Department of Anesthesiology, University of Maryland School of Medicine, 22 South Greene Street, S11C0, Baltimore, MD 21201, USA.
Med Clin North Am. 2013 Nov;97(6):1095-107. doi: 10.1016/j.mcna.2013.06.001. Epub 2013 Aug 27.
Chronic pulmonary disease is common among the surgical population and the importance of a thorough and detailed preoperative assessment is monumental for minimizing morbidity and mortality and reducing the risk of perioperative pulmonary complications. These comorbidities contribute to pulmonary postoperative complications, including atelectasis, pneumonia, and respiratory failure, and can predict long-term mortality. The important aspects of the preoperative assessment for patients with chronic pulmonary disease, and the value of preoperative testing and smoking cessation, are discussed. Specifically discussed are preoperative pulmonary assessment and management of patients with chronic obstructive pulmonary disease, asthma, restrictive lung disease, obstructive sleep apnea, and obesity.
慢性肺部疾病在手术人群中很常见,因此彻底和详细的术前评估对于降低发病率和死亡率以及减少围手术期肺部并发症的风险非常重要。这些合并症会导致肺部术后并发症,包括肺不张、肺炎和呼吸衰竭,并可预测长期死亡率。本文讨论了慢性肺部疾病患者术前评估的重要方面,以及术前检查和戒烟的价值。具体讨论了慢性阻塞性肺疾病、哮喘、限制性肺疾病、阻塞性睡眠呼吸暂停和肥胖患者的术前肺部评估和管理。