麻醉專業(yè)英語.doc

精品文檔 麻醉專業(yè)英語 CHAPTER 1 FLUID ELECTROLYTE AND ACID BASE BALANCE 2 CHAPTER 2 INTRAVENOUS ANESTHESIA 4 CHAPTER 3 INHALATIONAL ANESTHETIC AGENTS 9 CHAPTER 4 MONITORING DURING ANESTHESIA 11 CHAPTER 5 RESPIRATORY PHYSIOLOGY 13 CHAPTER 6 CARDIOVASCULAR PHYSIOLOGY 18 CHAPTER 7 PHYSIOLOGY OF THE NS 22 CHAPTER 8 LOCAL ANESTHESIA AGENTS AND LOCAL ANESTHESIA 26 CHAPTER 9 NEUROMUSCULAR BLOCKING AGENTS 28 CHAPTER 10 INTRATHECAL ANESTHESIA 30 CHAPTER 11 ANESTHESIA FOR CARDIAC SURGERY 32 CHAPTER 12 NEUROSURGICAL ANESTHESIA 34 CHAPTER 13 ANESTHESIA FOR ABMORMAL SURGERY 37 CHAPTER 14 PAEDIATRIC ANESTHESIA AND INTENSIVE CARE 39 CHAPTER 15 ANESTHESIA FOR GYNECOLOGICAL AND OBSTETRIC SURGERY 45 CHAPTER 16 ANESTHETIC MANAGEMENT OF ELDERLY PATIENTS 48 CHAPTER 17 POSTOPERATIVE PAIN 50 精品文檔 CHAPTER 18 MANAGEMENT OF CHRONIC PAIN 54 精品文檔 ChapterChapter 1 1 Fluid Fluid ElectrolyteElectrolyte andand Acid BaseAcid Base BalanceBalance 1 The clinical manifestations of volume depletion are low blood pressure narrow pulse pressure tachycardia poor skin turgor and dry mucous membranes The history may suggest the reason for volume depletion 翻譯 血容量不足的臨床表現(xiàn)包括低血壓 脈壓狹窄 心動過緩 輕度皮 膚水腫以及粘膜干燥 病史的詢問可能提示病因 2 Combined water and electrolyte depletion may occur from gastrointestinal losses due to nasogastric suction enteric fistulas enterostomies or diarrhea Other causes are excessive diuretic therapy adrenal insufficiency profuse sweating burns and body fluid sequestration following trauma or surgery 翻譯 水合并電解質(zhì)的不足可以由腸道的丟失引起 其中包括鼻飼管的引 流 腸瘺 腸造口術(shù)以及腹瀉 其他原因還包括 過度的利尿藥治療 腎上 腺功能不足 過度出汗 燒傷 以及創(chuàng)傷和手術(shù)造成的體液丟失 3 Antidiuretic hormone released during anesthesia and surgical stress promotes water conservation by the kidneys Renal vasoconstriction and increased aldosterone activity reduce sodium excretion 翻譯 麻醉期間以及手術(shù)刺激時分泌的抗利尿激素會加強腎臟的保水能力 同時 腎血管的收縮和醛固酮的活動增強也會減少鈉的分泌 4 Hyponatremia in severe hyperglycemia results from the osmotic effects of the elevated glucose concentration which draws water from the intracellular apace to dilute ECF sodium 翻譯 高糖血癥時的低鈉血癥是由升高的血糖濃度的滲透作用造成的 也 精品文檔 就是說 過高的血糖濃度會迅速地將細胞內(nèi)的水轉(zhuǎn)移到血漿中對鈉進行稀釋 5 With extracellular acidosis a large proportion of the excess hydrogen is buffered intracellularly by an exchange of intracellular K for extracellular H this movement of K may produce dangerous hyperkalemia 翻譯 在胞外酸中毒時 很大一部分的胞外氫離子會和胞內(nèi)的鉀離子進行 交換 以此來對過多的氫離子進行緩沖 鉀離子的這種運動可能會導(dǎo)致危險的 高鉀血癥 6 The electrocardiographic changes are the most helpful indicators of the severity of hyperkalemia Early changes include peaking of the T waves widening of the QRS complex and depression of the ST segment 翻譯 心電描記圖上的變化是評估高鉀嚴重程度的最靈敏指標 早期的變 化包括 T 波高尖 QRS 波的增寬以及 ST 段的下移 7 The clinical