Worth H, Grundmann C, Goeckenjan G, Smidt U, Irlich G, Loogen F
Respiration. 1984;46(1):33-44. doi: 10.1159/000194668.
To study the effect of postoperative confinement to bed on respiratory muscle fatigue, 31 male subjects (age, 34-66 years) undergoing coronary artery revascularization were examined. Fatigue of both respiratory muscles (musculi intercostales externi) and leg muscles (musculus gastrocnemius) was determined by electromyography prior to and 7 and 12 days after operation. Additionally, oscillatory resistance to breathing and phase angle were measured. Pre- and postoperative routine lung function tests were performed. A comparison between preoperative and postoperative measurements reveals that respiratory as well as leg muscle fatigue occurred at higher loads during the preoperative and the second postoperative than during the first postoperative determination. After surgery vital capacity, total lung capacity, 1-second capacity, and, to a lower extent, thoracic gas volume were diminished, while specific airway conductance, oscillatory resistance to breathing, phase angle, residual volume, and relative 1-second capacity remained unchanged. The constancy of the latter parameters indicates that neither airway obstruction nor a significant restriction of the lung and/or thorax occurred due to surgery. Therefore, the increase of respiratory muscle fatigue after surgery may more probably be attributed to a lack of training of respiratory muscles which may contribute to limitation of ventilation in bedridden patients.
为研究术后卧床对呼吸肌疲劳的影响，对31名接受冠状动脉血运重建术的男性受试者（年龄34 - 66岁）进行了检查。在手术前以及术后7天和12天，通过肌电图测定呼吸肌（肋间外肌）和腿部肌肉（腓肠肌）的疲劳情况。此外，还测量了呼吸振荡阻力和相位角。进行了术前和术后的常规肺功能测试。术前和术后测量结果的比较显示，与术后第一次测定相比，术前和术后第二次测定时，呼吸肌以及腿部肌肉在更高负荷下出现疲劳。术后肺活量、肺总量、一秒量以及胸腔气体容积在一定程度上减少，而气道比传导率、呼吸振荡阻力、相位角、残气量和相对一秒量保持不变。后一组参数的恒定表明手术并未导致气道阻塞或肺和/或胸廓的明显受限。因此，术后呼吸肌疲劳的增加很可能归因于呼吸肌缺乏训练，这可能导致卧床患者通气受限。
