摘要背景 机械通气保障全身麻醉手术患者的呼吸和气体交换,但也可能诱发机械通气相关性肺损伤(ventilation induced-lung injury,VILI).随着对VILI发病机制的不断探索,能在一定程度上减轻VILI损伤程度的肺保护性通气策略的研究也越来越深入.目的 就全身麻醉期间肺保护通气策略的研究进展予以综述.内容 综述肺保护机械通气策略、低潮气量通气、复合适当呼气末正压通气(positive end expiratory pressure,PEEP)、肺复张策略(recruiting maneuvers,RM)、控制平台压及FiO2等相关进展与争议.趋向 肺保护性机械通气相关研究已取得一定进展,在全身麻醉过程中采取适当的、个体化的通气策略有待进一步研究.

abstractsBackground Mechanical ventilation provides an effective means to assist breathing and gas exchange during general anesthesia.It is noteworthy that mechanical ventilation sometimes could induce or exacerbate lung injury (ventilation inducedlung injury,VILI).Increasing number of investigations were conducted to advance our understanding of the causes of VILI,and revealed that protective lung ventilation might reduce the severity of VILI.Objective To review new progress of lung protective ventilation strategies during general anesthesia.Content This article reviews some theories and pros and cons about lung protective ventilation strategies,low tidal volume;proper positive end expiratory pressure (PEEP),recruiting maneuvers (RM),control of plateau pressure and FiO2.Trend Although integrated research of various lung protective ventilation strategies have achieved remarkable progress,individualized lung protective strategies need further investigations to improve the quality of anesthesia.