耳鼻咽喉科・頭頸部外科95巻13号

2023年12月発行

特集 めざせ！ 一歩進んだ周術期管理 《術前患者評価と対応》

呼吸器疾患

著者： 新井良¹

所属機関： ¹獨協医科大学内科学（呼吸器・アレルギー）

ページ範囲：P.1088 - P.1095

POINT

●周術期の術後肺合併症を減らすには，喘息，慢性閉塞性肺疾患（COPD）のような呼吸器疾患の評価・管理が重要である。

●喘息の術前管理として，病歴・重症度の評価により適切な治療介入を行うことで，1秒量を予測値あるいは自己最高値の80％以上にすることを目標にする。

●COPDの術前管理として，肺機能検査，血液ガス分析，画像検査，血液検査などで重症度の評価をし，最適な治療介入により術後肺合併症を減少させることを目標にする。

●周術期におけるステロイドカバーは，外科手術の侵襲に応じたグルココルチコイドの補充スケジュールを検討する。

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