manifestation of hypokalemia relate to neuromuscular function Decreased muscle contractility and muscle cell potential develop and in extreme cases death may result from paralysis of muscles of respiration 翻譯 低鉀血癥的臨床癥狀涉及神經(jīng)肌肉的功能 包括 肌肉的收縮能力 減弱 肌細胞的電位升高 在極少數(shù)病例中還會由于呼吸肌的癱瘓導(dǎo)致死亡 8 Acute respirtory acidosis occurs when respiration suddenly becomes inadequate CO2 accumulates in the blood and hydrogenion concentration increases This occurs most often in acute airway obstruction aspiration respiratory arrest certain pulmonary infections and pulmonary edema with impaired gas exchange 翻譯 急性呼吸性酸中毒的病因包括 突然的呼吸不足 血中 CO2 的堆積 精品文檔 以及氫離子濃度的升高 這種酸中毒最常見于急性呼吸道梗阻 誤吸 呼吸暫 停 某些肺部感染以及肺水腫時合并換氣不足等情況 9 Metabolic acidosis is caused by increased production of hydrogen ion from metabolic or other causes from excessive bicarbonate losses In either case the plasma bicarbonate concentration is decreased producing an increase in hydrogen ion concentration 翻譯 代謝性酸中毒的病因包括 代謝產(chǎn)生的氫離子增多或者是 其他原 因造成的碳酸氫鹽丟失過多 兩種情況下均是碳酸氫鹽的濃度降低 從而導(dǎo)致 氫離子的濃度升高 10 Volume deficit is best estimated of the basis of acute changes in weight or from clinical estimates the clinician should remember that deficits less than 5 of body water will not be detectable and that loss of 15 of body water will be associated with srvere circulatory compromise 翻譯 評估容量不足的兩項最好的指標 一 有體重急劇變化的根據(jù) 二 根據(jù)臨床評估 臨床醫(yī)生要始終記住 不足 5 的水分丟失不能被監(jiān)測出 而 15 的水分缺失將會造成嚴重的循環(huán)障礙 ChapterChapter 2 2 IntravenousIntravenous AnesthesiaAnesthesia 11 A widely accepted theory of anesthetic action is that both iv and inhalational anesthetics exert their primary sedative and hypnotic effects through an interaction with the inhibitory g aminobutyric acid GABA neurotransmitter system 翻譯 關(guān)于麻醉藥的作用機制 目前被廣泛接受的理論是 無論是靜脈還 精品文檔 是吸入性麻醉藥 都是通過和抑制性的 GABA 中樞傳遞系統(tǒng)相互作用來發(fā)揮它 們主要的鎮(zhèn)靜和催眠效應(yīng) 12 Benzodiazepines bind to specific receptor sites that are part of the GABAa receptor complex The binding of benzodiazepines to their receptor site increases the efficiency of the coupling between the GABA receptor and the chloride ion channal The degree of modulation of the GABA receptor function is limited which explains the celling effect produced by benzodiazepines with respect to CNS depression 翻譯 苯二氮卓類與 GABAa 受體復(fù)合物上相應(yīng)的結(jié)合位點相結(jié)合 提高了 GABA 受體和氯離子通道偶聯(lián)的效率 而 GABA 受體的調(diào)節(jié)能力是有限的 這 就解釋了為什么苯二氮卓類對中樞神經(jīng)系統(tǒng)的抑制作用會產(chǎn)生 封頂效應(yīng) 13 Ketamine produces a functional dissociation between the thalamocortical and limbic system a state that has been termed dissociative anesthesia Ketamine depresses neuronal function in the cerebral cortex and thalamus while simultaneously activating the limbic system 翻譯 氯胺酮會產(chǎn)生一種被稱為 