应用胸腹呼吸运动记录仪观察膈肌收缩功能

APPLANCE OF THORACOABDOMINAL MOTION RECORDER TO OBSERVE THE FUNCTION OF DIAPHRAGMATIC CONTRACTILITY

呼吸衰竭是肺心病患者死亡的主要原因之一,而呼吸肌疲劳是促使呼吸衰竭发展的重要因素.因此,为了达到诊断膈肌疲劳和改善膈肌功能的目的,我们研制了胸腹壁运动图的记录装置,是一种简单的测定膈肌疲劳的方法之一.发现住院的慢性肺心病患者中,出现膈肌疲劳的占有相当高的比率。作者对27例住院的肺心病患者,通过胸腹壁运动图的描记,发现有11例患者呈现胸腹壁运动曲线的矛盾运动,说明存在膈肌疲劳。对这11例患者给予氨茶碱的负荷剂量6mg/kg,于30min 内静脉滴注完毕,立即进行胸腹壁运动曲线的描记,以便与滴药前的图形进行比较。11例中有7例滴药后其胸腹壁运动曲线已由滴注前的矛盾运动转为同步运动,说明膈肌收缩功能有明显改善.另有16例滴注前呈同步运动(无膈肌疲劳),也有14例在滴注完毕时腹壁吸气时曲线幅度较用药前平均提高39.22%,说明对膈肌收缩性能也有一定改善。文中对胸腹壁运动记录装置的制作、正常及异常曲线的产生机理和临床意义,以及氨茶碱改善膈肌收缩性能的机制做了介绍和讨论。

Respiratory insufficiency was one of the most causes that chronic pulmonary heart disease resulted in death.But respiratory muscle fatigue was an important factor which leaded to development of respiratary insufficiency.Therefore,In order to di- agnosing diaphragmatic fatigue and improving diaphragmatic contractility.We had made a respiratory recorder,which is a simple and well-recognized apparatus measuring the degree of diaphragmatic fatigue,we have found a quite hige rate of diaphragmatic fatigue among the in-patients in chronic cor pulmonale disease.Among the admitted 27 patients 11 cases have asynchronously thoracoabdominal breathing movement due to diaphragmatic fatigue were recorded.These patients were given a loading dose (6 mg/kg,v.gtt in 30 min) of aminophylline.Patient's thoracoabdominal breathing movement was recordered immeditely after loading dosages.The breathing synchronization was then observed in 7 patients.This indicated a substantial improvement in patients' diaphragmatic contractility. Of the 16 in-patients in synchronous breathing (no diaphragm fatigue) before the aminophylline administration,14 case shaved an elevated abdominal breathing amplitude after aminophylline dosing by a percent of 39.2,implying also an enhanced diaphragmatic contractility.The assembly of the thoracoabolominal respiratory movement recorder,ab- normality in breathing patterns and their clinical significance as well as the mechanism of improving diaphragmic contractility with aminophylline were discussed in this report.