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血流经肺和离开肺的阻力观察。

OBSERVATIONS ON RESISTANCE TO THE FLOW OF BLOOD TO AND FROM THE LUNGS.

机构信息

Hospital of The Rockefeller Institute for Medical Research.

出版信息

J Exp Med. 1927 Mar 31;45(4):655-71. doi: 10.1084/jem.45.4.655.

Abstract
  1. Embolism of pulmonary arterioles and capillaries produced by the intravenous injection of starch grains results in a dilatation of the pulmonary artery and the right chambers of the heart. This has been demonstrated both by x-ray studies and direct inspection. 2. The dilatation of the pulmonary artery and heart occurs synchronously with the acceleration of respirations. 3. Dilatation of these structures produced by other means, such as obstruction to the flow of blood to and from the lungs, by gradually clamping either the pulmonary artery (cat and dog) or pulmonary veins (cat) does not, however, give rise to rapid and shallow breathing. 4. The effect of these maneuvers on respiration does not become apparent until respirations suddenly cease. 5. Neither does sudden restriction of the pulmonary vascular bed by clamping the left branch of the pulmonary artery give rise to rapid and shallow breathing, though this procedure may cause an increase in CO(2) tension and in hydrogen ion concentration of the blood. 6. Since rapid and shallow breathing is not the result of (1) anoxemia, (2) increased pCO(2) and hydrogen ion concentration of the serum, (3) restriction of pulmonary vascular bed by nearly half, (4) increase in resistance to the flow of blood to and from the lungs) (5) the presence of starch grains in the lungs acting as a local irritant, it must be the result of the secondary pathological changes which occur in the pulmonary parenchyma following embolism. 7. The nature of these changes, congestion and edema, has been discussed elsewhere. Whether they operate directly on nerve endings or through their influence on lung volume and tissue elasticity is not certain. 8. Various important clinical analogies have been emphasized.
摘要
  1. 淀粉颗粒经静脉注射进入肺小动脉和毛细血管,导致肺动脉和右心腔扩张。这一点已通过 X 射线研究和直接观察得到证实。

  2. 肺动脉和心脏的扩张与呼吸加速同步发生。

  3. 通过其他方式(如阻塞肺内外血流)扩张这些结构,例如逐渐夹闭肺动脉(猫和狗)或肺静脉(猫),不会导致快速而浅的呼吸。

  4. 这些操作对呼吸的影响直到呼吸突然停止才变得明显。

  5. 夹闭肺动脉左支突然限制肺血管床也不会导致快速而浅的呼吸,尽管这一操作可能会导致二氧化碳分压和血液氢离子浓度升高。

  6. 由于快速而浅的呼吸不是(1)缺氧、(2)血清 pCO2 和氢离子浓度增加、(3)肺血管床几乎减半、(4)血流进出肺的阻力增加、(5)肺部淀粉颗粒作为局部刺激物的结果,因此,它一定是栓塞后肺实质发生的继发性病理变化的结果。

  7. 这些变化的性质,充血和水肿,已在其他地方讨论过。它们是否直接作用于神经末梢,还是通过对肺容量和组织弹性的影响,尚不确定。

  8. 强调了各种重要的临床类比。

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本文引用的文献

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A USEFUL HEART METHOD.一种实用的心脏方法。
J Exp Med. 1921 May 31;33(6):675-6. doi: 10.1084/jem.33.6.675.

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