自1929年第一台“铁肺”在临床开始应用以来,机械通气已在现代医学中占有十分重要的位置,通气技术和理论日臻完善,本文就有关新理论和方法综述如下。 1 机械通气致肺损伤理论 1.1 容积性损伤机械通气常常导致气胸、高通透性肺水肿和系统性气体栓塞等,即所谓气压伤。传统观念认为,其发生原因主要与气道峰值压过高,造成肺泡压增高和肺泡损伤。然而,近年动物实验和临床观察到即使气道压和肺泡压不增高,只要肺泡容 Since 1929 the first “iron lung” in the clinical application began, mechanical ventilation has occupied a very important position in modern medicine, ventilation technology and theory is improving, this article on the new theories and methods are summarized below. A mechanical ventilation induced lung injury theory 1.1 Volume damage Mechanical ventilation often leads to pneumothorax, high permeability pulmonary edema and systemic gas embolism, the so-called air pressure injury. The traditional view that the main causes of its occurrence and peak airway pressure is too high, resulting in increased alveolar pressure and alveolar damage. However, animal experiments and clinical observations in recent years, even if the airway pressure and alveolar pressure is not increased, as long as the lung volume