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在图像和机器人之下,更深入地研究肺上皮膜:叙述性审查

Guido Mazzinari^1,2,3, Lucas Rovira⁴, Kim I Albers-Warlé^5,6

¹Perioperative Medicine Research Group, Health Research Institute la Fe, Avenida Fernando Abril Martorell 106, 46026 Valencia, Spain.

Journal of clinical medicine

|February 24, 2024

概括

在腹腔镜检查中肺上管管理需要进步. 优化腹腔内压力 (IAP) 和气体状况可以改善患者的治疗结果和手术精度.

科学领域:

最少侵入性的手术
生理学生理学生理学

背景情况:

laparoscopy 在开放式手术上提供了显著的优势.
肺上皮膜灌气技术的创新是有限的.
保持腹腔内静止是患者治疗结果的关键.

研究的目的:

探索肺上皮膜对患者结局的影响.
倡导一种最少的侵入性方法,优先考虑腹膜静止.
讨论优化肺上皮膜,以增强腹腔镜手术.

主要方法:

分析腹腔内压力 (IAP) 和腹腔内体积 (IAV) 之间的非线性关系.
评估神经肌肉阻塞 (NMB) 深度对手术条件的影响.
对吸气气体的温度和湿度控制的评估.

主要成果:

一般建议保持IAP低于10mmHg,但需要考虑患者的位置和手术复杂性.
深度神经肌肉阻塞 (NMB) 有助于手术静止,但与IAP的平衡至关重要.
灌气气体的加湿和加热可以改善腹腔内静止和视觉清晰度.

结论:

肺皮管管理的范式转变是可能的.
动态IAP调整和受控的气体温度/湿度可以保持腹腔内静止.
优化的肺上皮膜可以提高微创手术患者的治疗结果.

关键词:

腹部符合性腹部符合性腹内压力 (IAP) 是指腹内压力.腹腔镜外科手术腹腔镜外科手术微创手术是最少的侵入性手术.神经肌肉阻塞 (NMB) 是一种神经肌肉阻塞.在外科手术期间的温度控制.腹腔内静止的恒常性.气动操作子 (pneumoperitoneum) 是一种气动操作子.

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