呼吸或不呼吸:高风险COPD患者胸部手术期间自发通风-可行性研究
Matyas Szarvas1, Csongor Fabo1, Gabor Demeter1
1Department of Anesthesiology and Intensive Therapy, University of Szeged, H-6720 Szeged, Hungary.
Journal of clinical medicine
|November 27, 2025
概括
在COPD和非COPD患者中,自发通风与输管 (SVI) 对于VATS叶切除术是安全的. 慢性肺炎患者可以耐受更长的自发呼吸时间,没有任何不良事件,这表明SVI是一种肺部保护的替代方案.
科学领域:
- 胸部外科手术 胸部外科手术
- 麻醉学 麻醉学
- 肺部病理学 肺部病理学
背景情况:
- 在视频辅助胸腔镜手术 (VATS) 期间,自发通风与输管 (SVI) 提供自发呼吸和呼吸道安全的好处.
- 在患有慢性阻塞性肺病 (COPD) 的患者中使用SVI是有争议的,因为人们对高头和低氧症的担忧.
- 没有先前的研究直接比较了COPD和非COPD患者在SVI下接受VATS脑膜切除术的标准化方案.
研究的目的:
- 为了比较在COPD患者和非COPD患者的VATS叶切除术期间SVI的可行性和安全性.
- 评估手术内呼吸道和血液动力学参数,以及两组手术后的结果.
主要方法:
- 对36名患者进行前性观察性研究,这些患者接受了SVI的VATS叶切除术.
- 根据GOLD标准将患者分为COPD (n=17) 和非COPD (n=19) 组.
- 记录了动脉血液气体,呼吸系统参数,血液动力学和自发通风指标;分析了手术后的结果.
主要成果:
- 所有36个程序在SVI下成功完成,没有转换.
- 慢性肺炎患者保持自发通风时间显著长 (82分钟与58分钟相比),耐受性良好.
- 两组之间血液动力学稳定性,氧和度,ICU停留时间或并发症率没有显著差异.
结论:
- 在COPD和非COPD患者中,SVI是可行的和安全的VATS叶切除术.
- 在SVI期间,COPD患者可以在没有显著不良影响的情况下维持更长时间的自发呼吸.
- SVI可以作为肺部保护策略,特别是在适应过度头症的COPD患者中.
相关概念视频
Assessment of Ventilation I: Respiratory Rate
1.9K
Assessment of Ventilation
A Ventilation assessment is critical for monitoring a patient's health status. Respiration, one of the most accessible vital signs, provides insights into the function of numerous body systems and can indicate serious health issues, such as brainstem injuries from head trauma.
Critical Guidelines for Assessing Ventilation:
A Ventilation assessment is critical for monitoring a patient's health status. Respiration, one of the most accessible vital signs, provides insights into the function of numerous body systems and can indicate serious health issues, such as brainstem injuries from head trauma.
Critical Guidelines for Assessing Ventilation:
1.9K
Factors Affecting Pulmonary Ventilation
2.8K
Besides the pressure difference between the external environment and the lungs, the airflow rate and ease of pulmonary ventilation are also influenced by three other factors: surface tension of the fluid in the alveoli, compliance of the lungs, and airway resistance.
Alveolar Surface Tension
The alveolar fluid lines the luminal surface of the alveoli and exerts a force called surface tension. This force is caused by the polar water molecules in the liquid being more strongly attracted to each...
Alveolar Surface Tension
The alveolar fluid lines the luminal surface of the alveoli and exerts a force called surface tension. This force is caused by the polar water molecules in the liquid being more strongly attracted to each...
2.8K
Mechanical Ventilation II: Invasive Ventilation
598
Ventilators are essential medical equipment used to aid patients with respiratory difficulties. Their primary function is to assist or replace spontaneous breathing by providing mechanical ventilation. There are two general classes of mechanical ventilators: negative-pressure and positive-pressure ventilators.
Negative-Pressure Ventilators
Negative-pressure ventilators create a vacuum around the chest or body to draw air into the lungs, simulating breathing. This method does not require an...
Negative-Pressure Ventilators
Negative-pressure ventilators create a vacuum around the chest or body to draw air into the lungs, simulating breathing. This method does not require an...
598
Mechanical Ventilation III: Noninvasive Ventilation
488
Noninvasive positive-pressure ventilation (NIPPV), continuous positive airway pressure (CPAP), and bilevel positive airway pressure (BiPAP) are essential methods in respiratory care. These ventilation techniques offer unique benefits for patients with various respiratory conditions, providing adequate support without requiring intubation. Let's explore how each method is crucial in improving patient outcomes and enhancing respiratory therapy.
Noninvasive Positive-Pressure Ventilation...
Noninvasive Positive-Pressure Ventilation...
488
Cardiopulmonary Resuscitation II: ACLS Airway Management
502
Airway management is a key skill in emergency and critical care settings, as maintaining a clear airway is essential for adequate oxygenation and ventilation.Head Tilt-Chin Lift TechniqueThe head tilt-chin lift maneuver is an essential technique primarily used in patients without suspected cervical spine injuries. To perform this maneuver, one hand is placed on the patient’s forehead, and gentle pressure is applied backward to tilt the head. The fingertips of the other hand are positioned...
502
Mechanical Ventilation I: Indication and Settings
2.5K
Mechanical ventilation is a life-saving technique for managing acute respiratory failure and other respiratory complications. The process involves using a machine known as a ventilator to supply oxygen to the lungs and assist in removing carbon dioxide. It serves as a bridge to long-term mechanical ventilation or a temporary measure until ventilatory support is discontinued. The ventilator can maintain this function for a prolonged period, providing critical support for patients until they can...
2.5K


