Kremer M J
Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois, USA.
AANA J. 1998 Oct;66(5):467-80.
Postoperative pulmonary complications most often involve atelectasis followed by pneumonia and arterial hypoxemia. The severity of these complications is related to the decreases that occur in vital capacity and functional residual capacity. Astute anesthetists can prospectively identify patients and surgical procedures likely to be associated with pulmonary complications. Upper abdominal surgery carries a 30% to 40% pulmonary complication rate. Vertical laparotomies and lateral thoracotomies are associated with pulmonary risk, as are patients who are obese, emphysemic, asthmatic, or have cardiac disease. Optimal use of clinical data coupled with selective application of diagnostic tests, such as arterial blood gases and pulmonary function tests, help in the development of an appropriate anesthetic management plan that minimizes pulmonary risk, especially in patients with known pulmonary risk factors.
术后肺部并发症最常见的是肺不张，其次是肺炎和动脉低氧血症。这些并发症的严重程度与肺活量和功能残气量的降低有关。敏锐的麻醉医生可以前瞻性地识别可能与肺部并发症相关的患者和手术。上腹部手术的肺部并发症发生率为30%至40%。垂直剖腹术和侧开胸术与肺部风险相关，肥胖、肺气肿、哮喘或患有心脏病的患者也是如此。最佳利用临床数据并选择性应用诊断测试，如动脉血气分析和肺功能测试，有助于制定适当的麻醉管理计划，将肺部风险降至最低，尤其是对于已知有肺部风险因素的患者。
