国际麻醉学与复苏杂志
國際痳醉學與複囌雜誌
국제마취학여복소잡지
INTERNATIONAL JOURNAL OF ANESTHESIOLOGY AND RESUSCITATION
2013年
4期
348-351
,共4页
单肺通气%急性肺损伤%炎症
單肺通氣%急性肺損傷%炎癥
단폐통기%급성폐손상%염증
One-lung ventilation%Acute lung injury%Inflammation
背景 单肺通气(one-lung ventilation,OLV)是现代胸外科手术麻醉中常用的呼吸管理方法,然而这种非生理性的通气方式会引起急性肺损伤(acute lung injury,ALI). 目的 分析总结OLV期间肺损伤的机制及最新研究进展. 内容 主要机制包括4方面:肺气压伤、肺容积伤、肺不张伤以及缺血/缺氧性损伤.以上因素促使肺组织分泌细胞因子、释放炎性介质,引发肺部炎症,造成生物伤. 趋向 细胞力学、分子生物学、信号转导机制的研究可望更深入地阐明OLV致ALI的机制,为临床麻醉实施肺保护提供思路和途径.
揹景 單肺通氣(one-lung ventilation,OLV)是現代胸外科手術痳醉中常用的呼吸管理方法,然而這種非生理性的通氣方式會引起急性肺損傷(acute lung injury,ALI). 目的 分析總結OLV期間肺損傷的機製及最新研究進展. 內容 主要機製包括4方麵:肺氣壓傷、肺容積傷、肺不張傷以及缺血/缺氧性損傷.以上因素促使肺組織分泌細胞因子、釋放炎性介質,引髮肺部炎癥,造成生物傷. 趨嚮 細胞力學、分子生物學、信號轉導機製的研究可望更深入地闡明OLV緻ALI的機製,為臨床痳醉實施肺保護提供思路和途徑.
배경 단폐통기(one-lung ventilation,OLV)시현대흉외과수술마취중상용적호흡관리방법,연이저충비생이성적통기방식회인기급성폐손상(acute lung injury,ALI). 목적 분석총결OLV기간폐손상적궤제급최신연구진전. 내용 주요궤제포괄4방면:폐기압상、폐용적상、폐불장상이급결혈/결양성손상.이상인소촉사폐조직분비세포인자、석방염성개질,인발폐부염증,조성생물상. 추향 세포역학、분자생물학、신호전도궤제적연구가망경심입지천명OLV치ALI적궤제,위림상마취실시폐보호제공사로화도경.
Background One-lung ventilation (OLV) is a quite special ventilation way in the anesthesiology,offering the convenience for the thoracic surgery,meanwhile it also causes acute lung injury (ALI).Objective This review updates recent researches on the mechanisms of lung injury caused by OLV.Content The mechanisms of lung injury by OLV include four hands:barotrauma、volutrauma、atelectrauma and hypoxia injury associated with reperfusion.These factors result in biotrauma which induced by cytokines and inflammatory mediators.Trend The undergoing mechanisms of lung injury during OLV still need to be studied deeply and explored continuously,and it has great significance for performing the protection strategy.
