剖腹术后低氧血症的机制。
The mechanism of hypoxaemia after laparotomy.
作者信息
Georg J, Hornum I, Mellemgaard K
出版信息
Thorax. 1967 Jul;22(4):382-6. doi: 10.1136/thx.22.4.382.
Abstract
In 18 patients who were undergoing upper laparotomies the alveolo-arterial oxygen difference and right-to-left shunt were measured before the operation, on the first post-operative day, and in some cases also later in the post-operative period. The arterial oxygen tension was found to be considerably reduced post-operatively. The right-to-left shunt estimated by the hydrogen isotope technique was moderately increased in most instances, but the increase was far from large enough to account for the observed hypoxaemia. It is concluded that uneven distribution of ventilation relative to perfusion is the main cause of post-operative hypoxaemia, whereas veno-arterial shunt through atelectatic areas is of minor importance.
摘要
在18例接受上腹部剖腹手术的患者中，于手术前、术后第一天以及部分病例在术后更晚时间测量了肺泡 - 动脉血氧分压差和右向左分流。发现术后动脉血氧张力显著降低。用氢同位素技术估算的右向左分流在大多数情况下有适度增加，但增加幅度远不足以解释观察到的低氧血症。结论是通气与灌注的不均匀分布是术后低氧血症的主要原因，而通过肺不张区域的静脉 - 动脉分流的作用较小。
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J Clin Invest. 1933 Jul;12(4):651-8. doi: 10.1172/JCI100526.
2
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Pflugers Arch Gesamte Physiol Menschen Tiere. 1951 Dec;254(2):107-25. doi: 10.1007/BF00369988.
3
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4
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