足月新生儿肺通气功能肺力学改变与心功能的关系  

Dynamic change and correlation of ventilative function pulmonary mechanics with cardiac function in the term infants

作　　者：吴本清[1] 唐其柱[1] 闫玉琴[2] 马晓利[2] 

机构地区：[1]武汉大学人民医院心血管内科专业,430060 [2]深圳市人民医院新生儿科,518020

出　　处：《中国小儿急救医学》2011年第1期41-43,共3页Chinese Pediatric Emergency Medicine

摘　　要：目的探讨足月新生儿肺通气功能、肺力学及心功能的变化规律及其相关性。方法200例足月儿，据日龄分为A、B、C、D四组，其日龄分别为0～24h、～72h、-1周、-28d。采用德国耶格公司Masterscreen Paed型肺功能仪测定肺通气功能及单次阻断法测定气道阻力、肺顺应性。肺功能主要参数：潮气量（TV）、分钟通气量（MV）、呼吸系统顺应性（Crs）、呼吸系统阻力（Rrs）。采用美国SonoSite180PLUS彩色多普勒超声诊断仪检测心功能。心功能主要参数：每搏输出量、心输出量（CO）。结果A、B、c、D四组的TV分别为20．2±3．8、21．1±3．7、22．3±4．5、23．9±4．9（m1），C、D组TV与A组比较，D组TV与B组比较，差异有显著性（P〈0．05）。Rrs、Crs组问差异无显著性（P〉0．05）。A、B、C、D四组CO分别为0．93±0．23、0．934-0．23、1．02±0．21、1．084-0．27（L／rain），D组cO与A、B组比较差异有显著性（P〈0．05）。CO与Rrs呈负相关（r=-0．16，P〈0．05），与MV、Tv、Crs呈正相关（r分别为0．50、0．54、0．t3，P均〈0．05）。结论足月儿生后72h后肺通气功能趋于稳定。左心输出量于生后1周明显增加。肺通气功能和肺力学指标是影响心功能的因素。Objective To investigate the dynamic change and correlation of the pulmonary ventilative function, mechanic and cardiac function in the term infants. Methods Twenty hundred term infants were divided into A,B ,C and D groups by age which was 0 -24 h, -72 h, - 1 w and 28 d respectively. The lung ventilative and mechanical function were measured respectively by using techniques of tidal breathing flow-volume loop（TBFVL） and the single occlusion. The Master screen Paed-lung function devices of Germanic JAEGER Co. was be used in this study. The parameter of pulmonary function including minute volume（MV） ,tidal volume （TV）,respiratory system compliance（Crs） and respiratory system resistance（Rrs）. The cardiac function were measured by using SonoSite 180 PLUS color Doppler ultrasonic diagnostic apparatus. The main parameter of cardiac function including cardiac output（CO） and stroke volume （SV）. Results The TV of A, B, C and D group were 20. 2 ±3. 78,21.1 ±3. 71,22. 3±4.48 and 23.9±4. 90 （ml）respectively,the TV of C and D group were higher than that of A group, and the TV of D group was higher than that of B group（ P 〈 0.05 ）. There were no significantly difference of Crs,Rrs among A,B,C and D group（P 〉0. 05）. The CO of A,B, C and D group were 0. 93 ±0. 23,0. 93 ± 0. 23,1.02 ± 0. 21 and 1.08 ±0. 27 （L/min） ,the CO of D group was higher than that of A and B groups（ P 〈 0. 05 ）. The CO was negative correlation with Rrs （ r = - 0. 16, P 〈 0. 05 ） and positive correlation with MV, TV, Crs （ r was 0. 50,0. 54,0. 13 respectively, P 〈 0. 05 ）. Conclusion The lung ventilative function is mature gradually with increasing age. The cardiac output has been obviously improved for postnatal 1 week in the term infants. The pulmonary ventilative function and mechanic parameter are important effective factors of cardiac function.

关 键 词：肺功能 心功能 超声心动图 潮气呼吸流速-容量环 新生儿 

分 类 号：R722.1[医药卫生—儿科]