Spirography - what is it? Spirography with bronchial asthma. Where to do spirography. Spirography indices

The breath of a person occurs in two important stages - external and tissue. Moreover, the system of ways to carry air from the nasal cavity to the alveolar lung tree is only the first of them. And if the anatomical structure of the organs can be viewed with the help of radiation diagnostic methods (X-ray, fluorography, ultrasound, computer, magnetic resonance imaging), then completely different instruments help us to assess the functional state.

The essence of the method

Many patients of a pulmonologist or family therapist, after receiving a referral for this study, are asked the question: "Spirography - what is this?" Let's try to figure it out together.

The fact that this analysis is assigned to people with diseases of the respiratory system, and completely healthy, even to athletes, and therefore this misunderstanding arises. So, spirography of the lungs is an important method of studying the function of external respiration, which allows us to determine the consistency of these organs in order to provide the whole organism with oxygen and sufficient removal of carbon dioxide. All the data are recorded graphically, that is, on paper, and the result becomes known instantly after the analysis. The parameters of spirography give the doctor important information about the airway conduction and the ventilation capacity of the lungs, which allows him to identify the link of the disorder and the possibility of reversibility of pathological changes in it. In addition, it is possible to evaluate the effectiveness of the drug by removing the spirogram before and after its administration. So, for example, a simple test with bronchodilators is performed for suspected asthma.

Terms and conditions

So, we understood the concept of "spirography". How this study is conducted is also important to know. It is usually prescribed for the morning or afternoon, preferably on an empty stomach. However, it is possible to hold it after a light breakfast, provided that at least 2 hours have elapsed since the time of ingestion. First, so that the analysis parameters do not give false information, the patient is given a physically and emotionally rest for 15 minutes sitting. During this time, the heart rate and respiratory rate should be normalized, which means that the study will show a real picture of his health. It is also important that during the last 6-12 hours the patient does not take medications with bronchodilating effect.

Equipment

Next, the patient is seated near the table on which the spirograph is located, a special clamp is placed on the nose so that all air is released exclusively through the mouth. Further, it is connected to the device by means of a mouthpiece and is suggested to follow the doctor's recommendations for measuring all the necessary parameters. As a rule, modern spirographs process data independently, that is automatically, due to what the result appears instantly by the type of check from the cash register: so ends spirography. The norm of all indicators is also given by the device by calculating them relative to the sex and age of the patient. Further the doctor, comparing them among themselves, reveals the localization of the disorder. It is also possible to perform tests after the introduction of bronchodilators, which reveals the presence or absence of their effect. Thus, this study is an important tool for diagnosing a patient's health or illness.

Indication for the study

It is also important to know about the survey called "spirography", that this analysis, like any other, has certain indications for carrying out. Namely:

• Upcoming surgical intervention (to assess risk during the operation);
• Detected wheezing, coughing, shortness of breath and other symptoms of the respiratory system damage during the initial examination of the patient;
• Diagnosis of the degree, stage of an already diagnosed pulmonological disease accompanied by bronchial obstruction or severe organic and functional impairment of the ventilation system (COPD, bronchial asthma, chronic bronchitis), as well as evaluation of the effectiveness of the prescribed therapy;
• Determination of the prognosis of life, work capacity and professional suitability of a patient with diagnosed lung diseases;
• Extrapulmonary diseases, often accompanied by impaired function of the respiratory system (cardiovascular pathology, diabetes, systemic lesions of connective tissue).

Other indications

In addition, periodically spirography of the lungs should be performed in patients belonging to the risk group for respiratory system diseases. These are smokers with many years of experience, workers of heavy industry and other industries, one way or another falling into the category of harmful production. On the contrary, contraindications to this survey are mental, acute infectious diseases, a serious condition of the patient, pulmonary tuberculosis with bacilli, hemoptysis, a threat of miscarriage during pregnancy.

Structure of analysis

So, we found out that they are registered by means of such a survey as spirography, indicators of the state of the human respiratory system. Basically they are functional, that is, they reflect not the organic disturbances, but the ventilating capacity.

In more detail, they include the frequency of respiratory movements (the number in one minute), the total respiratory volume (that is, the amount of air that can enter the lungs in one breath), the minute volume (similar to the previous one, only counts for one minute), vital Lung capacity for inhalation and exhalation (measures the maximum capacity of organs), oxygen consumption and utilization factor, forced inspiratory and expiratory volumes (produced with chest muscle tension), air velocity, Tiffno index ( Is measured by the ratio of the forced expiratory volume to the lung capacity in 1 second) and some others. All these indicators help the doctor to compile a comprehensive informative picture about the state of the conducting air paths and sufficient exchange of gases. So, the absorption of oxygen occurs by diffusing it from the alveolar sacs of the lungs into the blood and is disturbed by structural lesions of the lungs.

Role in diagnosis

Spirography with bronchial asthma has its own peculiarities both in the technique of conducting and in the interpretation of the results.

An important role in the diagnosis of this disease is played by the test of forced inspiration and expiration, on the basis of which a graph on the type of a loop - "volume-flow" is constructed automatically. It is in its form in the presence of respiratory failure that its type is determined: restrictive (associated with organic lung damage), obstructive (caused by violation of air flow through the bronchial or alveolar tree) or mixed. Also, on the obtained curve, it is possible to trace the decrease in the volume forced exhalation rate of the peak and in the FVC interval of 25-75%, as well as the volume of the forced inspiration. This visually demonstrates the pathogenesis of asthma, in which there is a sudden spasm of the distal parts of the bronchi, which is manifested by attacks of suffocation.

Tests

In obstructive type of respiratory failure , it is also important to determine the degree of reversibility of changes, which allows you to diagnose and severity of the disease. Thus, the most common test is a pharmacological test with short-acting B2-adrenoreceptor agonists, which include the drug Salbutamol. To conduct it for 6 hours is appointed to cancel other drugs of a similar action, then the curve "volume-flow" is recorded. Further, the patient makes one or two inhalations with the drug, and after 15 minutes-half an hour after that a repeated spirography is performed. What is this type of obstruction, let you know the changes in the indicators of analysis. So, if they increase by more than 15% of the initial results, the test is considered positive.

Another method

Since patients with bronchial asthma must continuously monitor their health, there is another method for calculating the "flow-volume" curve - pneumotachography. In comparison with spirography, it is simpler, and therefore, suitable for self-administration by the patient at home. This allows a person to monitor the performance of his respiratory system on a daily basis, and also greatly simplifies the work of the doctor, since it most accurately reflects the dynamics of the disease in the intervals between visits to a medical institution. The pneumotachograph is also a tube with a replaceable mouthpiece that connects the patient to a computing device that can automatically calculate many functional parameters and a flow-volume curve in the automatic mode.

Conclusion

Of course, the tests of functional diagnostics are sent exclusively by the pulmonologist, because to them there are strict indications. To begin with, he, of course, must obtain informed consent from the patient, and so he will certainly tell where to make spirography, what it is and what its purpose is. It is extremely important to establish the confidential relations of the physician with the patient, as well as create a favorable environment for the test, since only with the psychological comfort of the patient the results of the study will be reliable. And already in place, the laboratory technician accepting the analysis will explain the rules of the tests, so that the results obtained not only turned out to be correct, but also helped the doctor diagnose the patient's illness.