• 作者： 張西川; 張慧英; 陳芳祝; 蕭光明; 王聖賢
• 作者服務機構： 台北榮民總醫院胸腔部; 台北榮民總醫院內科部胃腸內科暨國立陽明大學醫學院內科學系
• 中文摘要： 本研究擬探討不等腹水量與姿勢改變對22位肝硬化病人氣體交換功能之影響。氣體交換功能之評估乃採用單息一氧
  化碳肺瀰散量（single breath carbon monoxide diffusing capacity, DLco）方法，在坐、?姿分別測量，至於體位順序
  完全是隨機的。結果顯示，病患的Kco（DLco經肺泡容積[VA]校正）值與肺量呈負相關。坐姿的DLco值高於臥姿的，
  但Kco值卻相反。坐、?姿DLco與Kco之差值（?姿值減去坐姿值）與用力肺活量（forced vital capacity, FVC）和一
  秒用力呼氣量（forced expiratory volume in one second, FEV1）有顯著相關。在22位病患中，有13位接受腹水大量放
  液治療，在放液治療的前一天與後一天施檢肺功能。結果顯示，放液治療後，病人的肺量與DLco值均有明顯改善；然
  而，Kco值卻明顯變差。此外，放液治療前後Kco差值（放液後值減去放液前值）與肺量之差值呈負相關。至於放液治
  療後，坐與臥姿所測得的DLco與Kco值均無顯著差異。總結，肝硬化併發腹水病人當其腹水量增至某一程度時，可緩
  ／其氣體交換功能之惡化以及姿勢改變對氣體交換功能之影響。
  所
• 英文摘要： The effects of ascites and body position on gas exchange were evaluated in 22 male cirrhotics．Allunderwent spirometry and plethysmography in the sitting (erect) position. Single breath carbon monoxidediffusing capacity (DLco) was measured in the erect and supine positions in a random sequence. A sig-nificantly negative correlation was found between Kco (DLco corrected by alveolar volume [VA]) and lungvolumes. DLco was significantly higher in the erect than in the supine position. On the other hand, Kcowas significantly higher in the supine position. The differences of DLco and Kco between the erect andsupine positions (the data in the supine minus those in the erect position) correlated highly with FEV1and FVC. Thirteen patients underwent large volume paracentesis, and pulmonary function tests were doneone day before and after paracentesis. Lung volumes and DLco increased significantly after paracentesis.In contrast, Kco decreased significantly. A significantly negative correlation was found between the changeof Kco before and after paracentesis and that of lung volumes (the data after minus those before para-centesis). There was no remarkable change in the differences of DLco and Kco between the two positionsafter paracentesis. It is concluded that ascites may prevent further worsening of gas exchange and attenuatethe postural effect on gas exchange in cirrhotic patients with significant amounts of ascites.
• 中文關鍵字： ascites; body position; gas exchange; liver cirrhosis.
• 英文關鍵字： --