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,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,www.drsarma.in,www.drsarma.in,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,肺功能检查,Pulmonary Function Tests,肺通气功能检查, Ventilatory Function,,,Spirometry,肺功能检查,通气功能检查,换气功能检查,血流灌注检查,通气,/,血流匹配检查,通气功能检查,Air out,气道通畅性,支气管平滑肌张力,分泌物,等,Air in,肺容积,肺顺应性,Air Out,问题,阻塞性通气功能障碍,Air In,问题,限制性通气功能障碍,Both,Air Out and In ,混合性通气功能障碍,峰流速仪,肺功能工作站,肺通气功能指标,FVC,(,Forced Vital Capacity,),用力肺活量,FEV,1,(,Forced Expiratory Volume in the first,second ),1,秒量,FEV,1,/FVC 1,秒率,PEFR,(,Peak Expiratory Flow Rate,),呼吸峰流速,FET,(,Forced Expiratory Time,),用力呼气时间,流量,-,容积曲线,容积,-,时间曲线,肺通气功能检查正常值,无固定的所谓“正常值”,正常预计值影响因素: 年龄,性别,身高,体重,种族,测定值表达为占预计值百分比,%,FVC 80%,预计值,FEV1 80%,预计值,FEV1/FVC,70%,PEFR 80%,预计值,FET,4,秒,四方格游戏,FEV,1,正常,FEV,1, 80% Pred.,FVC,正常,FVC 80% Pred.,80%,80%,四方格游戏,FVC,正常,FVC 80% Pred.,80%,80%,正常肺,FEV,1,/FCV,正常,FEV,1,正常,FEV,1, 80% Pred.,四方格游戏,FVC,正常,FVC 80% Pred.,80%,80%,FEV,1,正常,FEV,1, 80% Pred.,阻塞性肺疾病,FEV,1,/FCV,降低,四方格游戏,FVC,正常,FVC 80% Pred.,80%,80%,FEV,1,正常,L,FEV,1, 80% Pred.,限制性肺疾病,FEV,1,/FCV,升高,四方格游戏,FEV,1,正常,FEV,1, 80% Pred.,FVC,正常,FVC 80% Pred.,80%,80%,混合型(阻塞,+,限制),FEV,1,/FCV,正常或 降低,四方格游戏,FEV,1,正常,FEV,1, 80% Pred.,FVC,正常,FVC 80%,FVC 80%,FEV1 80%,正常肺功能,阻塞性,可逆性,不可逆性,肺外源性,FEV1 80%,限制性,混合性,肺源性,IBD,IBD,:吸入性支气管扩张剂,正常气道和肺,FVC 80%,FEV,1, 80%,FEV,1/,FCV 70%,PEFR 80%,FET4 sec,吸气 正常,呼气 正常,FEV1 is LOW,FVC is Normal,FEV1 FVC is 80%,FEV,1, 80%,FEV,1/,FCV 70%,PEFR4 sec,吸气 正常,呼气 困难,FEV1 is LOW,FVC is Normal,FEV1 FVC is 75%,气道阻塞性疾病,-,肺功能,FEV1 is LOW,FVC is Normal,FEV1 FVC is 75%,阻塞性,VS,正常,轻度阻塞,支气管哮喘,支气管哮喘,可逆性阻塞,(,支气管舒张试验,),支气管扩张,(,阻塞,),支气管造影,双侧,单侧,重度阻塞,肺气肿,重度阻塞,支气管舒张试验,肺气肿,气道阻塞性肺疾病,囊性肺纤维化,变应性支气管肺曲霉菌病,上气道阻塞,流量,-,容积曲线平台,呼气平台,胸内可变性,吸气平台,胸外可变性,双相平台,固定性,大气道肿瘤,气管狭窄,气管异物,声带功能不全,限制性肺疾病,结节病,肺结核, (,纤维干酪性,),肺间质性疾病,- ILD,特发性肺间质纤维化,- IPF,尘肺,药物或放射线所致肺疾病,肺叶切除术后,肺外限制性通气功能障碍,脊柱后凸、侧凸,强制性脊柱炎,大量胸腔积液,妊娠,肥胖,大量腹水,肋骨骨折,神经肌肉疾病,限制性肺疾病,FVC 80%,FEV,1/,FCV 70%,PEFR 80%,FET4 sec,吸气 困难,呼气 正常,FEV1 is LOW,FVC is Normal,FEV1 FVC is 75%,限制性肺疾病,肺功能检查,FEV1 is LOW,FVC is Normal,FEV1 FVC is 75%,间质性肺疾病,/,特发性肺间质纤维化,限制性,VS,正常,间质性肺疾病,/,特发性肺间质纤维化,限制性肺疾病,间质性肺疾病,间质性肺疾病,/,特发性肺间质纤维化,限制性肺疾病,-,间质性肺疾病,大体切面呈肝样变,限制性肺疾病,-,间质性肺疾病,外周网织结节状影,限制性肺疾病,-,间质性肺疾病,胸部,HRCT,间质性肺疾病,胸片,限制性肺疾病,结节病,网织结节状影,混合性通气功能障碍,FVC 80%,FEV,1, 80%,FEV,1/,FCV 70%,PEFR4 sec,吸气 困难,呼气 困难,FEV1 is LOW,FVC is Normal,FEV1 FVC is 75%,混合性通气功能障碍,FEV1 is LOW,FVC is Normal,FEV1 FVC is 75%,混合性通气功能障碍,肺结核,+,肺气肿,其它,固定性上气道阻塞,其它,EXTRA THORACIC,咳嗽,Case 1,28,岁男性, 172cm, 71kg,不吸烟,咳嗽,3,个月,诊断,:,哮喘,支气管舒张试验阳性,Test,Pred.,Meas.,%,FVC,5.5 L,4.5 L,82%,FEV1,4.9 L,3.0 L,61%,Ratio,89%,66%,-,Case 2,8,岁男孩, 128 cm, 19 kg,喘鸣,气促,.,Test,Pred.,Meas.,%,FVC,1.9 L,0.7 L,36%,FEV1,1.6 L,0.4 L,25%,Ratio,84%,57%,-,气道异物,Case 3,诊断,:,结核,+,支气管肺曲霉菌病,Test,Pred.,Meas.,%,FVC,3.5 L,1.8 L,51%,FEV1,2.8 L,1.2 L,43%,Ratio,80%,66%,-,29,岁女性, 160cm, 41 kg,气促、喘息,Case 4,68,岁男性, 165cm, 51kg,吸烟史,16,年,气促明显,.,诊断,:COPD,Test,Pred.,Meas.,%,FVC,4.5 L,3.7 L,82%,FEV1,3.6 L,1.8 L,50%,Ratio,80%,49%,-,支气管舒张试验阴性,
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