710032 西安,空军军医大学航空航天医学系航空航天人机工效学教研室
Received:19 December 2023,
Revised:2024-02-22,
Published:30 August 2024
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Zhijun GAO, Hang WANG, Chunchen WANG, et al. Real-time evaluation of pulmonary ventilation of HP movements based on electrical impedance tomography: an observational study[J]. Journal of Army Medical University, 2024, 46(16): 1882-1889.
Zhijun GAO, Hang WANG, Chunchen WANG, et al. Real-time evaluation of pulmonary ventilation of HP movements based on electrical impedance tomography: an observational study[J]. Journal of Army Medical University, 2024, 46(16): 1882-1889. DOI: 10.16016/j.2097-0927.202312101.
目的
2
探索电阻抗断层成像技术(electrical impedance tomography,EIT)用于实时精准监测HP动作中呼吸环节的可行性以及肺通气整体及局部关键参数。
方法
2
2023年9月纳入12名空军军医大学健康男性大学生受试者,于抗荷生理训练仪中进行HP动作30 s各3次,期间进行EIT及眼水平动脉压测量,用于分析肺通气整体及局部参数[吸气量(inspiratory volume,IV)、呼气均匀性(expiratory uniform,EU)、呼气流速(expiratory speed,ES)、通气中心(center of ventilation,COV)、左右肺通气比(right-to-left lung ventilation ratio,RtoL)等]与抗荷动作(anti-G straining maneuver,AGSM)抗荷能力之间的关系。
结果
2
HP动作期间眼水平收缩压为(148.82±22.75)mmHg,明显高于平静呼吸(PJ)期间眼水平收缩压[(95.17±8.51)mmHg,
P
<
0.001
]
。从整体肺通气来看,与平静呼吸相比,受试者HP动作期间IV明显增大(
P
<
0.001)。按照d值(即眼水平收缩
压均值升高值=SBP
HP
-SBP
PJ
)
>
60、30~60、
<
30 mmHg将受试者分为3组,吸气量比值(IV
HP
/IV
PJ
)在d
>
60 mmHg组最大,而在d
<
30 mmHg组最小,差异有统计学意义(
P
<
0.01);受试者HP动作期间EU明显减小,呼气更均匀,差异有统计学意义(
P
<
0.05),呼气均匀性比值(EU
HP
/EU
PJ
)在各组无统计学差异;HP动作期间ES明显更快,差异有统计学意义(
P
<
0.001),呼气流速比值(ES
HP
/ES
PJ
)在各组无统计学差异;HP动作期间吸气时间[(0.77±0.32)s
]
、呼气时间[(1.59±0.21)s
]
均明显缩短,差异均有统计学意义(
P
<
0.001,
P
<
0.01)。从局部肺通气来看,与平静呼吸相比,受试者HP动作期间COV明显更小,通气中心偏向腹侧,差异有统计学意义(
P
<
0.001);RtoL减小,通气分布偏向左肺,差异有统计学意义(
P
<
0.05)。
结论
2
EIT可对HP动作期间肺整体及局部通气进行实时成像,在AGSM训练及监测中具有很大的应用前景。
Objective
2
To explore the feasibility of electrical impedance tomography (EIT) for real-time and accurate monitoring of respiration during HP anti-G movements and the key parameters of pulmonary ventilation.
Methods
2
Twelve healthy male students in our university were enrolled in September 2023 and subjected in this study. HP anti-G movements were performed 3 times each for 30 s in the anti-G physiological training apparatus
during which EIT and ophthalmic horizontal arterial pressure were measured to analyze the relationship of the global and local parameters of pulmonary ventilation
including inspiratory volume (IV)
expiratory uniform (EU)
expiratory speed (ES)
center of ventilation (COV) and right-to-left lung ventilation ratio (RtoL) with anti-G ability of anti-G straining maneuver (AGSM).
Results
2
The average eye horizontal systolic blood pressure (SBP) at the eye level was 148.82±22.75 mmHg during HP anti-G movements
which was significantly higher than that during quiet breathing (PJ) (95.17±8.51 mmHg
P
<
0.001). From the global pulmonary ventilation
the participants had significantly
increased IV during HP anti-G movements (
P
<
0.001). According the d value (mean increase of eye horizontal SBP=SBP
HP
- SBP
PJ
)
the subjects were divided into 3 groups
with the d value of
>
60
30~60 and
<
30 mmHg
respectively. The inspiratory volume ratio (IV
HP
/IV
PJ
) was the highest in the
>
60 mmHg group and the smallest in the
<
30 mmHg group (
P
<
0.01). The subjects had significantly decreased EU and more evenly expiration (
P
<
0.05)
but no change was seen in the expiratory uniformity ratio (EU
HP
/EU
PJ
) among the 3 groups. ES was obviously faster during HP anti-G movements (
P
<
0.001)
and the expiratory speed ratio (ES
HP
/ES
PJ
) had no significant difference among the 3 groups. The inspiratory time and expiratory time were 0.77±0.32 and 1.59±0.21 s
respectively
and both of them were notably shorter during HP anti-G movements (
P
<
0.001
P
<
0.01). From the local pulmonary ventilation
COV during HP anti-G movements was significantly smaller than that during PJ (
P
<
0.001)
and the ventilation center deviated to the ventral side
and RtoL was decreased and the ventilation distribution deviated to the left lung (
P
<
0.05).
Conclusion
2
EIT can perform real-time imaging of pulmonary global and local ventilation during HP anti-G movements
and it has a great application prospect in AGSM training and monitoring.
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