RT期刊文章SR电子T1胸壁和肺对呼吸系统弹性性质的贡献在患有慢性阻塞性肺部疾病的患者中188bet官网地址A1 Giuliani，R A1 Mascia，L A1 Grasso，S A1 Petruzzelli，V A1 Bruno，F A1 Fiore，T A1 Brienza，A YR 1996 UL //www.qdcxjkg.com/content.com/content/9/6/6/6/1232.abstractAB冲突的数据可在胸壁（CW）对慢性阻塞性肺疾病（COPD）患者中总呼吸系统（PEEPI，RS）的固有正急性末期压力的相对贡献中获得。为了评估急性通气衰竭期间COPD患者呼吸系统弹性特性的胸壁和肺贡献，使用“脑膜外线技术”，总呼吸系统（RS）的静态通胀体积压力（V-P）曲线在施用零端验证压力（ZEEP）和不同水平（0-15 cmh2O）的PEEP时，在七名机械通风的COPD患者中获得了肺（L）和CW。在Zeep上，PEEPI，RS存在于所有患者（范围10.5-13.1 CMH2O）中，Peepi，CW和Peepi分别贡献了17 +/- 2和83 +/- 1％。Zeep上RS，L和CW的静态V-P曲线朝向水平轴凹面，表明随着膨胀的体积而增加弹性。直到超过peepi的90％，在Zeep上的CW（PEEP的临界值（PCRIT）），PEEP的应用不会影响肺部和胸壁力学。在高于PCRIT的PEEP水平上，相对于Zeep上的V-P曲线，我们观察到：1）RS的V-P曲线显示沿Zeep上的曲线沿曲线的初始移位，然后向下移位，并具有充气体积；2）L的V-P曲线在整个膨胀体积过程中沿Zeep上的曲线移动；3）CW的V-P曲线最初沿着Zeep的曲线取代，而向下位移出现在较高的肺部体积下。 In conclusion, our data show that, in chronic obstructive pulmonary disease patients with flow limitation, the increase in pleural pressure does not make a significant contribution to the intrinsic positive end-expiratory pressure of the total respiratory system. However, during tidal ventilation, a substantial increase in elastance of the chest wall is present. The critical values of positive end-expiratory pressure below which there are no changes in chest wall and lung mechanics amount to 90% of the total PEEPi,rs on ZEEP. Positive end-expiratory pressure levels higher than such critical value cause important alterations of the elastic properties of the lung and chest wall.