稳定期中重度慢性阻塞性肺疾病患者运动时胸腹矛盾呼吸以及氧疗的作用  

The extent of paradoxical thoracoabdominal motion during exercise was improved with oxygen therapy in patients with stable moderate to severe chronic obstructive pulmonary disease

作　　者：郭忠良[1] 蔡映云[1] 梁永杰[2] 杨文兰[1] 揭志军[1] 

机构地区：[1]上海医科大学附属中山医院肺科,200032 [2]上海市东方医院呼吸科,200120

出　　处：《中华结核和呼吸杂志》2000年第3期141-143,共3页Chinese Journal of Tuberculosis and Respiratory Diseases

摘　　要：目的　探讨慢性阻塞性肺疾病 (COPD)患者运动时胸腹矛盾呼吸的影响因素并观察氧疗对胸腹矛盾呼吸的影响。方法　 30例稳定期中重度COPD患者 ,运动前按常规进行肺功能检查和血气分析 ,分别在吸空气和 30 %氧气状态下进行两次递增负荷运动试验 ,通过呼吸感应性体表描记仪监测运动过程中胸腹呼吸量之和与实际潮气量之比 (TCD/VT) ,以了解胸腹呼吸协调性。结果　在吸空气时 30例受试者中有 18例在最大运动过程中TCD/VT>1 2 0。相关分析显示 ,最大运动时TCD/VT 与静息时一秒钟用力呼气容积 (FEV1)、用力肺活量 (FVC)、最大通气量 (MVV)和动脉血二氧化碳分压 (PaCO2 )等通气功能指标显著相关 (r =- 0 6 6 ,- 0 6 3,- 0 5 1和 0 5 1) ,但与一氧化碳弥散量无显著相关性 (r=- 0 33)。氧疗可以使运动时胸腹矛盾呼吸的程度降低或延缓。结论　COPD患者运动时胸腹矛盾呼吸与静息时通气功能损害有关 ,吸入 30Objective To assess the synergetic change of thoracoabdominal motion in COPD patients during incremental exercise testing, and to evaluate the effect of oxygen therapy on thoracoabdominal synergetic motion Methods 30 stable moderate to severe COPD patients performed incremental exercise test with ergometer twice while breathing either air or 30% oxygen Thoracoabdominal motion (assessed by TCD/V T) was monitored with respigraph during the whole test Results 18 of 30 patients had TCD/V T>1 20 during maximal exercise TCD/V T at maximal exercise (TCD/V Tmax) was significantly correlated with FEV 1, FVC, MVV and PaCO 2 ( r =-0 66, -0 63, -0 51, and 0 51), but not correlated with DL CO The thoracoabdominal synergetic motion could be obviously improved with oxygen therapy Conclusions The change of thoracoabdominal synergetic motion during exercise in COPD patients was related with ventilatory function and blood gases Oxygen therapy could obviously ameliorate paradoxical thoracoabdominal motion

关 键 词：阻塞性肺疾病 运动试验 胸腹矛盾呼吸 氧疗法 

分 类 号：R563.9[医药卫生—呼吸系统]