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PulmonaryFunctionTests
临床肺功能检查
WhatPulmonaryFunctionTestsDoYouNeedSpirometryLungVolumesBodyPlethysmographyDiffusingCapacity(DLCO)ArterialBloodGasAnalysis
Water-sealspirometer:水鼓式
Pneumotach
流速仪
Portablespirometer
便携式
Portablespirometer
动态肺量计
Bodybox
体描箱
Diffusion
WhatInformationDoesPFTProvideThefunctionoftheairwaysThefunctionofpulmonaryparenchymaPulmonaryvasculatureRespiratorymuscle
SpirometryDetectlungdisease(screening)QuantifyextentofknowndiseaseDeterminebenefits/risksoftherapyAssesssurgicalriskIndications
LungVolumesDiagnose/assessrestrictivelungdiseaseAssesshyperinflationinobstructivediseaseAssessresponsetotreatmentLungtransplantationLungvolumereductionRadiation,chemotherapyIndications
DiffusionCapacityFollowprogressofinterstitiallungdiseaseAssesspulmonaryinvolvementinsystemicdiseaseEvaluategasexchangeinobstructivediseaseAssesspulmonaryvasculardiseasesIndications
TestingGuidelinesForcefulexpiration,nohesitation,atleast6secondsAtleast3acceptablemaneuversobtainedTwolargestFVCandFEV1valueswithin150mlBesttest=largestFVC+FEV1Spirometry
Interpretationof
PulmonaryFunctionTesting
Step1.Examineflow-volumeloopIsitagoodPFT’sIsitnormalCharacteristicpatternofobstructionPatternofrestrictionPatternofupperairwayobstruction
NormalFlow-VolumeLoop
Cough
VariableEffort
SevereObstruction
Restriction
UpperAirwayObstruction
Step2.Arethedataconsistentwithflow-volumeloopFVC(VC):anexpressionoflungsizeFEV1:influencedbylungsizeandthedimensionsofairwayFEV1/FVC:ameasureofairwayobstructionReducedFVCwithnormalFEV1/FVConlysuggestsrestriction.TLCisindicatedtoconfirmtherestriction
CriteriaforRestrictionReducedTLCisaGoldenstandardReducedFVCwithnormalFEV1/FVCratioissensitivebutlacksofspecificity
NonspecificVentilationLimitationReducedFVCandFEV1NormalFEV1/FVCNormalTLCRestrictiveObs
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