Mase Kyoushi, Yamamoto Kenta, Murakami Sigefumi, Kihara Kazuaki, Matsushita Kazuhiro, Nozoe Masafumi, Takashima Sachie
Department of Physical Therapy, Faculty of Nursing and Rehabilitation, Konan Women's University: 6-2-23 Morikitamachi, Higashinada, Kobe, Hyogo 658-0001, Japan.
Department of Rehabilitation, Konan Hospital, Japan.
J Phys Ther Sci. 2018 Jun;30(6):820-824. doi: 10.1589/jpts.30.820. Epub 2018 Jun 12.
[Purpose] The purpose of this study was to clarify the differences in ventilation mechanics between quiet breathing and expiratory rib cage compression, and between expiratory rib cage compression on the upper rib cage and on the lower rib cage. [Subjects and Methods] Subjects comprised 6 healthy males. Expiratory rib cage compression was performed manually by compressing the upper and lower rib cages. Changes in the lung volume, flow rate, and esophageal and gastric pressure were examined. [Results] The end expiratory lung volume was significantly lower during expiratory rib cage compression than at rest, but the end inspiratory lung volume was not significantly different. When compared with the esophageal and gastric pressures on the upper and lower rib cages at rest, the gastric pressures were significantly higher at end expiration. Lung resistance was significantly higher during expiratory rib cage compression than at rest. [Conclusion] Although expiratory rib cage compression promoted expiration and increased tidal volume, the lung volume did not increase beyond end inspiratory levels at rest. Lung resistance may increase during expiratory rib cage compression due to a decrease in lung volume. The mechanism by which expiration is promoted differed between the upper and lower rib cages.
[目的] 本研究的目的是阐明安静呼吸与呼气时胸廓按压之间、以及上胸廓和下胸廓呼气时胸廓按压之间通气力学的差异。[对象与方法] 对象包括6名健康男性。通过手动按压上、下胸廓进行呼气时胸廓按压。检测肺容积、流速、食管和胃内压力的变化。[结果] 呼气时胸廓按压期间的呼气末肺容积显著低于静息时,但吸气末肺容积无显著差异。与静息时上、下胸廓的食管和胃内压力相比,呼气末时胃内压力显著更高。呼气时胸廓按压期间的肺阻力显著高于静息时。[结论] 尽管呼气时胸廓按压促进了呼气并增加了潮气量,但肺容积并未超过静息时的吸气末水平。呼气时胸廓按压期间肺阻力可能因肺容积减小而增加。上、下胸廓促进呼气的机制有所不同。