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本文论述了慢性阻塞性肺疾病(COPD)病人围手术期呼吸的判断和处理,指出由于COPD病人缺乏肺弹性组织支持,肺泡、肺泡管及肺泡细支气管扩张,使通气受限,呼吸困难,产生低氧血症及高碳酸血症.术前根据症状、体征等估测病情严重程度,围术期实施理疗,术前吸入沙丁胺醇2.5～5mg,可减少并发症.其继发病主要是肺大泡,右室功能不全,故在通气时应注意.区域阻滞麻醉与全麻一样应重视呼吸管理,术后宜选用PEEP或CPAP,也可采用压力支持通气.
This article discusses the diagnosis and treatment of perioperative respiration in patients with chronic obstructive pulmonary disease (COPD). It is pointed out that due to the lack of pulmonary elastic tissue support in patients with COPD, alveolar, alveolar and alveolar bronchiectasis, limited ventilation, difficulty breathing, Hypoxemia and hypercapnia .Preoperative symptoms, signs and other estimates of the severity of the disease, perioperative implementation of physiotherapy, preoperative inhalation of salbutamol 2.5 ~ 5mg, can reduce the complications of its secondary disease is mainly bullae , Right ventricular dysfunction, it should be noted when ventilation. Regional anesthesia and general anesthesia should pay attention to respiratory management, postoperative should use PEEP or CPAP, pressure support ventilation can also be used.