CAJ | 학술논문

背景机械通气致肺损伤(ventilator induced lung injury,VILI)的机制研究众多,传统认为生物学损伤为主要机制,机械性损伤为触发因素.VILI的致死因素之一就是肺水肿的发生发展或以全身炎症反应综合征及多器官功能衰竭而终结. 目的探讨肺水肿发生的机械损伤机制及其干预措施. 内容现就生物学损伤及机械性损伤致VILI肺水肿的发生机制的最新研究作一综述,以期预防肺水肿的发生,为临床麻醉及重症监护过程中VILI致肺水肿的发生奠定理论基础. 趋向机械性损伤触发肺水肿的发生,做为机械通气诱发肺损伤的特殊感受器,研究综述了机械力直接损伤、瞬时感受电位(transient receptor potential,TRP)超家族介导机械刺激诱发神经源性炎症反应(neurogenic inflammation,NI)在肺水肿的发生中所起的闸门作用,阻断早期肺损伤的诱发因素对于围术期肺保护具有重要意义.
배경 궤계통기치폐손상(ventilator induced lung injury,VILI)적궤제연구음다,전통인위생물학손상위주요궤제,궤계성손상위촉발인소.VILI적치사인소지일취시폐수종적발생발전혹이전신염증반응종합정급다기관공능쇠갈이종결. 목적 탐토폐수종발생적궤계손상궤제급기간예조시. 내용 현취생물학손상급궤계성손상치VILI폐수종적발생궤제적최신연구작일종술,이기예방폐수종적발생,위림상마취급중증감호과정중VILI치폐수종적발생전정이론기출. 추향 궤계성손상촉발폐수종적발생,주위궤계통기유발폐손상적특수감수기,연구종술료궤계력직접손상、순시감수전위(transient receptor potential,TRP)초가족개도궤계자격유발신경원성염증반응(neurogenic inflammation,NI)재폐수종적발생중소기적갑문작용,조단조기폐손상적유발인소대우위술기폐보호구유중요의의.
Background Mechanisms of lung injury induced by mechanical ventilation are multiple.Biological damage is a key cause in ventilator induced lung injury (VILI).One of the lethal factor in the development of lung injury induced by mechanical ventilation is the vulnerant pulmonary edema,and usually ends on systemic inflammatory response syndrome and multiple organ failure.Objective To explore the mechanism of pulmonary edema and its interventions.Content This article reviews the latest research on the mechanism of VILI caused by biological damage and mechanical damage in order to prevent the occurrence of pulmonary edema,and establish theoretical basis for pulmonary edema induced by VILI during clinical anesthesia and intensive care units stay.Trend As a special receptors of lung injury induced by mechanical ventilation,mechanical damage trigger the occurrence of pulmonary edema.The study reviewed the mechanisim of transient receptor potential (TRP) superfamily in early lung edema,which take an important role in the perioperative lung preservation.