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| 先天性心脏病患儿术后肺不张预防和诊断的研究进展 |
| Research progress in prevention and diagnosis of postoperative atelectasis in children undergoing congenital heart disease surgery |
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| DOI：10.12089/jca.2026.04.016 |
| 中文关键词: 先天性心脏病 小儿 肺不张 肺保护性通气策略 |
| 英文关键词: Congenital heart disease Child Atelectasis Pulmonary protective ventilation strategy |
| 基金项目:贵州省卫生健康委科学技术基金项目（gzwkj2024-172） |
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| 中文摘要: |
| 近年来，肺部超声指导肺复张、电阻抗断层扫描滴定最佳PEEP、食管压监测指导通气被证实可进一步减少肺不张，但目前多限于重症监护室使用，尚未普及。减少先天性心脏病患儿术后肺不张的发生，有助于加快康复，并缩短其在重症监护室及总住院时间。术中PEEP联合小潮气量通气可有效降低肺不张，但早产患儿需警惕低血压风险。目前尚无统一的最佳方法能最大程度减少患儿术后肺不张，未来可向个体化通气参数设定与人工智能辅助影像诊断等方向进一步探索。本综述旨在总结现有可减少此类患儿术后肺不张的方法，以提升临床对该问题的重视与理解。 |
| 英文摘要: |
| In recent years, lung recruitment maneuver guided by lung ultrasound, optimal positive end-expiratory pressure (PEEP) titrated by electrical impedance tomography, and ventilation guided by esophageal pressure monitoring have been confirmed to further reduce atelectasis. However, these strategies are mostly limited to the intensive care unit and have not been widely implemented. Reducing postoperative atelectasis in children undergoing congenital heart disease surgery contributes to accelerated recovery and shortened lengths of stay in the intensive care unit and overall hospitalization. Intraoperative PEEP combined with low-tidal volume ventilation can effectively reduce atelectasis, although hypotension should be cautioned in preterm infants. At present, there is no uniform optimal strategy to minimize postoperative atelectasis in children. Future research may be directed toward individualized ventilation parameter setting and artificial intelligence-assisted imaging diagnosis. This review summarizes the available strategies to reduce postoperative atelectasis in this pediatric population, aiming to improve clinical awareness and understanding of this issue. |
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