Abstract: Objective To observe whether lung ultrasound （LUS） and diaphragm ultrasound can be used to evaluate and intervene in lung ventilation and diaphragm function in patients undergoing abdominal surgery during the recovery period of general anesthesia. Methods This study included a total of 130 patients who underwent elective abdominal surgery in our hospital and were planned to be sent to the post-anaesthesia care unit （PACU）. The patients were randomized into ultrasound group （group U） and control group （group N）. In group U, LUS and diaphragm ultrasonography were performed at admission in operating room （T₀）, at admission in PACU （T₁）, 15 minutes after extubation （T₂）, and at discharge of PACU （T₃）. LUS score and the diaphragm thickening fraction （DTF） at each time point were recorded and intervention based on the ultrasound results were performed in group U, Conventional resuscitation without ultrasound assessment was used in group N. Arterial blood gas analysis and oxygenation index were recorded at T3 of patients in both groups. The all patients were followed up for seven days after operation for pulmonary complications（PPCs）. Results Compared with T0, DTF decreased significantly （P<0.01） and LUS score increased significantly （P<0.01） after T₁, T₂, and T₃ in the U group, and did not return to the preoperative level at T₃ （P<0.01）. Compared with group N, the total number of intervention measures in group U and the number of taking intervention measures in group U at T₁ increased （P<0.05）. Compared with group N, the incidence of postoperative hypoxemia,extubation time,and PACU lengthofstay at T3 in the group U were significantly reduced （P<0.01）. Conclusion Ultrasound evaluation of lung and diaphragm function can dynamically monitor the ventilation status and diaphragm function recovery degree of patients during anesthesia recovery, enabling timely interventions to improve the recovery of respiratory function in patients undergoing general anesthesia after abdominal surgery.

Key words: ultrasound, abdominal surgery, respiratory function, post-Anesthesia Care Unit

摘要： 目的 观察腹部手术患者全麻恢复期通过肺超声（LUS）和膈肌超声评估并干预肺通气状态及膈肌功能,能否改善患者术后呼吸功能恢复。方法 选择我院2022年8月至2022年12月接受择期腹部手术且术后计划送入麻醉后恢复室（PACU）患者130例,将患者随机分为超声组（U组）和对照组（N组）。U组分别在入室（T₀）、入PACU（T₁）、拔管后15 min（T₂）、出PACU（T₃）进行LUS和膈肌超声检查,并记录各时间点肺超声评分（LUSS）和膈肌增厚率（DTF）,记录两组患者T3时采集动脉血气分析并记录氧合指数。结果 与T₀相比,U组T₁、T₂、T₃术后DTF显著降低（P<0.01）、LUSS显著升高（P<0.01）,且在T3时仍未恢复至术前水平（P<0.01）。与N组相比,U组采取干预措施的总例数及T₁时U组采取干预措施例数均增加（P<0.05）。与N组相比,U组拔管时间、PACU停留时间明显缩短、术后T₃时低氧血症发生率显著降低（P<0.01）。结论 超声评估肺部和膈肌功能可动态监测患者麻醉恢复期的肺通气状态及膈肌功能恢复程度,从而采取有效干预措施,改善腹部手术患者全麻恢复期呼吸功能的恢复。

关键词: 超声, 腹部手术, 呼吸功能, 全麻恢复期