Scherrer M
Schweiz Med Wochenschr. 1975 Jul 12;105(28-29):919-23.
The degree of disability of a patient with chronic respiratory failure must be determined on a theoretical basis. Using a water filled spirometer, VC and FEV1 tracings are observed several times until the maximal values are clearly reproduced. The percentage deficit of the patients' ventilatory capacity is determined by the formula (see article) and represents the first approximation of the degree of disability (in %). The result must now be corrected by arterial blood gas data obtained during 5 mon exhaustive work on a bicycle or tread-mill ergometer. The percentage disability results from a correction depending on the arterial pO2 and the pCO2 found during exercise: deterioration of the arterial hypoxemia and/or hypercapnia leads to an increase and their normalization to a decrease in the disability quota found during spirometry. Patients with unstable chronic obstructive lung disease and respiratory failure should be evaluated only after adequate rehabilitation at home and at work, and after cessation of smoking. Patients under tuberculostatic treatment must also be excluded from disability evaluation. The degree of disability determined on the basis of lung function tests is a theoretical one; the tests must be performed by trained staff in a pulmonary function laboratory.
慢性呼吸衰竭患者的残疾程度必须在理论基础上确定。使用充满水的肺活量计，多次观察肺活量（VC）和第一秒用力呼气量（FEV1）曲线，直到清晰再现最大值。患者通气能力的百分比缺陷通过公式（见文章）确定，它代表残疾程度的初步近似值（以%表示）。现在必须根据在自行车或跑步机测力计上进行5分钟力竭运动期间获得的动脉血气数据对结果进行校正。残疾百分比是根据运动期间发现的动脉血氧分压（pO2）和二氧化碳分压（pCO2）进行校正得出的：动脉低氧血症和/或高碳酸血症的恶化会导致残疾配额增加，而它们恢复正常则会导致肺活量测定期间发现的残疾配额减少。不稳定的慢性阻塞性肺疾病和呼吸衰竭患者应仅在家庭和工作场所进行充分康复以及戒烟后进行评估。接受抗结核治疗的患者也必须排除在残疾评估之外。基于肺功能测试确定的残疾程度是理论上的；测试必须由肺功能实验室的训练有素的人员进行。
