肺移植围手术期液体管理的新进展

New advances in perioperative fluid management in lung transplantation

  • 摘要: 肺移植是多种终末期肺病的有效治疗手段,优化围手术期液体管理可降低术后肺水肿的发生率并改善肺移植受者的预后。过度的液体补充可能引发肺水肿、移植肺的缺血再灌注损伤,并增加心脏负担,诱发心力衰竭;而过于严格的液体限制则可能导致血容量不足,影响组织灌注,引发器官功能异常。因此,精准调控液体平衡对肺移植患者的术后恢复至关重要。本文就肺移植受者的生理特征、输注液体类型、液体治疗方案及血流动力学监测等方面进行综述,旨在阐明肺移植围手术期液体管理的特殊性,以期为个体化液体管理提供新的思路和方向。

     

    Abstract: Lung transplantation is an effective treatment for various end-stage lung diseases. Optimizing perioperative fluid management can reduce the incidence of postoperative pulmonary edema and improve the prognosis of lung transplant recipients. Excessive fluid administration may lead to pulmonary edema, ischemia-reperfusion injury of the transplant lung, and increased cardiac burden, which can induce heart failure. On the other hand, overly strict fluid restriction may lead to hypovolemia, affecting tissue perfusion and causing organ dysfunction. Therefore, precise regulation of fluid balance is crucial for the postoperative recovery of lung transplant patients. This article reviews the physiological characteristics of lung transplant recipients, types of infused fluids, fluid therapy regimens, and hemodynamic monitoring, aiming to elucidate the particularities of perioperative fluid management in lung transplantation and provide new ideas and directions for individualized fluid management.

     

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