分離麻醉 的狀態(tài) 也就是丘腦皮質(zhì)和 邊緣系統(tǒng)的功能分離 氯胺酮會在抑制大腦皮層和丘腦神經(jīng)元功能的同時激活 邊緣系統(tǒng) 14 When a drug infusion is administered without a loading dose 3 5 times the t1 2BETA value may be required to reach a steady state plasma concentration The steady state concentration obtained during an anesthetic infusion depends on the rate of drug administration and its clearance rate 翻譯 當某種藥物在給藥時沒有給予負荷劑量 則它將需要 3 到 5 倍的消 精品文檔 除半衰期才能達到血漿穩(wěn)態(tài)濃度 麻醉期間能達到的穩(wěn)態(tài)濃度取決于給藥速度 和藥物的消除速率 15 The context sensitive half time is defined as the time necessary for the effect compartment concentration to decrease by 50 in relation to the duration of the infusion The context sensitive half time becomes particularly important in determining recovery after variable length infusion of sedative hypnotic drugs 翻譯 情境相關(guān)半衰期是指輸藥時程不同時效應(yīng)室的濃度下降一半所需的 相應(yīng)時間 這種半衰期在決定某些可變時程的鎮(zhèn)靜催眠藥輸注后的恢復(fù)顯得尤 為重要 16 When steady state plasma concentrations are achieved it can be presumed that the plasma concentration is in equilibrium with the effect site concentration Under these circumstances it is possible to describe the relationship between drug and effect using a concentration effect curve 翻譯 當血漿中的藥物濃度達到穩(wěn)態(tài)濃度時 可以認為效應(yīng)處的濃度和血 漿中的藥物濃度已經(jīng)達到了平衡 在這種情況下 用濃度 效應(yīng)曲線描述藥物劑 量和效應(yīng)的關(guān)系成為可能 17 Barbiturates cause dose dependent respiratory depression However bronchospasm or laryngospasm following induction with thiopental is usually the result of airway manipulation in lightly anesthetized patients 翻譯 巴比妥類會引起劑量依賴性的呼吸抑制作用 但是 硫噴妥鈉誘導(dǎo) 后產(chǎn)生的支氣管痙攣和喉痙攣卻通常是由淺麻醉過程中的氣道操作引起的 18 Propofol is rapidly and extensively metabolized to inactive water soluble 精品文檔 sulfate and glucuronic acid metabolites which are eliminated by the kidneys Propofol s clearance rate 1 5 2 2 L Min exceeds hepatic blood flow suggesting that an extrahepatic route of elimination lung also contributes to its clearance 翻譯 丙泊酚被迅速而廣泛地代謝為沒有活性的 水溶性的硫酸鹽和葡萄 醛酸等產(chǎn)物 這些代謝產(chǎn)物都由腎臟清除 丙泊酚的清除率 1 5 2 2L min 超 過了肝臟的血流量 這就提示了還存在另外一條肝外清除途徑 即肺的清除 19 All benzodiazepines have anxiolytic amnestic sedative hypnotic anticonvulsant and spinally mediated muscle relaxant properties Benzodiazepines differ in potency and efficacy with regard to their distinctive pharmacologic properties 翻譯 所有的苯二氮卓類藥物均具有抗焦慮 致遺忘 鎮(zhèn)靜 催眠 抗驚 厥 以及由脊髓介導(dǎo)的肌松作用等特性 此類藥物的效價強度和效能會由于各 自不同的藥理特性而各不相同 20 Etomidate is associated with a high incidence of postoperative nausea and emesis when used in combination with opioids for short outpatient procedure In addition the increased mortality in critically ill patients sedated with an etomidate infusion has been attibuted to its inhibitory effect on cortisol synthesis 翻譯 當和阿片類聯(lián)合用于門診病人的短小手術(shù)時 