压的牵拉作用*DepartmentofAnesthesiology,AffiliatedHospitalofXUZHOUMedicalCollege**DepartmentofAnesthesiology,AffiliatedHospitalofXUZHOUMedicalCollege*第一节剖胸及侧卧位对呼吸循环的影响剖胸所引起的病理生理改变剖胸后对呼吸的影响剖胸侧肺萎陷肺萎陷剖胸后,剖胸侧胸膜腔负压消失,肺泡内及肺表面均受大气压的作用,因而肺泡只受自身回缩力的净作用,导致萎陷。*DepartmentofAnesthesiology,AffiliatedHospitalofXUZHOUMedicalCollege*第一节剖胸及侧卧位对呼吸循环的影响剖胸所引起的病理生理改变剖胸后对呼吸的影响剖胸侧肺萎陷危害①肺的弥散面积可减少50%②肺血管阻力↑(萎陷的肺组织压迫肺血管、缺氧性肺血管收缩hypoxicpulmonaryvasoconstrictionHPV)③肺内分流(pulmonaryshunt)↑*DepartmentofAnesthesiology,AffiliatedHospitalofXUZHOUMedicalCollege*第一节剖胸及侧卧位对呼吸循环的影响剖胸所引起的病理生理改变剖胸后对呼吸的影响纵隔移位及纵隔摆动(Mediastinalshift)纵隔移位:两侧胸腔压力失去平衡纵隔摆动:健侧肺的呼吸运动*DepartmentofAnesthesiology,AffiliatedHospitalofXUZHOUMedicalCollege*纵隔移位及纵隔摆动(Mediastinalshift)吸气相+—剖胸侧*DepartmentofAnesthesiology,AffiliatedHospitalofXUZHOUMedicalCollege*吸气相—+剖胸侧
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