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在多种测量鼻腔气道阻力的方法应用了数十年之后,Kern(1981)和Clement(1984)曾先后发表了有关鼻压计测量标准化委员会的报告,特别是在1984年布鲁塞尔国际会议上将自动前鼻腔测压法确定为国际标准测量法,并以此作为常用测量法和提供资料。尽管如此,至今有关研究鼻腔开放程度的方法仍未在国际上达到完全一致。其结果描述亦不甚统一。由于鼻压计是通过测量经鼻压差(P)和通气量(V)来计算鼻阻力(R),即:R=P/V,在人类鼻腔,压力-流量并非呈简单的线型关系,而是呈层流和湍流混合的复杂关系,由此获得的阻力值难于解释,与患者的客观感觉亦不甚一致。再者,鼻腔的阻力主要来自鼻腔前部,理论上阻力又是呈连续分布的,单凭阻力值很难对鼻腔后部较小的生理或病理性变化作出正确评价,因此仅凭从鼻压计获得的单一参数作出评估往往是不充分的。鼻腔具有较为特殊的血管分布,并有较多的粘膜血流量,容易发生较大的迅速的生理变化,鼻压计测量中容易诱发上述变化,并且研究者的技能程度以及被检查者的配合程度都会对结果产生较大的影响。因此有必要寻找一种更为精确、易于操作、不必要对患者进行训练的方法。声反射鼻腔测量法就是其一。本文就其基本原理及临床应用资料予以介绍。
After several decades of methods of measuring nasal airway resistance, Kern (1981) and Clement (1984) published reports on the standardization of sphygmomanometers, particularly at the 1984 Brussels International Conference Automatic pre-nasal manometry determined as an international standard measurement method, and as a common measurement method and provide information. In spite of this, so far the method of studying the degree of nasal opening up has not yet reached a complete international consensus. The result description is not very uniform. Since the sphygmomanometer computes the nasal resistance (R) by measuring the nasal pressure difference (P) and the ventilation volume (V), ie, R = P / V, the pressure- , But a complicated relationship of mixed laminar and turbulent flow, the resistance value obtained therefrom is difficult to explain and the patient’s objective feeling is also not very consistent. Furthermore, the resistance of the nasal cavity mainly comes from the front of the nasal cavity. In theory, the resistance is continuously distributed. It is difficult to correctly evaluate the minor physiological or pathological changes of the posterior nasal cavity based on the resistance value. Therefore, It is often not sufficient to evaluate a single parameter. Nasal cavity has a more special vascular distribution, and more mucosal blood flow, prone to rapid physiological changes in large, easy to induce such changes in the measurement of the manometer, and the researchers of the degree of skill and the degree of cooperation with the subjects Will have a greater impact on the results. Therefore, it is necessary to find a more precise, easy to operate, unnecessary training of patients. Acoustic reflex nasal measurement is one of them. This article describes its basic principles and clinical application information.