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呼吸治疗期间患者的肺功能研究。诊断和预后评估。

Studies on pulmonary function in patients during respiratory treatment. Diagnostic and prognostic evaluations.

作者信息

Gertz I, Hedenstierna G, Löfström B

出版信息

Acta Anaesthesiol Scand. 1976;20(4):343-50. doi: 10.1111/j.1399-6576.1976.tb05048.x.

Abstract

Twenty-nine patients, divided into three groups: 1) chronic obstructive pulmonary disease; 2) acute or chronic pulmonary disease with left heart failure; 3) respiratory insufficiency after peritonitis, pancreatitis, and/or sepsis, were studied during respirator treatment with regard to gas exchange, breathing mechanics and central circulation. The dead space ventilation was somewhat greater in group 1 than in the other groups. The alveolar-arterial oxygen tension difference was least in group 1, greater in group 2 and extremely high in group 3. Neither dynamic compliance of the thorax nor inspiratory resistance showed any significant differences between the groups. The cardiac output had the highest values in group 3. The venous admixture was generally small in group 1 and extremely large in group 3. The pulmonary artery pressures were highest in group 2. Three variables proved to be valuable when assessing the prognosis of a patient: a large venous admixture; a large alveolar-arterial oxygen tension difference, and a high pulmonary artery pressure indicated a less favourable prognosis.

摘要

29名患者被分为三组:1)慢性阻塞性肺疾病;2)伴有左心衰竭的急慢性肺部疾病;3)腹膜炎、胰腺炎和/或败血症后的呼吸功能不全,在呼吸机治疗期间对其气体交换、呼吸力学和中心循环进行了研究。第1组的死腔通气量略高于其他组。第1组的肺泡-动脉氧分压差最小,第2组较大,第3组极高。各组之间胸廓的动态顺应性和吸气阻力均无显著差异。第3组的心输出量最高。第1组的静脉混合血一般较小,第3组则极大。第2组的肺动脉压力最高。有三个变量在评估患者预后时被证明是有价值的:静脉混合血量大;肺泡-动脉氧分压差大;肺动脉压力高表明预后较差。

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