·综述·设置最佳呼气末正压的临床应用进展李俊辉韩志强DOI:10．12089/jca．2023．01．020基金项目:内蒙古自治区医疗卫生科技计划项目(202201252)作者单位:010050呼和浩特市内蒙古医科大学第一临床医学院(李俊辉);内蒙古医科大学附属医院麻醉科(韩志强)通信作者:韩志强，Email:hzqfy68@163．com【摘要】术后肺部并发症(PPCs)是全身麻醉后常见的并发症。俯卧位手术围术期呼吸管理复杂且机械通气导致的呼吸机相关肺损伤(VILI)发生率高。肺保护性通气策略(LPVS)不仅可以降低围术期VILI发生率，还可以预防PPCs，改善预后。相较于固定的呼气末正压(PEEP)值，基于患者个体差异设置最佳PEEP更具有优势及和应用前景，是肺保护通气最有效的措施之一。本文对LPVS与最佳PEEP的可行性以及设置最佳PEEP的临床应用进行综述，以期为全身麻醉尤其是俯卧位手术患者提供更好的肺保护，减少术后肺部并发症的发生。【关键词】呼气末正压;肺保护性通气策略;术后肺部并发症Progressinclinicalapplicationofsettingoptimalpositiveend-expiratorypressureLIJunhui，HANZhiqiang．theFirstClinicalMedicalCollegeofInnerMongoliaMedicalUniversity，Hohhot010050，ChinaCorrespondingauthor:HANZhiqiang，Email:hzqfy68@163．com【Abstract】Postoperativepulmonarycomplications(PPCs)arecommoncomplicationsaftergeneralanesthesiasurgery．Ｒespiratorymanagementintheperioperativeperiodofpronesurgeryiscomplex，andtheincidenceofventilator-inducedlunginjury(VILI)ishighduetomechanicalventilation．Notonlydolungprotectiveventilationstrategies(LPVS)reducetheincidenceofVILI，butalsopreventPPCsandimproveprognosis．Comparedwiththefixedpositiveendexpiratorypressure(PEEP)value，settingtheoptimalPEEPbasedonindividualpatientdifferenceshasmoreadvantagesandapplicationprospects，whichisoneofthemosteffectivemeasuresforlungprotectionventilation．ThisarticlemainlyreviewsthefeasibilityofLPVSandoptimalPEEPandtheclinicalapplicationofoptimalPEEPtoprovidebetterlungprotectionandtoreducetheoccurrenceofpostoperativelungcomplicationsinpatientswithgeneralanesthesiainpronepo-sitionsurgery．【Keywords】Positiveend-expiratorypressure;Lungprotectiveventilationstrategies;Postoperativepulmonarycomplications俯卧位手术是常见的...