依托咪酯的術(shù)后惡心 和嘔吐發(fā)病率會較高 此外 在那些用依托咪酯輸注進行鎮(zhèn)靜的危重病人中顯 示的高死亡率已經(jīng)被歸咎為它對糖皮質(zhì)激素合成的抑制作用 21 Katemine produces dose dependent CNS depression leading to a so called dissociative anesthetic state characterized by profound analgesia and amnesia even 精品文檔 though patients may be conscious and maintain protective reflexes 翻譯 氯胺酮產(chǎn)生的劑量依賴性的中樞神經(jīng)系統(tǒng)的抑制作用會產(chǎn)生一種被 稱為分離麻醉的狀態(tài) 這種狀態(tài)的特征是 即使病人的意識清醒并且保持保護 性反射 但是他們的痛覺和記憶卻是完全缺失的 22 An important consideration in the use of katemine anesthesia relates to the high incidence of psychomimetic reaction namely hallucination nightmares altered short term memory and cognition during the early recovery period 翻譯 使用氯胺酮麻醉時需要著重考慮術(shù)后恢復(fù)早期擬精神癥狀的高發(fā)病 率 這些癥狀包括幻覺 噩夢 以及短期的記憶和認知改變 23 Morphine produces its major theraputic as well as adverse effects in the central nervous system brain and spinal cord and the gastrointestinal system but other system are also affected CNS effects include analgesia sedation changes in affect respiratory depression nausea and vomitting pruritus and changes in pupil size 翻譯 嗎啡主要是在神經(jīng)系統(tǒng) 腦和脊髓 和胃腸道系統(tǒng)發(fā)揮它的治療作 用和副作用 但同時其他系統(tǒng)也會受累 中樞神經(jīng)系統(tǒng)效應(yīng)包括痛覺缺失 鎮(zhèn) 靜 呼吸抑制 惡心嘔吐 瘙癢以及瞳孔大小的改變 24 Patients who are critically ill e g patients with severe trauma or cardiac disease can be expected to have high sympathetic tone and thus may experience hypertention in response to doses of morphine which would not normally produce hemodynamic instability 翻譯 有嚴重創(chuàng)傷或心臟病的危重病人通常交感神經(jīng)的緊張度都比較高 精品文檔 所以這些病人可能會由于嗎啡的劑量而出現(xiàn)高血壓 而通常情況下嗎啡是不會 引起血流動力狀態(tài)的不穩(wěn)定的 25 Nausea and vomitting are among the most distressing side effects of morphine and its derivatives The incidence of opioid induced nausea appears to be similar irrespective of the route of administration Morphine causes dose dependent nausea and vomitting but the physiology and neuropharmacology of opioid induced nausea and vomitting are complex 翻譯 惡心嘔吐是嗎啡和它的衍生物的最痛苦的副作用之一 阿片類誘導(dǎo) 產(chǎn)生的惡心不會因給藥途徑的不同而發(fā)生改變 嗎啡會誘發(fā)一種劑量依賴性的 惡心嘔吐 但是阿片類誘發(fā)的惡心嘔吐的具體生理和神經(jīng)藥理機制則比較復(fù)雜 26 High doses of fentanyl significantly blunt the stress response e g hemodynamic and hormonal responses to surgical stimuli while producing only minimal cardiovascular depression 翻譯 大劑量的芬太尼會顯著抑制應(yīng)激反應(yīng) 例如對手術(shù)刺激所產(chǎn)生的血 流動力學(xué)反應(yīng)和激素反應(yīng)都會受到抑制而只會產(chǎn)生最輕微的心血管系統(tǒng)的抑制 ChapterChapter 3 3 InhalationalInhalational AnestheticAnesthetic AgentsAgents 27 MAC is the minimum alveolar concentration of an anesthetic at 1 atmosphere absolute that prevents movement of 50 of the population to a standard stimulus It has gained widespread acceptance as an index of anesthetic potency as it is 精品文檔 measured 翻譯 