论文部分内容阅读
为了观察自主呼吸增强后通气和气体代谢变化对动脉血气的影响，对７例健康志愿者和５例慢性阻塞性肺病（ＣＯＰＤ）患者进行体外膈肌起搏，对９例ＣＯＰＤ患者静脉滴注可拉明，另外９例口服阿米脱林。结果显示：综合通气和代谢两方面变化的指标△ＶＡ％／△ＶＣＯ２％能预示ＰａＣＯ２变化趋势；全部受检者中△ＶＡ％／△ＶＣＯ２％＞１者２２例，除１例外ＰａＣＯ２均降低；而△ＶＡ％／△ＶＣＯ２％＜１的７例中ＰａＣＯ２增高５例，降低２例；健康志愿者△ＶＣＯ２／△ＶＡ均＜３０ｍｌ／Ｌ，而ＣＯＰＤ患者则大都＞３０ｍｌ／Ｌ。说明ＣＯＰＤ患者增强自主呼吸时机体代谢增强削弱了肺泡通气增加的效果；口服阿米脱林组ＰａＯ２增高较ＰａＣＯ２降低明显，提示阿米脱林除增强通气以外，还能改善换气功能，使ＰａＯ２进一步提高
In order to observe the effects of ventilatory and gas metabolism changes on arterial blood gas after spontaneous breathing enhancement, in vitro diaphragmatic pacing was performed on seven healthy volunteers and five patients with chronic obstructive pulmonary disease (COPD). Nine patients with COPD Ming, the other 9 cases of oral amilipin. The results showed that: △ VA% / △ VCO2%, the index of comprehensive ventilation and metabolism, could predict the trend of PaCO2; in all the subjects, 22 cases of △ VA% / △ VCO2%> 1, except PaCO2 of 1 case, all decreased; In the 7 cases with △ VA% / △ VCO2% <1, the PaCO2 increased in 5 cases and decreased in 2 cases. The △ VCO2 / △ VA in healthy volunteers was <30ml / L, while the COPD patients were mostly> 30ml / L. The results showed that the increase of body metabolism in COPD patients impaired the effect of increased alveolar airway pressure. The increase of PaO2 in oral amiloride group was significantly lower than that of PaCO2, suggesting that in addition to enhancing aeration, amiodarone improved the ventilation function and PaO2 Further improve