Bapoje Srinivas R, Whitaker Julia Feliz, Schulz Tara, Chu Eugene S, Albert Richard K
Department of Medicine, Denver Health Medical Center, 660 Bannock St, MC 4000, Denver, CO 80204, USA.
Chest. 2007 Nov;132(5):1637-45. doi: 10.1378/chest.07-0347.
Preoperative pulmonary evaluation is important in the management of patients with lung disease who are undergoing elective cardiothoracic or noncardiothoracic surgery. In some instances, preoperative pulmonary evaluations may also contribute to the management of patients being considered for urgent surgery. The incidence of postoperative pulmonary complications (PPCs) is high and is associated with substantial morbidity and mortality, and prolonged hospital stays. Perioperative pulmonary complications in patients undergoing elective noncardiothoracic surgery can be more accurately predicted than in patients undergoing elective cardiothoracic surgery. Effective strategies to prevent complications in the postoperative period are few. Incentive spirometry and continuous positive airway pressure are the only modalities of proven benefit. Identifying patients who are at risk for the development of PPCs and managing their underlying modifiable risk factors aggressively prior to surgery is essential.
术前肺部评估对于接受择期心胸手术或非心胸手术的肺部疾病患者的管理至关重要。在某些情况下，术前肺部评估也可能有助于对考虑进行急诊手术的患者进行管理。术后肺部并发症（PPCs）的发生率很高，与严重的发病率、死亡率以及延长的住院时间相关。与接受择期心胸手术的患者相比，接受择期非心胸手术的患者围手术期肺部并发症能够得到更准确的预测。预防术后并发症的有效策略很少。激励性肺量测定法和持续气道正压通气是仅有的已证实有获益的方法。识别有发生PPCs风险的患者，并在手术前积极管理其潜在的可改变风险因素至关重要。
