肺功能检测spirometry.pptVIP

Pulmonary Function Testing 肺功能发展简史 肺功能发展已有300余年历史，从水封式——楔型式——滚筒式肺计量——电子计算机配合 1679年——BORELLI首先进行肺容量测定 1846年——HUTCHINSON提出肺活量概念 1919年——NIANSTROHL提出用力肺活量[FVC] 1967年——DOLLFUSS提出小气道疾病概念和小气道功能特点 1979年——美国胸科协会制定肺功能操作规范，1987年修订 What is Spirometry? What is Spirometry? Why Perform Spirometry? Why Perform Spirometry? Diagnostic Causes of symptoms (eg. breathlessness) Is breathlessness due to heart or lung disease? Assess pre-operative risk. Fit for surgery? Screen individuals at risk of lung disease (eg. smokers) Measure severity of airway obstruction or restriction Demonstrates to the patient, the presence and reversibility of airway obstruction. Eg Asthma Why Perform Spirometry? Objective Assessment The patients subjective assessment is often misleading Helps differentiate organic and psychosomatic disorders Numerical results can be compared with other data Provides objective feedback to the patient about the presence and severity of respiratory defect Why Perform Spirometry? Monitoring Assess response to bronchodilator therapy Determine the minimum effective dose of preventative medication Tool used in the Asthma 3+ Plan Evaluations for Disability / Impairment Assessment for: rehabilitation program - capacity for work? medico-legal reasons insurance evaluation -risk? Fitness to dive Limitations to Spirometry Effort dependant If patient can’t or won’t follow instructions, the quality of results are poor and interpretation difficult Doesn’t exclude asthma if spirometry is normal but may diagnose it Normal Spirometry doesn’t mean there is no problem eg. Pulmonary vascular disease: Normal spirometry but reduced TLCO May be a prelude to further investigations Respiratory Function Test Lung volumes Ventilation function Gas exchange Blood flow Respiratory motive force Lung Volume and Subdivisions Clinical Significance VC depends on sex, age and height. VC% 80% is abnormal. VC : restrictive ventilation disorder severe obstr