仰卧和俯卧位心脏对煤尘肺患者肺组织体积与功能的影响

Effects of heart at supine and prone position on the volume and function of lung in patients with anthracosis

目的:观察仰卧位和俯卧位心脏对煤尘肺患者肺组织体积和肺功能的影响,为临床应用俯卧位治疗成人呼吸窘迫综合征等肺部疾病提供依据。方法:2006-08/2007-01河南鹤煤集团公司总医院放射科对10例煤尘肺患者行仰、俯卧位高分辨螺旋CT扫描,分别测量位于心脏下方肺组织的体积,测量仰、俯卧位状态下肺功能,用配对t检验进行统计学分析。结果:10例患者均进入结果分析。①CT扫描心脏压迫下的肺组织体积:俯卧位时均小于仰卧位[左肺:(7.74±9.55),(242.60±72.11)mm3;右肺:(12.21±11.41),(156.49±76.54)mm3,P均<0.01]。②肺功能测量结果:仰卧位时,患者的用力肺活量、第1秒用力呼气容积、第1秒用力呼气容积预计值百分率、最大呼气量,分别为(2.14±0.58)L、(1.62±0.79)L、(89.80±29.26)、(3.42±1.98)L/s;俯卧位时,患者的用力肺活量、第1秒用力呼气容积、第1秒用力呼气容积预计值百分率、最大呼气量,分别为(2.36±20.79)L、(1.80±0.77)L、(100.10±22.46)、(4.30±2.37)L/s。俯卧位时肺功能明显优于仰卧位(P<0.05)。结论:俯卧位时位于心脏下方的肺组织明显减少,可显著改善人体的肺换气功能。

AIM： To observe the effects of heart at supine and prone position on the lung tissue volume and lung function in patients with anthracosis, so as to provide evidence for the clinical application of prone position in treating adult respiratory distress syndrome and other pulmonary diseases. METHODS： Between August 2006 and January 2007, ten patients with anthracosis were subjected to high-resolution CT scanning at both supine and prone position in Department of Radiology, General Hospital of Hebi Coal Industry （Group）. The relative volume of lung located directly under the heart and pulmonary function at supine and prone position were measured, respectively. Paired t-test was used for statistical analysis. RESULTS： Ten patients were involved in the result analysis. （1）The total volume of lung located under the heart at prone position was [left lung： （7.74±9.55）, （242.60±72.11） mm^2, right lung： （12.21 ±11.41）, （156.49±76.54） mm^3, P 〈 0.01]. （2）At supine position, the forced vital capacity （FVC）, forced expiratory volume at I s （FEV1）, forced expiratory volume at I s percentage of predicted （FEV1%） and peak expiratory flow （PEF） were （2.14±0.58） L, （1.62±0.79） L, （89.80±29.26） L/s, （3.42±1.98） L/s; at prone position, the FVC, FEV1, FEV1% and PEF were （2.36.±_20.79） L, （1.80±0.77） L, （100.10±22.46） L/s, （4.30.±2.37） L/s, respectively .The results indicated that the lung function at prone position was superior to that at supine position. CONCLUSION： The volume of lung located under heart at prone position is obviously decreased, which could greatly improve the gas exchange of lung in patients with anthracosis.