MAC 是指在一個標準大氣壓下 能阻止 50 受試對象對一個標準刺 激的體動反應(yīng)的肺泡內(nèi)麻醉藥的最小濃度 在被測量證實后 它作為一種衡量 麻醉藥的效價強度的指標已被廣泛接受 28 Halothane causes a dose dependent decrease in mucociliary function which may persist for several hours after anesthesia This may contribute to postoperative sputum retention 翻譯 氟烷會對粘液纖毛的功能產(chǎn)生一種劑量依賴性的抑制作用 而這種 作用可能會一直持續(xù)到術(shù)后幾個小時 這樣就可能導(dǎo)致術(shù)后的痰液滯留 29 The second type of hepatic dysfunction is extremely uncommon and takes the form of severe jaundice progressing to fulminating hepatic necrosis The mortality of this condition is quite high and varies between 30 70 The incidence of type 2 is extremely low 翻譯 第二種類型的肝功能障礙極其罕見 通常是以嚴重黃疸的形式出現(xiàn) 并發(fā)展為暴發(fā)性肝壞死 一旦發(fā)生上述情況 則死亡率相當高 波動于 30 70 之間 但是 2 型的發(fā)病率極低 30 Enfulurane anesthesia is associated with a much smaller incidence of arrhythmias than halothane and much less sensitization of the myocardium to catecholamines either endogenous or exogenous 翻譯 使用恩氟烷麻醉時出現(xiàn)心律失常的幾率比氟烷時要低得多 且心肌 對兒茶酚胺的敏感性 無論是內(nèi)源性的還是外源性的 也要低得多 31 Isoflurane is the least with exception of desflurane soluble of the modern 精品文檔 inhalational agents and thus alveolar concentrations equilibrate more rapidly However the rate of induction is limited by the pungency of the vapor 翻譯 異氟烷在目前使用的吸入麻醉藥中是最不易溶解的 地氟烷除外 這樣它的肺泡濃度可以更快達到平衡 但是 誘導(dǎo)的速度卻是要受到氣體的刺 激性的限制的 32 Nitrous oxide is a weak anesthetic whose MAC is 105 It s used usually in combination with other agents Because of the low solubility a change in alveolar ventilation has less effect on the rate of uptake than occurs with the more soluble agents such as halothane and ether 翻譯 一氧化二氮 即笑氣 是一種低效麻醉劑 它的 MAC 達到了 105 通常和其他藥物聯(lián)合使用 由于一氧化二氮的溶解度較低 所以和那些 比它溶解度大的藥物如氟烷 乙醚相比 肺泡通氣量的改變對它的攝取率影響 更小 ChapterChapter 4 4 MonitoringMonitoring DuringDuring AnesthesiaAnesthesia 33 Maintenance of perfusion of vital organs is one of the principal tasks of the anesthetist during surgery Adequate perfusion is dependent on adequate venous return to the heart cardiac performance and arterial pressure Adequacy of cardiac output and circulating blood volume may be inferred indirectly from observation of the variables peripheral pulse arterial oxygen saturation peripheral perfusion urine production arterial prssure 翻譯 保持重要器官的灌流是麻醉醫(yī)生在術(shù)中的主要職責之一 而充足的 精品文檔 灌流則依賴于足夠的靜脈回心血量 心臟的性能和動脈血壓 心輸出量和循環(huán) 血量是否充足則可以通過對以下指標的觀測間接反映 包括 外周脈搏 動脈 氧飽和度 外周灌流 尿量以及動脈血壓 34 Advantages Pulse oximeters are simple to use non invasive and require no warm up They provide an overall assessment of the integrity of all the systems involved in delivering oxygen to the tissues oxygen supply to the patients oxygen uptake by the lungs oxygen delivery to the tissues via the circulatory system 翻譯 優(yōu)點 脈搏血氧測量操作簡單 無創(chuàng)且不需要預(yù)熱時間 