of prevention strategy and treatment are discussed and summarized.