动脉血液气体分析判读检查与氧合评估.doc

七、動脈血液氣體分析判讀檢查與氧合評估 下列何者不影響DLCO 結果：(92年特考第一次,8) (A)貧血 (B)血中含Carboxy hemoglobin (C)肺纖維化 (D)肥胖 ANS：D 【解析】各種因數影響DLco: DLco 減少: Anemia DLco 增加: Polycythemia Carboxyhemoglobin Exercise Pulmonary embolism CHF Diffuse pulmonary fibrosis Pulmonary emphysema 參考來源: Egans:Fundamentals of Respiratory Care(8th edition)Robert L.Wilkins P.423,Table 17-8 DLCO 下降最多的是：(92年特考第一次,9) (A)慢性支氣管炎 (B)肺氣腫 (C)氣喘病 (D)心臟衰竭 ANS：B 【解析】肺氣腫的gas exchange surface area 下降 參考來源: Manual of Pulmonary Function Testing(8th Edition)Gregg L.Ruppel 下列何者不會造成Pulse Oximeters 錯誤判讀？(92年特考第一次,10) (A)動作大(motion artifact) (B)血管收縮血流灌注不良 (C)Bilirubin 升高 (D)皮膚黑色素沈著 ANS：C 【解析】Table 16-7—〉Factors Affecting the Accuracy or Precision of Pulse oximeters Factor Potential Error *Presence of HbCO Falsely high %HbO2 *Presence of high level of metHb Falsely low%HbO2 if SaO285%,falsely high%HbO2 if SaO285% *Presence of fetal hemo- globin No effect *Anemia(low hematocrit)Falsely low%HbO2 * Vascular dyes (e.g;methylene blue) Falsely low%HbO2 *Elevated bilirubin level No effect *Dark skin pigmentation Falsely high%HbO2 (3%-5%) *Nail polish(esp.black) Falsely high%HbO2 *Ambient light Varies(e.g,falsely high%HbO2 in sunlight),also may cause falsely high pulse reading *Poor perfusion(vaso- constriction) Inadequate signal;unpredictable results *Motion artifact Unpredictable,spurious readings