對向組織 供氧的各系統(tǒng)的完整性 這項指標則可以提供比較全面的評估 35 Measurement of CVP is useful in situations similar to those warranting direct measurement of arterial pressure The surface marking of the right atrium is the true zero reference point The normal range of values is 0 6cm H2O in the spontaneously breathing patients Measurement of CVP is a valuable aid to blood and fluid replacement 翻譯 和在那些需要測量動脈血壓相似的情況下一樣 中心靜脈壓的測量 也很有意義 右心房的表層標志才是真正的零基準線 CVP 的正常值在自主呼 吸的病人是 0 6cmH2O 其測量對血液和體液的補充是一項很有價值的輔助措施 36 Whichever route is chosen meticulous attention to antisepsis is necessary The tip of the catheter should lie above the level of the pericardium to minimize the risk of erosion through the wall of right atrium 翻譯 無論采取哪種途徑 都要格外重視消毒的重要性 導(dǎo)管的尖端不應(yīng) 精品文檔 超過心包膜水平 這樣才能盡可能減小導(dǎo)管磨蝕右心房壁的危險性 37 Losses of up to 10 of blood volume are tolerated well and may be replaced by an approprite volume of crystalloid solution Blood loss in excess of 15 of blood volume during surgery should be replaced by blood 翻譯 10 以內(nèi)的血容量丟失可以被機體很好地代償 且這部分缺失可以 由適量的晶體液補充 但如果術(shù)中血容量的丟失高達 15 此時則需要對病人 進行補血 38 Estimation of fluid losses includes measurement of blood loss on swabs and drapes fluid collection in suction jars and an allowance for evaporative loss Fluid input and output must be measured as accurately as possible in babies and children 翻譯 對液體丟失的評估包括 對棉簽 圍巾上血量丟失的測量 吸引器 中的液體收集量 同時還要考慮到蒸發(fā)的丟失量 在嬰幼兒和兒童病人的手術(shù) 中 液體的輸入和輸出要盡可能精確 ChapterChapter 5 5 RespiratoryRespiratory PhysiologyPhysiology 39 The principal purpose of the respiratory system is the exchange of oxygen and carbon dioxide between the blood and respired gas It has secondary roles in the control of acid base balance the metabolism of hormones and the removal of compounds and particulate matter taking advantages of its position as the only organ which receives the entire cardiac output 翻譯 呼吸系統(tǒng)的主要功能是進行血液和吸入氣體中的氧氣和二氧化碳的 交換 同時由于它有利的生理解剖位置 作為可以接受全部心輸出量的唯一器 精品文檔 官 還發(fā)揮著調(diào)節(jié)酸堿代謝的平衡 激素的代謝以及化合物和一些微粒的清除 等次要生理作用 40 The lung surface area is about the size of a tennis court and so this point of intersection with the external environment is huge This is both an advantage and a disadvantage 翻譯 肺的表面積大約有一個網(wǎng)球場大小 因此這個和外環(huán)境相聯(lián)系的場 所就顯得相當巨大 而這樣既有利也有弊 41 Therefore the lungs are also a site of defense The defense system exists at two levels The first is to deal with inhaled particles Depending upon their size particles are either swept out of the airways entrapped in mucous or digested by macrophage 翻譯 如此說來 肺同時也扮演著機體防線的作用 它的防御作用體現(xiàn)在 兩個水平 第一個是對吸入的顆粒的處理 由于顆粒大小的不同 那些黏附在 黏膜表面的顆粒會被直接清除出呼吸道 而有些則被巨噬細胞吞噬 42 The lungs are a reservior of blood that can be mobilized during times of reduced volume Approxiamtely 20 of the total blood