手术后的肺部并发症和外科手术期间的策略:系统性审查
João Lusquinhos1, Mafalda Tavares2, Fernando Abelha1,3
1Anesthesiology, Centro Hospitalar Universitário de São João, Porto, PRT.
Cureus
|June 12, 2023
概括
手术后的肺部并发症 (PPC) 可以通过使用特定的通风策略来减少. 保护性肺透气 (PLV) 和持续正气道压力 (CPAP) 与氧气治疗有效降低PPC发生率和机械通风的需要.
科学领域:
- 麻醉学 麻醉学
- 关键护理医学 关键护理医学
- 肺部医学 肺部医学
背景情况:
- 手术后肺部并发症 (PPC) 很常见,导致发病率,死亡率和医疗费用增加.
- 了解干预措施的证据对于优化患者结果至关重要.
研究的目的:
- 系统地审查手术后肺部并发症的随机对照试验 (RCT).
- 确定减少PPC的通风策略,以及需要术后的非侵入性通风 (PNIV) 或用术后机械通风 (POMV) 进行再输管.
主要方法:
- 从PubMed和Cochrane图书馆对RCT进行系统审查,截至2020年11月29日.
- 包括13项涉及6,609名患者的研究;分析了PPC患病率,PNIV,POMV和住院的数据.
- 专注于四个具有统计学意义的结果的RCT.
主要成果:
- 保护性肺透气 (PLV) 带有低潮水体积和正极呼气压 (PEEP),压力控制通风 (PCV) 和持续正气道压力 (CPAP) 带有氧气降低PPC发生率.
- PLV和特定的外科手术机动减少了对PNIV的需求.
- 氧气治疗的CPAP是唯一减少再输管率的干预措施.
结论:
- 特定的手术内和术后通风策略可以显著降低PPCs.
- PLV和CPAP有效地减少了对PNIV和POMV的需求.
- 优化通风策略是改善患者康复和减少医疗负担的关键.
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