上腔静脉血流速度频谱呼吸性变化规律的临床与实验研究
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摘要
目的 探讨健康成人上腔静脉(SVC)血流速度频谱随自主呼吸变化的特点、频谱参数与胸内压力的关系、在不同右心房压力时的呼吸变化规律，并通过观察分析右心功能衰竭患者SVC血流速度频谱随自主呼吸变化的特点，评价检测SVC血流速度频谱呼吸变化的临床应用价值。
方法 1．经右侧锁骨上窝切面探查健康志愿者SVC血流速度频谱，测量自主呼吸周期中SVC主波流速最大和流速最小的频谱曲线各波峰值及速度时间积分(VTI)，计算各波峰值及VTI随呼吸的变化率。2．采用可显示压力的密闭呼吸面罩，通过健康志愿者自主控制呼吸深度，分别将胸内压调整到-8mmHg、-4mmHg、4 mmHg、8mmHg，记录相应胸内压时的SVC血流速度频谱，测量不同胸内压时的SVC血流速度频谱参数。3．通过静脉快速输注高渗盐水的方法升高杂种犬的右心房压力，通过调整灌注速度将右心房平均压力分别调整到5mmHg，10mmHg，15mmHg，记录不同右心房压力时自主呼吸周期中SVC主波流速最大和流速最小的频谱曲线各波参数，计算其呼吸变化率。4．记录自主呼吸时右心功能衰竭患者及健康对照组的SVC血流速度频谱，观察SVC血流速度频谱形态，测量同一呼吸周期中回心方向血流速度最大和最小的频谱曲线各波参数，计算其呼吸变化率。所有结果采用统计软件SPSS 11.0处理。
结果 1．健康成人SVC血流速度频谱各波峰值及VTI随自主呼吸出现规律
Objectives Aimed to study the rule of respiratory changes of the spectra of superior venae cavae (SVC) of health adults, explore the relationships between the parameters of the spectra of SVC and intrathoracic pressure (TIP) and right atrium pressure (RAP), and evaluate the clinical value of respiratory changes of the spectra of SVC through studying the characteristics of respiratoiy changes of the spectra of SVC in patients with right heart failure.
Methods 1. Through supraclavicular fossa view, maximum and minimum return flow velocity spectra of SVC of health adults in respiration cycle were recorded, peak velocities and velocity time integrals (VTI) of them were measured, and the change ratios were calculated. 2. Various ITP (-8 mmHg, -4 mmHg, 4 mmHg and 8 mmHg) were obtained by respiratory mask, the spectra of SVC of health adults under various ITP were recorded, and the parameters of SVC were measured accordingly. 3. Canine models with different RAP (5mmHg, 10mmHg and 15mmHg) were constructed through infusing hypertonic saline rapidly, and the respiratory changes of the parameters of the spectra of SVC were calculated accordingly. 4. The spectra of SVC in patients with right heart failure and their
方法 1．经右侧锁骨上窝切面探查健康志愿者SVC血流速度频谱，测量自主呼吸周期中SVC主波流速最大和流速最小的频谱曲线各波峰值及速度时间积分(VTI)，计算各波峰值及VTI随呼吸的变化率。2．采用可显示压力的密闭呼吸面罩，通过健康志愿者自主控制呼吸深度，分别将胸内压调整到-8mmHg、-4mmHg、4 mmHg、8mmHg，记录相应胸内压时的SVC血流速度频谱，测量不同胸内压时的SVC血流速度频谱参数。3．通过静脉快速输注高渗盐水的方法升高杂种犬的右心房压力，通过调整灌注速度将右心房平均压力分别调整到5mmHg，10mmHg，15mmHg，记录不同右心房压力时自主呼吸周期中SVC主波流速最大和流速最小的频谱曲线各波参数，计算其呼吸变化率。4．记录自主呼吸时右心功能衰竭患者及健康对照组的SVC血流速度频谱，观察SVC血流速度频谱形态，测量同一呼吸周期中回心方向血流速度最大和最小的频谱曲线各波参数，计算其呼吸变化率。所有结果采用统计软件SPSS 11.0处理。
结果 1．健康成人SVC血流速度频谱各波峰值及VTI随自主呼吸出现规律
Objectives Aimed to study the rule of respiratory changes of the spectra of superior venae cavae (SVC) of health adults, explore the relationships between the parameters of the spectra of SVC and intrathoracic pressure (TIP) and right atrium pressure (RAP), and evaluate the clinical value of respiratory changes of the spectra of SVC through studying the characteristics of respiratoiy changes of the spectra of SVC in patients with right heart failure.
Methods 1. Through supraclavicular fossa view, maximum and minimum return flow velocity spectra of SVC of health adults in respiration cycle were recorded, peak velocities and velocity time integrals (VTI) of them were measured, and the change ratios were calculated. 2. Various ITP (-8 mmHg, -4 mmHg, 4 mmHg and 8 mmHg) were obtained by respiratory mask, the spectra of SVC of health adults under various ITP were recorded, and the parameters of SVC were measured accordingly. 3. Canine models with different RAP (5mmHg, 10mmHg and 15mmHg) were constructed through infusing hypertonic saline rapidly, and the respiratory changes of the parameters of the spectra of SVC were calculated accordingly. 4. The spectra of SVC in patients with right heart failure and their
引文
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