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残气量(RV)测定是临床诊断慢性阻塞性肺气肿(简称肺气肿)的一个重要肺功能指标。但是,尸检资料表明生前残气量及残气占肺总量百分比(RV/TLC％)的改变与死后肺气肿病理形态学方面的发现并不密切吻合,而且,近来有人认为残气量增加不是肺气肿的特异性表现,慢性支气管炎也可见残气量增加,因此如何评定残气量测定在肺气肿诊断中的意义,目前尚有争议。我院于1964年曾对159例慢性阻塞性肺气肿进行了临床观察,提出了以 RV/TLC％增高作为肺气肿诊断、分度标准具有一定的临床实用价值。本文在此基础上就80年11月至81年4月诊治的110例临床疑有及确诊肺气肿病例,进行了病史、体征、X线及肺功能检查,着重验证并进一步探讨残气量测定在肺气肿诊断中的意义,残气量测定本身的重复可靠性以及支气管舒张试验对残气量的影响等技术问题。
Residual volume (RV) determination is clinically diagnosed as chronic obstructive pulmonary emphysema (referred to as emphysema) an important indicator of pulmonary function. However, autopsy data suggest that changes in prenatal and residual percentages of total lung volume (RV / TLC%) are not closely related to the findings in post-mortem emphysema histopathology, and recently it has been suggested that the increase in residual volume is not Specific manifestations of emphysema, chronic bronchitis can also be seen increased residual volume, so how to assess the significance of residual volume measurement in the diagnosis of emphysema, is still controversial. Our hospital in 1964 had 159 cases of chronic obstructive pulmonary emphysema clinical observation, proposed RV / TLC% increase as emphysema diagnosis, indexing standard has some clinical value. Based on the above, 110 cases of clinical suspects and diagnosed emphysema diagnosed and treated from November 1980 to April 2001 were reviewed. The medical history, signs, X-ray and pulmonary function tests were examined. The residual gas was measured and further investigated The significance of the diagnosis of emphysema, the residual reliability of the measurement of residual volume and the impact of bronchial diastolic test on the residual gas and other technical issues.