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单肺移植受者呼吸肌的力学特性

Mechanics of respiratory muscles in single-lung transplant recipients.

作者信息

Ratnovsky Anat, Elad David, Izbicki Gabriel, Kramer Mordechai R

机构信息

Department of Biomedical Engineering, Faculty of Engineering, Tel Aviv University, Tel Aviv, Israel.

出版信息

Respiration. 2006;73(5):642-50. doi: 10.1159/000092671. Epub 2006 Apr 7.

Abstract

BACKGROUND

Emphysema and pulmonary fibrosis force the patients to breathe at an abnormal lung volume, which alters the lengths of the respiratory muscles and thereby their work capability is reduced. After single-lung transplantation, muscle function is restored on the side of the transplant but it may be asymmetric to that on the side of the native diseased lung.

OBJECTIVE

Investigating the hypothesis that single-lung transplantation induces mechanical asymmetry of the respiratory muscles on the two sides.

METHODS

Simultaneously noninvasive measurements of inspiratory and expiratory mouth pressure, airflow rate and electromyography signals from the sternomastoid, external intercostal, rectus abdominis and external oblique muscles were acquired during different breathing maneuvers. The study group included 10 single-lung transplant recipients (5 with pulmonary fibrosis and 5 with emphysema) and 10 healthy controls.

RESULTS

Analysis of the finding shows a significant lower global strength of the respiratory muscles of single-lung transplant recipients compared to that of healthy subjects. No significant difference in the EMG signals of respiratory muscles was found either between the different groups or between the sides of the transplant and the native lung in the patient groups. Both single-lung transplant recipients and healthy subjects demonstrated high EMG activity of the inspiratory muscles during inspiration at different breathing efforts.

CONCLUSION

Patients after single-lung transplantation have lower respiratory muscle strength than healthy subjects, but apparently normal electrical activity. The lower global respiratory muscle strength emphasizes the importance of their rehabilitation before and after single-lung transplantation.

摘要

背景

肺气肿和肺纤维化迫使患者在异常肺容积下呼吸,这改变了呼吸肌的长度,从而降低了其工作能力。单肺移植后,移植侧的肌肉功能得以恢复,但可能与患侧的原生肺不对称。

目的

研究单肺移植是否会导致两侧呼吸肌的机械不对称这一假设。

方法

在不同呼吸动作期间,同时无创测量吸气和呼气时的口腔压力、气流速率以及胸锁乳突肌、肋间外肌、腹直肌和腹外斜肌的肌电图信号。研究组包括10名单肺移植受者(5例肺纤维化患者和5例肺气肿患者)以及10名健康对照者。

结果

分析结果显示,单肺移植受者呼吸肌的整体力量显著低于健康受试者。在不同组之间以及患者组中移植侧与原生肺侧之间,呼吸肌的肌电图信号均未发现显著差异。单肺移植受者和健康受试者在不同呼吸努力程度下吸气时,吸气肌均表现出较高的肌电图活动。

结论

单肺移植后的患者呼吸肌力量低于健康受试者,但电活动明显正常。呼吸肌整体力量较低凸显了单肺移植前后康复治疗的重要性。

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