Ikeda S, Imamura T, Sawai T, Naitoh T, Ohta M, Hata S, Hamabe S, Miyahara Y, Yamasa T, Hara K
Department of 2nd Internal Medicine, Nagasaki University.
Kokyu To Junkan. 1993 Dec;41(12):1197-200.
A 22-year-old man was admitted to the department of plastic surgery in our university with diagnosis of ankylosis and microgeniea. His complaints were snoring and somnolence in the daytime, so we performed a Respigraph (Chest) that showed obstructive apnea during sleep. We diagnosed obstructive sleep apnea syndrome. So we observed pulmonary circulation and measured lung water using the double indicator dilution method (Nihon Koden, MTV-1100) during sleep. During the period of apnea, arterial oxygen pressure and mixed venous saturation decreased, reversely, mean pulmonary arterial pressure rose, lung water (ETV) and central blood volume increased. We considered that the increase of lung water during sleep apnea is caused by hemodynamic change due to hypoxia and increase of venous return. After operation, the value of blood gas assay and apnea index were improved.
一名22岁男性因关节强硬和小颌畸形入住我校整形外科。他的主诉是打鼾和白天嗜睡,因此我们进行了呼吸描记图(胸部)检查,结果显示睡眠期间存在阻塞性呼吸暂停。我们诊断为阻塞性睡眠呼吸暂停综合征。于是我们在睡眠期间使用双指示剂稀释法(日本光电,MTV - 1100)观察肺循环并测量肺水含量。在呼吸暂停期间,动脉血氧分压和混合静脉血氧饱和度下降,相反,平均肺动脉压升高,肺水(ETV)和中心血容量增加。我们认为睡眠呼吸暂停期间肺水增加是由缺氧导致的血流动力学变化和静脉回流量增加引起的。术后,血气分析值和呼吸暂停指数得到改善。