腰椎手术围术期氧浓度调控的智慧平衡与氧化应激管理
摘要
流比例失调风险显著增加，围术期呼吸功能易受抑制进而引发低氧血症，这使得术中及术后氧合水平的精细化监测
与管理成为保障患者预后的关键环节。现有指南强调个体化氧疗原则，但在吸入氧浓度（Fraction of inspiration O2，
FiO2）阈值设定及抗氧化辅助治疗策略上仍存争议。本文系统综述了不同FiO2对患者氧合功能的调控机制及临床决
策路径。通过分析FiO2与氧合动力学的量效关系，结合肺保护性通气策略，建立个体化氧合管理框架。研究揭示合
理调控FiO2可优化肺泡复张与氧输送平衡，降低高氧性肺损伤风险。基于术中动态血气监测与呼吸力学参数反馈，
旨在为脊柱手术围术期呼吸管理提供精准化决策支持。未来需通过多中心研究明确不同手术类型及患者亚群的最佳
FiO2范围，开发基于人工智能的动态监测系统，并探索线粒体靶向抗氧化剂等新型干预手段。临床实践中需综合患
者基础疾病、手术体位及氧代谢特征，平衡氧合需求与医源性损伤，推动“精准氧疗”向“智慧氧疗”的范式转变。
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