婴幼儿重症肺炎治疗前后潮气呼吸肺功能的改变及意义  

Changes of Tidal Breathing Lung Function of Severe Pneumonia Infants After Treatment

作　　者：舒俊华[1] 黄娟[1] 周小勤[1] 龙珍[1] 

机构地区：[1]湖北省妇幼保健院儿科,湖北武汉430070

出　　处：《武汉大学学报（医学版）》2014年第3期395-397,共3页Medical Journal of Wuhan University

基　　金：湖北省自然科学基金资助课题(编号:2013CFB048)

摘　　要：目的:探讨婴幼儿重症肺炎治疗前后潮气呼吸肺功能的变化及意义。方法:选择年龄在1个月-3岁湖北省妇幼保健院儿科重症监护室(PICU)2012年6月-2013年6月重症肺炎婴幼儿40例,测定治疗前,临床治愈出院时,及出院后3个月患儿的潮气呼吸肺功能;另选38例无呼吸系统疾病健康婴幼儿潮气呼吸肺功能做正常对照组。主要测定参数:潮气量(VT/kg),呼吸频率(RR),吸气时间(TI),呼气时间(TE),吸呼比(TI/TE),达峰时间(TPTEF),达峰时间比(TPTEF/TE),达峰容积比(VPTEF/VE)。结果:治疗前重症肺炎患儿RR显著增高,VT/kg,TI,TE,TI/TE,TPTEF,TPTEF/TE,VPTEF/VE均显著下降,与对照组比较差异有统计学意义(P<0.05);临床治愈时重症肺炎患儿RR较治疗前显著下降,差异有统计学意义(P<0.05),与对照组相当(P>0.05),VT/kg,TI,TE较治疗前增高,差异有统计学意义(P<0.05),与对照组水平相当,差异无统计学意义(P>0.05),TPTEF,TPTEF/TE,VPTEF/VE与治疗前比较增高,差异有统计学意义(P<0.05),但仍显著低于对照组,差异有统计学意义(P<0.05);出院后3月VT/kg,TI,TE,TI/TE,TPTEF,TPTEF/TE,VPTEF/VE逐渐恢复与治疗前比较差异均有统计学意义(P<0.05),VT/kg,TI,TE,TI/TE与对照组比较差异无统计学意义(P>0.05),而TPTEF,TPTEF/TE,VPTEF/VE仍显著低于对照组,差异有统计学意义(P<0.05)。结论:婴幼儿重症肺炎患儿潮气呼吸肺功能明显受损,临床症状缓解后其肺功能损害可持续存在,潮气呼吸测定能反映婴幼儿重症肺炎气道病变的程度、临床治疗的效果以及预后情况。Objective： To investigate the changes and the clinical significance of the tidal breathing lung function of severe pneumonia infants after treatment. Methods： Forty cases of severe pneumonia infants from June 2012 to June 2013 in Pediatric Intensive Care Unit （PICU） of Hubei Maternal and Child Health Hospital, ranged in age from one month to 3 years, were involved in this study. The tidal breathing lung function was measured before treatment, after clinical cure and 3 months after discharging from hospital. Thirty-eight healthy infants were set as the normal controls. Such parameters were measured as： tidal volume （VT/kg）, respiratory rate （RR）, inspiratory time （TI）, ,expiratory time （TE）, inspiratory to expiratory ratio （TI/TE）, peak time （TPTEF）, peak time ratio （TPTEF/TE）, and peak volume ratio （VPTEF/VE）. Results： Before treatment,the RR of severe pneumonia infants was significantly higher than that of control group, VT/kg, TI, TE, TI/TE, TPTEF, TPTEF/TE, and VPTEF/VE were significantly lower than that re- spectively of control group （all P〈0. 05） ; after treatment and clinical cure, the RR was de- creased to normal level （P〈0.05）, while TPTEF, TPTEF/TE, and VPTEF/VE increased （P〈 0.05） in pneumonia group, but still lower than the control group （all P〈0.05） ; 3 months later after discharging from hospital, the VT/kg, TI, TE, and TI/TE were gradually recovered to the normal level （all P%0.05）. The TPTEF, TPTEF/TE, and VPTEF/VE were gradually recov- ered （P〈0.05） but still lower than the control group. Conclusion. Tidal breathing lung function in infants with severe pneumonia was significantly impaired even after the clinical symptoms dis- appeared. The tidal breathing lung function can measure the degree of severe pneumonia in in- fants＇ airway disease for clinical treatment and prognostic evaluation.

关 键 词：重症肺炎 潮气呼吸 肺功能 婴幼儿 

分 类 号：R72[医药卫生—儿科]