癌症患者全身麻醉中人工肺通气的现代概念:А文献综述

N. Abdukhalilov, A. Arynov, D. Baidaulet, M. Mukanova, A. Nurmanova, E. Seidalieva, V. Chursin
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引用次数: 0

摘要

相关性:在全麻下采用人工通气(呼吸机)进行广泛手术干预的患者中,经常发现各种阻塞性或限制性的术后呼吸并发症。该研究旨在总结系统综述、荟萃分析和科学出版物中关于使用肺通气预防和治疗策略以提高癌症患者麻醉护理质量的现有数据。方法:检索PubMed电子数据库(NCBI),检索2016年至2023年期间发表的随机对照和前瞻性观察性研究、系统评价、荟萃分析以及英文科学文章,这些研究重点是肺保护通气策略与常规机械通气在大手术和长时间手术患者中的应用结果和比较。结果:通过对大规模科学研究和文献资料的比较,我们确定了使用低潮气量(6-8 ml/kg理想体重)的保护性肺通气策略,结合个体化PEEP,定期肺招募操作与手术患者临床结局、呼吸并发症、早期死亡率和住院时间的显著改善之间的关系。结论:大手术麻醉中使用保护性肺通气可减少术后肺部并发症的发生。
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MODERN CONCEPTS OF ARTIFICIAL LUNG VENTILATION DURING GENERAL ANESTHESIA IN CANCER PATIENTS: А LITERATURE REVIEW
Relevance: Among patients who have undergone extensive surgical interventions under general anesthesia with artificial ventilation (ventilator), various postoperative respiratory complications of an obstructive or restrictive nature are often found The study aimed to generalizе current data from systematic reviews, meta-analyses, and scientific publications on the use of preventive and therapeutic strategies for lung ventilation to improve the quality of anesthetic care for cancer patients. Methods: The PubMed Electronic Database (NCBI) was searched to identify randomized controlled and prospective observational studies, systematic reviews, and meta-analyses, as well as scientific articles published in English between 2016 and 2023 that focused on the results of application and comparison of lung protective ventilation strategies with conventional mechanical ventilation in patients undergoing major and prolonged surgery. Results: As a result of a comparison of data from a review of large-scale scientific studies and articles, a relationship was established between the use of a protective lung ventilation strategy with a low tidal volume (6-8 ml/kg of ideal body weight), in combination with individualized PEEP, periodic lung recruitment maneuvers and significant improvement in clinical outcomes, respiratory complications, early mortality and length of hospital stay in patients undergoing surgery. Conclusion: Using protective lung ventilation during anesthesia during major surgical interventions reduces the incidence of postoperative pulmonary complications.
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