在接受选择性新发性食道切除术的患者中,术后肺部并发症的术内通风风险因素:一项回顾性队列研究
Cédric Cirenei1, Raphaëlle Lefebvre2, Damien Rousseleau3
1CHU Lille, Department of Anesthesiology, Critical Care and Perioperative medicine, F-59000, Lille, France; Univ. Lille, CHU Lille, ULR 2694 - METRICS: Evaluation des Technologies de santé et des Pratiques médicales, F-59000, Lille, France.
Anaesthesia, critical care & pain medicine
|February 19, 2026
概括
消化管切除术后的术后肺部并发症 (PPC) 与特定的呼吸设置有关. 在单肺和双肺通风期间的平原压力,驱动压力和呼吸率是影响PPC风险的关键因素.
科学领域:
- 麻醉学 麻醉学
- 胸部外科手术 胸部外科手术
- 关键护理医学 关键护理医学
背景情况:
- 手术后的肺部并发症 (PPC) 是食管切除术后的重大风险.
- 识别与PPC相关的手术内因素对于患者的治疗结果至关重要.
研究的目的:
- 在单肺通风 (OLV) 和双肺通风 (TLV) 期间确定与PPC相关的手术内通风参数.
- 建立基于通风策略的PPC预测模型.
主要方法:
- 对454名接受选择性食道切除术的患者进行了回顾性队列研究.
- 多变量后勤回归分析,以确定OLV和TLV阶段的PPC预测因素.
- 分析了包括平原压力,驱动压力,呼吸率,潮体积,PEEP和机械功率在内的通风参数.
主要成果:
- 在42.7%的患者中发生PPC.
- 平原压力 (Pplat) 和驱动压力 (DP) 在OLV和TLV中独立与PPC相关.
- 呼吸速率 (RR) 也与PPC相关. 在TLV中,通风持续时间增加了PPC风险,而PEEP是保护性的. 在OLV中,较高的潮体积 (VTe) 和机械功率 (MP) 与PPC相关.
结论:
- 在OLV和TLV期间,Pplat,RR和DP始终与PPC相关.
- 通风持续时间和PEEP对TLV和OLV期间的PPC风险有不同的影响.
- 在OLV期间需要注意VTe和MP等特定参数,以减轻PPC风险.
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