Kips J C
Department of Respiratory Diseases, University Hospital Ghent, Belgium.
Acta Clin Belg. 1997;52(5):301-5. doi: 10.1080/17843286.1997.11718592.
The incidence of peri-operative pulmonary complications varies, depending on surgery and patient related determinants. Risk factors include upper abdominal or thoracic surgery, duration of anaesthesia, age, obesity, smoking history and underlying respiratory diseases such as COPD. The preoperative evaluation of patients undergoing general surgery is predominantly based on medical history and physical examination. A preoperative chest radiograph and pulmonary function tests are indicated in some high risk patient groups, and in all patients about to undergo lung resection surgery. If in this latter group, the preoperative lung function is severely compromised, a quantitative perfusion scan and exercise testing may be useful for the assessment of the operative risk. Prevention of postoperative pulmonary complications should begin with discontinuation of smoking at least 8 weeks prior to surgery. In high risk patients preoperative chest physiotherapy, including incentive spirometry, is clearly beneficial.
围手术期肺部并发症的发生率各不相同，取决于手术和患者相关的决定因素。风险因素包括上腹部或胸部手术、麻醉持续时间、年龄、肥胖、吸烟史以及潜在的呼吸系统疾病，如慢性阻塞性肺疾病（COPD）。普通外科手术患者的术前评估主要基于病史和体格检查。一些高风险患者群体以及所有即将接受肺切除手术的患者都需要进行术前胸部X光检查和肺功能测试。如果后一组患者的术前肺功能严重受损，定量灌注扫描和运动测试可能有助于评估手术风险。术后肺部并发症的预防应从手术前至少8周戒烟开始。对于高风险患者，术前胸部物理治疗，包括激励性肺量计训练，显然是有益的。
