1.1 肺癌合并慢性阻塞性肺疾病患者围手术期气道管理现状_车国卫.docVIP

·884· 中国肺癌杂志2 0 1 4 年1 2 月第1 7 卷第1 2 期 Chin J Lung Cancer, December 2014, Vol.17, No.12 DOI: 10.3779/j.issn.1009-3419.2014.12.11 · 综 述 · 肺癌合并慢性阻塞性肺疾病患者 围手术期气道管理现状 车国卫 支修益 【摘要】 肺癌患者均合并不同程度的慢性阻塞性肺疾病（chronic obstructive pulmonary disease, COPD），而 COPD导致的肺功能降低对其能否手术治疗及术后并发症发生具有重要的影响。研究证明围手术期气道管理可以有 效改善患者肺功能且减少术后并发症。本文针对近年来气道管理的临床应用现状及进展进行综述，主要有以下几方 面：①围手术期气道管理的必要性；②围手术期气道管理的药物治疗现状与特点；③围手术期应用气道管理在改善 肺功能中的价值；④围手术期需要气道管理的最佳人群；⑤围手术期气道管理应用存在的问题。 【关键词】 围手术期气道管理；慢性阻塞性肺疾病；肺肿瘤 Status of Perioperative Airway Management in Patients with Chronic Obstructive Pulmonary Disease and Lung Cancer Guowei CHE1, Xiuyi ZHI2 1Department of oracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China; 2Department of oracic Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China Corresponding author: Guowei CHE, E-mail: guowei_che@ 【Abstract】 The close association between chronic obstructive pulmonary disease (COPD) and lung cancer has long been known. New evidence suggests that there is an inverse relationship between the severity of pulmonary function and the risk of surgery in patients with lung cancer, COPD may play a key role in the incidence of postoperative pulmonary com- plications (PPC) and improving pulmonary function with perioperation airway management has been suggested as a possible preventive PPC. is review describes the current understanding and clinical application of perioperation airway management in lung cancer patients with COPD. We summarized that: (1) e necessity of perioperation airway management; (2) e status and characteristic of inhaled drug in perioperation airway management; (3) e clinical value in improving pulmonary function of perioperation airway management; (4) e optimum population of peri-operation airway management; (5) e problem of perioperation airway management. 【Key words】 Perioperation airway management; Chronic obstructive pulmonary disease; Lung neoplasms 肺癌的主要治疗手段仍是外科手术治疗，而患者 手术机会[3,4]。围手术期气道管理目前主要集中在雾化