Postural relief of dyspnea in severe chronic obstructive pulmonary disease.
Postural relief of dyspnea in severe chronic obstructive pulmonary disease.
复制标题
姿势缓解严重慢性阻塞性肺疾病的呼吸困难。
DOI：
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发表时间：
2015
期刊：
影响因子：
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通讯作者：
W. Machnach
中科院分区：
文献类型：
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作者：
J. Sharp;W. S. Drutz;T. Moisan;J. Foster;W. Machnach
对17例重度致残慢性阻塞性肺疾病患者体位变化的影响进行了研究。在安静呼吸时，分别测量仰卧位、站立位、直立坐姿和前倾（坐）位的多重呼吸肌肌电图、胃、食管和经膈压和胸腹直径（通过磁强计）。7例患者前倾体位呼吸困难明显缓解，其中3例仰卧位呼吸困难也明显缓解。所有7例患者在站立和直立坐姿时均表现出矛盾的（向内的）腹部吸气运动，通过采取仰卧和前倾的姿势来纠正。与其余10例患者相比，这7例患者的TLC （P < 0.01）、FRC （P < 0.05）和RV （P < 0.02）均显著升高，但FVC和FEV1/FVC值无显著差异。他们的副吸气肌肌电图活动在假设状态时明显增强。
The effect of body position change was studied in 17 patients with severe disabling chronic obstructive pulmonary disease. Multiple respiratory muscle electromyograms, gastric, esophageal, and transdiaphragmatic pressures, and thoracoabdominal diameters (by magnetometer) were measured in the supine, standing, erect seated, and forward leaning (seated) positions during quiet breathing. Seven patients showed striking relief of dyspnea in the leaning forward position, and 3 of these obtained relief upon lying supine as well. All 7 showed paradoxical (inward) inspiratory motion of the abdomen in standing and erect seated postures, which was corrected by assuming the supine and forward leaning positions. When compared to the remaining 10 patients, these 7 had significantly greater TLC (P < 0.01), FRC (P < 0.05), and RV (P < 0.02), although FVC and FEV1/FVC values were not significantly different. Their accessory inspiratory muscle EMG activity was augmented to a significantly greater degree on assuming the sta...