Higenbottam T, Allen D, Loh L, Clark T J
Thorax. 1977 Oct;32(5):589-95-09ENG. doi: 10.1136/thx.32.5.589.
589-595. The abdomen and ribcage volume contribution to the tidal volume have been determined using magnetometers in three groups of subjects—normal males, patients with hemidiaphragmatic palsy, and patients with bilateral diaphragmatic palsy. In all three groups the main moving parts appear to be the anterior surfaces of the abdomen and ribcage even in the presence of bilateral diaphragmatic palsy. In the group of patients with bilateral diaphragmatic paralysis the anterior abdominal wall moved inward paradoxically on inspiration. This `negative' movement increased with larger tidal breaths and was best seen in recumbent patients. The normal subjects and those with hemidiaphragmatic palsy showed an outward movement of the anterior abdominal wall on inspiration which increased with larger tidal breaths. It is believed that the paradoxical movement of the abdomen in bilateral diaphragmatic palsy is a valuable clinical sign of this condition. The contribution of the abdominal volume displacement to the tidal volume in the normal subjects and the hemidiaphragmatic palsy patients varied considerably between subjects and with different postures, but no difference could be discerned between the two groups. This supports the suggestion that the diaphragm is concerned more with maintaining a pressure difference between the abdomen and ribcage than displacing abdominal volume.
589 - 595。利用磁力计测定了三组受试者（正常男性、半侧膈肌麻痹患者和双侧膈肌麻痹患者）腹部和胸廓容积对潮气量的贡献。在所有这三组受试者中，即使存在双侧膈肌麻痹，主要的运动部位似乎仍是腹部和胸廓的前表面。在双侧膈肌麻痹患者组中，吸气时前腹壁反常地向内移动。这种“负向”运动随着潮气量增大而增加，在卧位患者中最为明显。正常受试者和半侧膈肌麻痹患者吸气时前腹壁向外移动，且随着潮气量增大而增加。据信，双侧膈肌麻痹时腹部的反常运动是该病症的一个重要临床体征。正常受试者和半侧膈肌麻痹患者中腹部容积位移对潮气量的贡献在不同受试者之间以及不同体位时差异很大，但两组之间没有明显差异。这支持了这样一种观点，即膈肌更多地是与维持腹部和胸廓之间的压力差有关，而非腹部容积的位移。
