Schindler Margrid B
Paediatric Intensive Care Unit, Bristol Royal Hospital for Children, Bristol, UK.
Crit Care. 2005 Aug;9(4):341-2. doi: 10.1186/cc3766. Epub 2005 Jul 7.
Lobar atelectasis is a common problem caused by a variety of mechanisms including resorption atelectasis due to airway obstruction, passive atelectasis from hypoventilation, compressive atelectsis from abdominal distension and adhesive atelectasis due to increased surface tension. However, evidence-based studies on the management of lobar atelectasis are lacking. Examination of air-bronchograms on a chest radiograph may be helpful to determine whether proximal or distal airway obstruction is involved. Chest physiotherapy, nebulised DNase and possibly fibreoptic bronchoscopy might be helpful in patients with mucous plugging of the airways. In passive and adhesive atelectasis, positive end-expiratory pressure might be a useful adjunct to treatment.
肺叶不张是一个常见问题，由多种机制引起，包括气道阻塞导致的吸收性肺不张、通气不足引起的被动性肺不张、腹部膨胀导致的压迫性肺不张以及表面张力增加引起的粘连性肺不张。然而，缺乏关于肺叶不张管理的循证研究。胸部X光片上的空气支气管造影检查可能有助于确定是近端还是远端气道阻塞。胸部物理治疗、雾化脱氧核糖核酸酶以及可能的纤维支气管镜检查对气道黏液阻塞患者可能有帮助。在被动性和粘连性肺不张中，呼气末正压可能是治疗的有用辅助手段。
