问题 问答题 简答题

试述气体分布测定的临床意义。

答案

参考答案:

健康人肺内气体分布也存在区域性差异,但基本相对均匀。如某些肺泡通气不足,则气体分布明显不均匀,通气不足的肺泡区域的通气/血流比值下降,导致静一动脉样分流效应,引起低氧血症。

对测定吸入气体分布有重要意义的是Ⅲ相肺泡坪。正常人肺组织各区域肺泡气体分布相对均匀,肺泡气的氮浓度基本一致,故Ⅲ相肺泡坪近于水平。如气体分布不均匀,通气不足区域的肺泡吸入纯氧少,则肺泡气含氮浓度高,而且呼气排空在后,故氮浓度曲线Ⅲ相就会由近于水平变为上扬。

单次呼吸法评价吸入气体分布不均的主要指标有①△N(曲线中呼出气750~1250mL间的氮浓度差),正常<1.5%。②Ⅲ相斜率,健康人平均为1.98±1.37%/L。

△N和Ⅲ相斜率增大,提示吸入气体分布不均匀,见于支气管痉挛、肺纤维化、肺淤血、肺水肿、肺气肿、胸腔积液等。

单项选择题
单项选择题

Robert Moody, 52, is an experienced police officer. Much of his work involves dealing with (16) and gang (团伙)problems in the schools of his community. Knowing that many kids often (17) trouble, he decided to do something about it. So in 1991 he began to invite small groups of kids to go fishing with him on his day (18) .

Those fun trips had a(n) (19) impact. A chance encounter in 2000 proved that. One day, (20) working security at a school basketball game, Moody noticed two young guys (21) . He sensed trouble between them. (22) one of them headed toward Moody and gave him a hug. "I (23) you. You took me (24) when I was in fifth grade. That was one of the (25) days of my life. "

Deeply touched by the boy’ s word, Moody decided to create a foundation (基金会)that (26) teenagers to the basics of fishing in camping programs. "As a policeman, I saw (27) there was violence, drugs were always behind it. They have a damaging (28) on the kids," says Moody.

By turning kids on to fishing, he (29) to present an alternative way of life, "When you’ re sitting there waiting for a (30) ," he says, "you can’t help but talk to each other, and such (31) can be pretty deep. "

"Talking about drugs helped prepare me for the peer(同龄人)pressures in high school," says Michelle, 17, who (32) the first program. "And I was able to help my little brother (33) drugs. "

Moody faces (34) in three years, when he hopes to run the foundation full-time. "I’ m living a happy life and I have a responsibility to my (35) to give back," Moody says. "If I teach a kid to

fish today, he can teach his brother to fish tomorrow. \

31().

A. concerns

B. interests

C. conversations

D. emotions