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呼吸困难时的胸腹力学

Thoracoabdominal mechanics in dyspnea.

作者信息

Todisco T

出版信息

Respiration. 1981;42(2):77-83. doi: 10.1159/000194408.

Abstract

80 severely ill patients with various lung diseases were studied in order to relate the feeling of breathlessness at rest with the severity of lung mechanical impairment. Moderate to severe dyspnea (grade 2 to grade 3) at rest was present only in 46 of 80 patients (57%) with severe lung disease. The prevalence of breathlessness at rest among the various lung diseases was as follows: 80% in acute bronchial asthma, 70% acute interstitial pneumonia, 50% in diffuse lung fibrosis and 30% in chronic obstructive lung disease. None of the 10 X 9 measured or calculated parameters (IVC, FEV1, FEV1/IVC X 100, TGV, RV, RV/TLC X 100, TLC, MMEF, CC/TLC X 100, SGaw I-E, FV curve indices, quasi-static transpulmonary pressure, dynamic compliance, gastric pressure and RR) seemed to characterize the patients presenting with severe dyspnea. High breathing frequency, low SCdyn and a near negative abdominal pressure consistently identified a small group of subjects with severe dyspnea at rest, regardless of the underlying lung disease.

摘要

为了将静息时的呼吸困难感与肺机械功能损害的严重程度联系起来,对80例患有各种肺部疾病的重症患者进行了研究。在80例患有严重肺部疾病的患者中,只有46例(57%)在静息时出现中度至重度呼吸困难(2级至3级)。各种肺部疾病静息时呼吸困难的患病率如下:急性支气管哮喘为80%,急性间质性肺炎为70%,弥漫性肺纤维化 为50%,慢性阻塞性肺疾病为30%。所测量或计算的10项参数(肺活量、第一秒用力呼气容积、第一秒用力呼气容积/肺活量×100、肺总量、残气量、残气量/肺总量×100、肺总量、最大呼气中期流速、闭合气量/肺总量×100、吸气末与呼气末比气道传导率、流速-容积曲线指标、准静态跨肺压、动态顺应性、胃内压和呼吸频率)似乎都无法表征出现严重呼吸困难的患者。无论潜在的肺部疾病如何,高呼吸频率、低动态比顺应性和接近负压始终能识别出一小部分静息时出现严重呼吸困难的受试者。

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