王青青,阿良德

机械通气作为确保呼吸道畅通的必要管理手段，属于一种非自然的干预方式，主要用于作为维持充分氧合的主要辅助治疗手段，对于全麻手术的顺利进行至关重要。然而，该方法可能会引起小气道及/或肺泡不同程度的塌陷，从而导致肺部局部通气不足，甚至可能出现完全的肺不张。肺不张乃机械通气中常见的并发症，是术后肺部并发症（postoperative pulmonary complications，PPCs）发生的主要因素。随着加速康复外科（Enhanced recovery after surgery，ERAS）理念的普及，其旨在减少术后并发症并促进患者迅速康复。围术期肺保护作为该理念的核心组成部分，因此成为麻醉医师高度关注的重点之一。肺部超声（lung ultrasound，LUS）作为一种实时、无创、便携、价格低、无放射性及可在床旁使用的评估手段，已被广泛用于围术期肺不张严重程度的评估和麻醉期间肺通气变化的监测。因此本文就超声指导肺复张在围术期的应用研究做一综述，为肺保护性通气策略提供一定参考。

肺部超声；肺复张；保护性通气策略；术后肺部并发症

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