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中华肥胖与代谢病电子杂志 ›› 2023, Vol. 09 ›› Issue (04) : 286 -292. doi: 10.3877/cma.j.issn.2095-9605.2023.04.010

综述

肥胖患者术后肺不张的研究进展
王嘉瑞1, 代领傲1, 王晟2,()   
  1. 1. 510630 广州,暨南大学附属第一医院麻醉科
    2. 510630 广州,暨南大学附属第一医院麻醉科;100029 北京,首都医科大学附属北京安贞医院麻醉科
  • 收稿日期:2023-09-20 出版日期:2023-11-30
  • 通信作者: 王晟

Research advances on postoperative atelectasis in patients with obesity

Jiarui Wang1, Lingao Dai1, Shen Wang2,()   

  1. 1. Department of Anesthesiology, The First Affiliated Hospital of Jinan University, Guangzhou 510630, China
    2. Department of Anesthesiology, The First Affiliated Hospital of Jinan University, Guangzhou 510630, China; Department of Anesthesiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
  • Received:2023-09-20 Published:2023-11-30
  • Corresponding author: Shen Wang
引用本文:

王嘉瑞, 代领傲, 王晟. 肥胖患者术后肺不张的研究进展[J]. 中华肥胖与代谢病电子杂志, 2023, 09(04): 286-292.

Jiarui Wang, Lingao Dai, Shen Wang. Research advances on postoperative atelectasis in patients with obesity[J]. Chinese Journal of Obesity and Metabolic Diseases(Electronic Edition), 2023, 09(04): 286-292.

肥胖患者术后肺部并发症(PPCs)的发生率高达18%,其中肺不张是最常见的PPCs,是术中及术后低氧血症的常见原因,也是术后呼吸衰竭和相关死亡的第四大常见原因。大约90%的全麻患者诱导后会发生肺不张,并可能持续至术后数天。肥胖患者因其特殊的病理生理改变使肺不张的持续时间和严重程度进一步增加,导致术后呼吸功能障碍,延缓康复进程。因此认识肺不张的危险因素,及时诊断并实施肺保护性通气策略来预防和治疗术后肺不张对于减少肥胖患者术后肺部并发症尤为重要。本文通过系统阐述肥胖患者的病理生理发生机制及肺不张的诊断、预防及治疗,旨在使临床工作者更加深入了解术后肺不张的发生机制,为临床肥胖患者围手术期肺保护策略提供更多方案,降低肥胖患者术后肺不张的发生率。

The incidence of postoperative pulmonary complications (PPCs) in patients with obesity can arrive at 18%, with atelectasis being the most common PPCs. Atelectasis frequently causes intraoperative and postoperative hypoxemia, and it is the fourth leading cause of postoperative respiratory failure and related mortality. Nearly 90% of patients under general anesthesia experience atelectasis after induction, which can persist for several days postoperatively. The duration and severity of atelectasis are further increased in obese patients due to their unique pathophysiological alterations, leading to postoperative respiratory dysfunction and delayed recovery. Therefore, understanding the risk factors for atelectasis, timely diagnosis, and implementing lung-protective ventilation strategies to prevent and treat postoperative atelectasis is particularly important for reducing PPCs in obese patients. This article systematically explores the pathophysiological mechanisms in obese patients and the diagnosis, prevention, and treatment of atelectasis. It aims to provide clinical practitioners with a deeper understanding of the mechanisms behind postoperative atelectasis, offering more options for perioperative pulmonary protection strategies for obese patients and ultimately reducing the incidence of postoperative atelectasis in this population.

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