基于EIT技术监测体姿改变对肺通气影响的实验研究  

Experimental study on effect of body position on lung ventilation determined by electrical impedance tomography

作　　者：张超 吴佳铭 代萌 夏军营 付峰 尤富生 ZHANG Chao;WU Jia-ming;DAI Meng;XIA Jun-ying;FU Feng;YOU Fu-sheng(School of Biomedical Engineering,the Fourth Military Medical University,Xi'an 710032,China;NCO Academy of Army Military Medical University,Shijiazhuang 050081,China)

机构地区：[1]空军军医大学军事生物医学工程学系,西安710032 [2]陆军军医大学士官学校,石家庄050081

出　　处：《医疗卫生装备》2018年第4期6-10,共5页Chinese Medical Equipment Journal

基　　金：陕西省重大专项课题(2013ZXC-06-04);原第四军医大学科技发展基金(2017XB006);军队重大项目(AWS14C006)

摘　　要：目的:利用电阻抗断层成像(electrical impedance tomography,EIT)技术监测和比较不同体姿下局部肺通气量和一秒率的改变情况。方法:选取课题组男性学生志愿者12名[年龄(26.6±2.5)岁]为测试对象,采取坐姿、仰卧位和俯卧位3种体姿进行用力肺活量测试,同步进行EIT监测;分别对用力肺活量和一秒率的功能EIT图像中肺区域内的像素进行定量分析,求取局部肺通气占比和局部一秒率的均值。结果:腹侧和背侧的局部肺通气占比在坐姿时为37.65%∶62.35%,仰卧位时为37.59%∶62.41%,而俯卧位时为48.56%∶51.44%(更接近1∶1);仰卧位和俯卧位时重力依赖区的局部一秒率均值分别为0.84和0.81,坐姿时相应部位的均值分别为0.90和0.94。结论:EIT监测结果表明,俯卧位时通气向重力依赖区明显转移,但肺通气流速下降,为机械通气患者轮换采用俯卧位以改善氧合提供了直接证据,也为临床上开展EIT监测局部肺通气研究打下了基础。Objective To monitor and compare the effects of body position on the regional lung volume and FEV1/FVC with electrical impedance tomography(EIT).Methods Twelve healthy young subjects[(26.6±2.5)yr]were detected by EIT during FVC maneuver in 3 body positions(sitting,supine and prone).Functional EIT images of FVC and FEV1/FVC were obtained;the proportion of regional ventilation volume and the mean of regional FEV1/FVC were calculated.Results The ventral and dorsal proportion of ventilation volume was 37.65%∶62.35%in sitting position and 37.59%∶62.41%in supine position,respectively.While in the prone position,the value was 48.56%∶51.44%,which was close to 1∶1.The mean of regional FEV1/FVC in the dependent lung region was 0.84 in supine position and 0.81 in prone position,while in sitting position,the corresponding value was 0.90 and 0.94,respectively.Conclusion The results shows that the ventilation transfers to the gravity dependent region obviously,while the flow rate decreases.The result provides direct evidences for mechanical ventilation patients using prone position to improve oxygenation,as well as a research foundation for EIT monitoring regional lung ventilation in the clinical setting.

关 键 词：电阻抗断层成像 体姿 肺通气量 肺通气流速 用力肺活量 重力依赖 

分 类 号：R318[医药卫生—生物医学工程] Q-334[医药卫生—基础医学]