肺容量不全對肺功能之影響及提升肺容量之訓練.pdf

The Loss of Lung volume 肺容量不全 對肺功能之影 響及提升肺容 量之訓練 區藹寧 香港物理治療師 23 SEPTEMBER 2017 Content ▪ Background of Lung volume ▪ Implication of the Loss of Lung Volume ▪ Causes of the Loss of Lung Volume ▪ Lung expansion therapy ▪ Mobilization ▪ Positioning ▪ Increase of Trans-pulmonary Pressure Gradient Lung Volume Tidal Volume (TV) ▪ Vol. of air inhaled/exhaled in each breath during normal respiration ▪ Norm : 6-8 ml/kg ▪ Minute Volume = TV x Respiratory Rate (MV inversely with PaCO ) 2 Reference of a Healthy young 70-kg adult male. Lung Volume Functional Residual Capacity (FRC) ▪ Vol. of air remaining in the lung after normal expiration ▪ FRC = RV + ERV ▪ Norm : 30-35ml/kg ▪ Correlates with oxygenation and respiratory system compliance Lung Volume Vital Capacity (VC) ▪ Maximum vol. of air expired after a max. inspiration ▪ VC = TV + ERV + IRV ▪ Norm: 60-70ml/kg ▪ Correlates with capability for deep breathing and effective cough Implication of the Loss of Lung Volume Causes of the Loss of Lung Volume ▪Atelectasis ▪ Consolidation ▪ Pleural effusion or Pneumothorax or abdominal distension ▪ Restrictive disorder of lung Atelectasis ▪ Definition: Closure or collapse of alveolar resulting in reduced or absent gas exchange Reabsorption •Blockage of airway ➢ Mucous plugging ➢ Ineffective cough ➢ Foreign body ➢ Tumor Atelectasis Passive/ Compression •Persistent small tidal volume •Space-occupying lesion ➢ Pain ➢ Post surgery (e.g. upper GI ; cardiothoracic) ➢ Prolonged Immobilization ➢ Neuromuscular disorder ➢ Sedation ➢ Pleural Disorder/ Tumor