Enjeti S, Terry P B, Menkes H A, Traystman R J
J Appl Physiol Respir Environ Exerc Physiol. 1982 Mar;52(3):647-54. doi: 10.1152/jappl.1982.52.3.647.
The role of mechanical interdependence in the perfusion of atelectatic lung was studied in two ways: a) regional hemodynamics were compared before (control) and after the development of lobar and sublobar atelectasis, and b) the effect of thoracotomy on regional hemodynamics was assessed. With lobar atelectasis mean lobar blood flow and vascular conductance decreased to 60% of control. Sublobar atelectasis caused mean sublobar blood flow and vascular conductance to decrease to 6% of control. Opening the chest after production of lobar atelectasis caused blood flow to fall to 50% of control. When sublobar atelectasis was produced in the open chest, sublobar blood flow decreased to 25% of control measurements made prior to thoracotomy. We conclude that with a closed chest, sublobar vascular distortion mediated by mechanical interdependence may be an important mechanism responsible for the differences in hemodynamic responses to atelectasis between lobes and sublobar regions.
a）比较了叶和亚叶肺不张形成前后（对照）的局部血流动力学，b）评估了开胸手术对局部血流动力学的影响。叶性肺不张时，叶平均血流和血管传导率降至对照值的60%。亚叶性肺不张导致亚叶平均血流和血管传导率降至对照值的6%。叶性肺不张形成后开胸使血流降至对照值的50%。当在开胸状态下产生亚叶性肺不张时，亚叶血流降至开胸手术前对照测量值的25%。我们得出结论，在闭合胸腔时，由机械相互依存性介导的亚叶血管扭曲可能是叶和亚叶区域对肺不张血流动力学反应差异的重要机制。
