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子宫肺脏:胎儿呼吸观念的历史

Pulmo uterinus: a history of ideas on fetal respiration.

作者信息

Obladen Michael

机构信息

Department of Neonatology, Charité University Medicine Berlin, Augustenburger Platz 1, 13353 Berlin, Germany.

出版信息

J Perinat Med. 2018 Jul 26;46(5):457-464. doi: 10.1515/jpm-2016-0403.

Abstract

Theories about fetal respiration began in antiquity. Aristotle characterized pneuma as warm air, but also as the enabler of vital functions and instrument of the soul. In Galen's system of physiology, the vital spirit was carried by the umbilical arteries, the nutrients by the umbilical vein from the placenta to the fetus. In 1569 Aranzio postulated that the maternal and fetal vasculatures are distinct. From 1670 to 1690, a century before the discovery of oxygen, researchers understood that during respiration some form of exchange with the air must occur, naming the substance biolychnium, phlogiston, sal-nitro, or nitro-aerial particles. An analogy of placental and pulmonary gas exchange was described in 1674 by Mayow. In 1779, Lavoisier understood the discovery of oxygen, discarded the phlogiston theory, and based respiration physiology on gas exchange. With the invention of the spectroscope, it became possible to measure hemoglobin oxygenation, and in 1876 Zweifel proved fetal oxygen uptake. Major progress in understanding fetal gas exchange was achieved in the 20th century by the physiologists Barcroft in Cambridge and Dawes in Oxford.

摘要

关于胎儿呼吸的理论始于古代。亚里士多德将元气描述为温暖的空气,但也将其视为生命功能的推动者和灵魂的工具。在盖伦的生理学体系中,生命灵气由脐动脉输送,营养物质则由脐静脉从胎盘输送给胎儿。1569年,阿兰齐奥提出母体和胎儿的血管系统是不同的。在氧气被发现的一个世纪前,即1670年至1690年间,研究人员就明白在呼吸过程中必然会与空气发生某种形式的交换,他们将这种物质命名为生物液、燃素、硝盐或硝气微粒。1674年,梅奥描述了胎盘与肺部气体交换的类比。1779年,拉瓦锡了解到氧气的发现,摒弃了燃素理论,并将呼吸生理学建立在气体交换的基础上。随着分光镜的发明,测量血红蛋白氧合成为可能,1876年茨韦费尔证明了胎儿对氧气的摄取。20世纪,剑桥的生理学家巴克罗夫特和牛津的生理学家道斯在理解胎儿气体交换方面取得了重大进展。

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