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体外膈肌起搏在X线荧光屏下对慢阻肺患者膈肌运动影响的观察
Measurement of Influence with Diaphragm Action in External Diaphragm Pacing to Chronic Obstructive Pulmonary Disease on X-ray
【摘要】 <正> 体外膈肌起搏(External diaphragm pacing,EDP)对健康人和COPD患者的潮气量增加有明显的作用已经肯定。COPD患者在电刺激膈神经之后由于潮气量的增加,PaCO2水平有相应下降,这对伴有CO2潴留的COPD患者在氧疗过程中作辅助治疗是十分有利的。然而,EDP器释放的电脉冲经膈神经传导至膈肌以后,对膈肌运动的影响可在X线荧屏下见到。通过这种方法来了解膈肌在接受电刺激后的运动变化情况至今仍未见报道。 对象与方法 一、病例选择 选自1987年3月至4月期间门诊和住院的COPD患者共9例,男性7例、女性2例。年龄35~67岁(平均48岁)。其中包括慢性支气管炎6例、慢性支气管炎合并肺气肿3例。
【Abstract】 Diaphragm action of 9 patients with chronic obstructive pulmonary disease (COPD) were measured on the x-ray screen by external diaphragm pacing (EDP). six Patients were chronic bronchitis, 3 patients were chronic bronchitis complicated obstructive emphysema. There are 7 males and 2 females, aged between 35 to 67 years old (M = 48).Nine patients standing on the front of x-ray screen were examined, diaphragm movements at static ventilation and electrical activation of the phrenic nerve were recorded by video.It is shown that the moving excursion of diaphragm is 0.8 to 1.5 cm (1.28±0.28cm) during static ventilation in 9 patients with COPD on x-ray screen; obviously increased excursion of diaphragm action during EDP from 1.5 to 4cm (2.5±0.78 cm), after diaphragm pacing from excursion of diaphragm action than more prior treatment from 0.79 cm to 1.67 cm (P<0.01). Hyaling increased of 9 cases assothiated excursion of diaphragm movement, after diaphragm contraction expired prolongation.It is suggested that external diaphragm pacemakers may increase excursion of diaphragm movement of patients with COPD, and may directly review on x-ray screen. Influence of ventilation volume and blood gas during EDP to patients with COPD were achieved by increased diaphragm movement,
- 【文献出处】 中山医科大学学报 , 编辑部邮箱 ,1988年02期
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