CAJ | 학술논문

目的探讨同步悬空俯卧位对稳定期慢性阻塞性肺疾病(chronic obstractive pulmonary disease,COPD)患者膈肌功能情况的影响.方法 5例稳定期COPD患者,在"人工呼吸床"上随机四种不同体位:①仰卧位;②悬空俯卧位;③托平俯卧位;④同步悬空俯卧位.每个体位观察10 min,通过呼吸功能检测电极监测膈肌肌电、食道压和胃压等指标.结果四种体位对心率、氧饱和度、呼气末二氧化碳无明显的影响(P>0.05),其中同步悬空俯卧的呼吸频率在四种体位中是最慢的(16±2.7)次/min,由慢至快呈现:同步悬空俯卧→仰卧→托平俯卧→悬空俯卧的趋势;同步悬空俯卧位的潮气量在四种体位中是最大的(600.7±122.5)ml;同步悬空俯卧位的跨膈压是(14.6±2.6)cm H2O,是四种体位中最小的,与托平俯卧位(22.6±2.5)cm H2O比较差异有统计学意义(P<0.05),同步悬空俯卧位的膈肌肌电是(76.4±38.9)μV,是四种体位中最高的,但与其他体位比较差异无统计学意义(P>0.05).结论 "人工呼吸床"上同步悬空俯卧位与其他两种俯卧呼吸体位一样,对COPD患者经短时间观察是安全稳定的;同步悬空俯卧位以最低的跨膈压,不但降低患者的呼吸频率,增加潮气量,在不增加呼吸做功的情况下,改善膈肌的运动能力.
목적 탐토동보현공부와위대은정기만성조새성폐질병(chronic obstractive pulmonary disease,COPD)환자격기공능정황적영향.방법 5례은정기COPD환자,재"인공호흡상"상수궤사충불동체위:①앙와위;②현공부와위;③탁평부와위;④동보현공부와위.매개체위관찰10 min,통과호흡공능검측전겁감측격기기전、식도압화위압등지표.결과 사충체위대심솔、양포화도、호기말이양화탄무명현적영향(P>0.05),기중동보현공부와적호흡빈솔재사충체위중시최만적(16±2.7)차/min,유만지쾌정현:동보현공부와→앙와→탁평부와→현공부와적추세;동보현공부와위적조기량재사충체위중시최대적(600.7±122.5)ml;동보현공부와위적과격압시(14.6±2.6)cm H2O,시사충체위중최소적,여탁평부와위(22.6±2.5)cm H2O비교차이유통계학의의(P<0.05),동보현공부와위적격기기전시(76.4±38.9)μV,시사충체위중최고적,단여기타체위비교차이무통계학의의(P>0.05).결론 "인공호흡상"상동보현공부와위여기타량충부와호흡체위일양,대COPD환자경단시간관찰시안전은정적;동보현공부와위이최저적과격압,불단강저환자적호흡빈솔,증가조기량,재불증가호흡주공적정황하,개선격기적운동능력.
Objective Explore the simultaneous suspended abdomen prone position on respiratory function in patients with stable chronic obstructive pulmonary disease(COPD). Methods Five cases of abdomen prone position. Each position observed for 10 minutes. Through the respiratory function test electrodes to monitor esophageal pressure and EMG,and gastric pressure. Results Four positions have no obvious effect to patient's heart rate, oxygen saturation, end-tidal CO2 ( P>0.05), particularly,Synchronization suspended abdomen prone position demonstrates the lowest breathing rate ( 16 ± 2.7)/min. In the process of the breathing rate from slow to fast of the four positions depicts a gradual change:Synchronization suspended abdomen prone position→ supine position→flat prone position→ suspended abdomen prone position, Synchronization suspended abdomen prone position reaches the highest tidal volume(600. 7 ± 122.5) ml, Synchronous suspended prone position of the transdiaphragmatic pressure (Pdi) is the smallest(14.6±2.6) cm H2O of the four position. There was significantly different compared with the flat prone position (22.6 ± 2.5) cmH2 O ( P<0.05). Synchronous suspended prone position of the EMG is the highest (76.4 ±38.9) μV, but there was no significant difference with the other position ( P>0.05). Conclusions Synchronization suspended abdomen prone position is secure to stable COPD patients compared to other prone position. With the lowest trans-diaphragmatic pressure, the subjects have significantly improved tidal volume and lower the breath rates. Without increasing work of breaths. Improved the exercise capacity of diaphragm.