臨床外科62巻3号

2007年03月発行

特集 術後呼吸器合併症―予防と対策の最新知識

肺水腫―急性肺傷害の病態と対策

著者： 小野聡¹ 辻本広紀¹ 望月英隆¹

所属機関： ¹防衛医科大学校外科学講座

ページ範囲：P.339 - P.344

要旨：術後急性肺傷害の病態と対策について概説した．手術侵襲後の急性肺傷害の病態には，高度な手術侵襲によって引き起こされる全身性炎症反応症候群（SIRS）に伴う炎症担当細胞の活性化が深く関与している．したがって，術後急性肺傷害対策の基本はSIRS対策と適切な輸液管理が重要である．具体的には，輸液管理ではoverhydrationにならないように厳密な投与量の設定をするとともに，術前から栄養状態の改善を目指すことが重要であり，また，SIRS対策ならびに術後の急性肺傷害対策としてプロテアーゼインヒビターの投与が有用である．

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