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30%氧气对慢性气道阻塞患者局部灌注与通气匹配的影响。

Effect of 30% oxygen on local matching of perfusion and ventilation in chronic airways obstruction.

作者信息

Eiser N M, Jones H A, Hughes J M

出版信息

Clin Sci Mol Med. 1977 Oct;53(4):387-95. doi: 10.1042/cs0530387.

Abstract
  1. Sixteen patients with chronic bronchitis and airways obstruction were given radioactive nitrogen (13N) by intravenous injection and by inhalation, while breathing air and after 10-20 min breathing 30% oxygen. The clearance of 13N from four zones of each patient's whole lung field was monitored. 2. The 13N clearance of each region in these patients with chronic bronchitis was much slower than in normal subjects. Oxygen breathing produced a significant delay in the clearance of intravenously administered 13N in 23 zones in 10 patients but no systematic change in clearance after inhaled 13N. 3. With inhalation of 30% oxygen there was no no significant change in the mean minute ventilation, tidal volume or arterial PCO2. 4. The results suggest that local hypoxic vasoconstriction is present in some patients on breathing air and that this is relieved by 30% oxygen, resulting in a diversion of local blood flow from well-ventilated to more poorly ventilated areas. The fall in VA/Q on 30% oxygen is insufficient to increase arterial PCO2.
摘要
  1. 对16例患有慢性支气管炎和气道阻塞的患者,通过静脉注射和吸入的方式给予放射性氮(13N),分别在其呼吸空气时以及呼吸30%氧气10 - 20分钟后进行。监测每位患者全肺野四个区域的13N清除情况。2. 这些慢性支气管炎患者每个区域的13N清除速度比正常受试者慢得多。吸氧使10例患者的23个区域静脉注射13N后的清除明显延迟,但吸入13N后清除无系统性变化。3. 吸入30%氧气时,平均分钟通气量、潮气量或动脉血二氧化碳分压无显著变化。4. 结果表明,一些患者在呼吸空气时存在局部低氧性血管收缩,而吸入30%氧气可缓解这种收缩,导致局部血流从通气良好的区域转向通气较差的区域。吸入30%氧气时VA/Q的下降不足以使动脉血二氧化碳分压升高。

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