volume resides in the pulmonary vasculature normally but this volume can increase or decrease depending upon the output of the left ventricle 翻譯 肺臟扮演著儲血庫的角色 而其中的血液在機體循環(huán)血量減少時可 以被調(diào)動出來 通常情況下 機體大約 20 的總血容量儲存在肺的血管網(wǎng)內(nèi) 但是這一儲存量會隨著左心室輸出量的變化而產(chǎn)生相應(yīng)的增加或減少 43 Air is through into the body through the conducting airway This begins 精品文檔 with the trachea which divideds into bronchi and subdivides multiple times into bronchioles The conducting airways warm and humidify the inspired air but not a site of gas exchange 翻譯 空氣是通過傳導(dǎo)氣道進入體內(nèi)的 這一過程起始于氣管 氣管再分 支為支氣管 再經(jīng)過很多級的分支成為細支氣管 傳導(dǎo)氣道的作用是對吸入氣 體進行加熱和濕化 但是沒有氣體交換功能 44 The blood supply of the conducting airways provides the heat and moisture to warm and humidify the inspired air It also provides for all the nutrient repuirments to lung tissue 翻譯 傳導(dǎo)氣道的血液供應(yīng)不僅保證了對吸入氣體進行加熱和濕化所需的 熱量和濕度 還提供了肺組織所需的營養(yǎng)物質(zhì) 45 Oxygen diffuses from the terminal bronchioles through the respiratory bronchioles and alveolar sacs into the alveoli It then diffuses across the alveolar epithelium basement membranes capillary endothelium plasma and red cell membrane before combining with hemoglobin Carbon dioxide diffuses in the reverse direction 翻譯 氧氣的擴散途徑如下 終末細支氣管 呼吸性細支氣管 肺泡囊 肺泡 到達肺泡后再依次穿過肺泡內(nèi)皮細胞 基底膜 毛細血管內(nèi)皮細胞等結(jié) 構(gòu)進入血漿 最后穿過紅細胞膜與血紅蛋白結(jié)合 二氧化碳則按相反的方向擴 散 46 Respiration is modified by many other factors particularly from higher centers in the brain including the cortex The pattern of respiration is modulated by 精品文檔 speech and ingestion of food and drink The anticipation of exercise as well as the activity itself increases respiration 翻譯 呼吸會受到很多其他因素的調(diào)節(jié) 特別是來自腦的高級中樞包括大 腦皮層的控制 呼吸模式會因說話或攝食水和食物等活動而發(fā)生相應(yīng)的調(diào)整 活動 甚至是對活動的期待也可以增強呼吸 47 If the PaCO2 is kept constant changes exponentially with PaO2 The response is linear when oxygenation is expressed as oxyhaemoglobin saturation SaO2 The response is much greater if PaCO2 increases at the same time 翻譯 如果將 PaCO2 的值保持恒定 則 將隨著動脈氧分壓呈指數(shù)型 變化 當用氧合血紅蛋白的飽和度來表示氧合的情況時 則兩者的關(guān)系曲線呈 線性變化 當二氧化碳的動脈分壓也同時增加時反應(yīng)會更顯著 48 The total volume of the respiratory system total lung capacity TLC when fully expanded by voluntary effort is about 3 6 litres in the average adult and is ralated more to height than weight 翻譯 在一個普通成人 呼吸系統(tǒng)的總?cè)萘?即肺總量 可以通過自主努 力完全擴張而達到 3 6 升 與體重相比 身高因素對肺總量的影響更大 49 The closing capacity CC is that volume of the lung where small airways in the dependent parts of the lung begin to collapse during expiration Normally CC is less than FRC but greater than RV CC increases with age and FRC is decreased by a number of factors e g increasing age posture anesthesia obesity etc and if CC is greater than FRC dependent parts of th