国际麻醉学与复苏杂志   2016, Issue (9): 7-7
    
急性呼吸窘迫综合征患者机械通气相关肺纤维化机制及治疗新进展
陈梦媛, 高巨1()
1.大连医科大学研究生院
Mechanical ventilation-associated lung fibrosis in acute respiratory distress syndrome:mechanisms and new progress of treatment
 全文:
摘要:

背景 机械通气在急性呼吸窘迫综合征(acute respiratory distress syndrome, ARDS)患者的救治过程中发挥着重要作用,然而机械通气使用不当,可诱发或加重肺损伤,即呼吸机相关性肺损伤,更关键的是机械通气可显著增加ARDS患者肺纤维化的发病率和病死率,有研究报道在ARDS的致死原因中,难以控制的肺纤维化占40%~60%。 目的 就ARDS患者机械通气相关肺纤维化的发生机制、防治策略等方面的研究新进展予以综述。 内容 机械通气产生的机械牵张可激活细胞信号通路最终导致肺纤维化的发生发展。 趋向 机械通气导致的肺纤维化已成为ARDS患者预后不良及肺功能下降的重要原因之一,我们应当予以高度重视。随着对其发病机制的不断探索,将为研发有效的防治措施提供更好的理论基础。

关键词: 急性呼吸窘迫综合征; 机械通气; 肺纤维化
Abstract:

Background Mechanical ventilation plays a very important role in the treatment of acute respiratory distress syndrome(ARDS) patients. But inappropriate use of mechanical ventilation will induce or aggravate lung injury(ventilator-induced lung injury). More importantly, mechanical ventilation would significantly increase morbidity of pulmonary fibrosis and mortality in patients with ARDS. It is reported that the mortality of ARDS caused by uncontrollable pulmonary fibrosis ranges from 40% to 60%. Objective This article reviews the new progress of the mechanisms, prevention and treatment in mechanical ventilation-associated lung fibrosis. Content Mechanical stretch caused by mechanical ventilation, could activated cell signaling pathways, leading to the development of pulmonary fibrosis. Trend Pulmonary fibrosis caused by mechanical ventilation has become one of the important reasons for the poor prognosis and lung function decline in patients with ARDS. We should attach great importance to this problem, along with continuous exploration to its pathogenesis, so as to provide a better theoretical basis to develop effective prevention and control measures.

Key words: Acute respiratory distress syndrome; Mechanical ventilation; Pulmonary fibrosis