成人体外循环心脏手术的肺保护策略.pdfVIP

2025628233ChinJECCVo1.23No.3Jun28,2025275

中国体外循环杂志年月日第卷第期

·综  述·DOI:10.13498/ki.chin.j.ecc.2025.03.16

成人体外循环心脏手术的肺保护策略

王 艺，侯丽宏

[摘要]：肺部并发症在心脏手术术后很常见，其临床表现多样，发生机制复杂，与炎症和氧化应激密切相关。本文

综述了成人体外循环心脏手术的肺保护策略，包括手术和体外循环技术的创新、围术期管理优化（肺保护性通气策略、麻

醉药物选择、血糖调控和血制品合理输注）、药物干预和呼吸肌锻炼等。深入理解现有治疗方法及其组合，有助于为不同

患者群体制定个体化的治疗策略，从而最大限度地争取患者的获益，并降低医疗负担。

[关键词]：心脏手术；体外循环；肺部并发症；围术期管理；药物治疗；机械通气

Strategiesforlungprotectioninadultpatientsundergoingcardiacsurgery

withcardiopulmonarybypass

WangYi,HouLihong

DepartmentofAnesthesiologyandPerioperativeMedicine,theFirstAffiliatedHospitalofAirForceMedical

University,ShaanxiXi’an710032,China

Correspondingauthor:HouLihong,Email:909723907@

[Abstract]:Postoperativepulmonarycomplications(PPCs)areprevalentfollowingadultcardiacsurgerywith

cardiopulmonarybypass,presentingwithdiverseclinicalmanifestationsandcomplexmechanismsthatarecloselylinkedto

inflammationandoxidativestress.Thisarticlereviewslungprotectionstrategiesinadultcardiacsurgerywithcardiopulmonary

bypass,encompassinginnovationsinsurgicalandbypasstechniques,optimizationofperioperativemanagement—suchaslung-

protectiveventilationstrategies,selectionofanestheticdrugs,bloodglucoseregulation,andrationaltransfusionofbloodproducts-

aswellaspharmacologicalinterventionsandrespiratorymuscletraining.Acomprehensiveunderstandingofexistingtreatment

methodsandtheircombinationscanhelptoformulateindividualizedtreatmentstrategiesforvariouspatientpopulations,thereby

maximizingpatientbenefitsandalleviatingthemedicalburden.

[Keywords]:Cardiacsurgery;Cardiopulmonarybypass;Pulmonarycomplications;Perioperativemanageme