重症肺炎恢复期婴幼儿潮气呼吸肺功能改变的意义  

The tidal breathing lung function changes and clinical significance of severe pneumonia in infants and young children during convalescent period

作　　者：乔俊英[1] 张丽敏[1] 栾斌[1] 

机构地区：[1]郑州大学第三附属医院儿科,450052

出　　处：《中华实用儿科临床杂志》2016年第4期292-295,共4页Chinese Journal of Applied Clinical Pediatrics

基　　金：河南省医学科技攻关计划项目

摘　　要：目的观察重症肺炎婴幼儿恢复期潮气呼吸肺功能改变及与病情和预后的相关性。方法采用德国耶格公司肺功能仪对44例重症肺炎恢复期和50例轻症肺炎恢复期婴幼儿进行潮气呼吸肺功能检查，根据达峰容积比判断肺功能损害程度，将重症肺炎患儿分为正常组、轻度组、中度组和重度组。随访所有肺炎患儿出院1年内因下呼吸道感染再次住院的次数及喘息的次数。统计方法采用t检验和∥检验。结果重症肺炎组与轻症肺炎组比较，呼吸频率[（36．31±0．78）次／min比（30．83±0．74）次／min]明显增快，呼吸比（0．65±0．01比0．70±0．01）、达峰时间[（0．24±0．08）S比（0．31±0．04）s]明显下降，差异均有统计学意义（P均〈0．01）；而达峰时间比[（19．15±0．77）％比（23．00±0．51）％]、达峰容积比[（21．28±0．86）％比（25．42±0．56）％]明显下降，差异均有统计学意义（P均〈0．01）。重症肺炎与轻症肺炎患儿比较出院1年内因下呼吸道感染住院的次数（χ^2=30．50，P〈0．01）及喘息次数（χ^2=23．43，P〈0．01）明显增加，差异有统计学意义；重症肺炎患儿肺功能损害组中，中度组和重度组出院1年内因下呼吸道感染住院的次数（χ^2=10．64，P=0．033；χ^2=20．81，P=0．001）及喘息次数（χ^2=10．53，P=0．037；χ^2=21．25，P=0．001）明显高于轻度组，而正常组和轻度组比较差异无统计学意义（P〉0．05）。13例重症肺炎患儿随访1年，1例3个月左右肺功能各项指标恢复正常，6例6个月左右恢复正常，3例出院1年恢复正常，3例1年仍未恢复正常。结论重症肺炎恢复期较轻症肺炎恢复期婴幼儿肺功能损害程度严重；重症肺炎患儿肺功能损害程度越重，短期内因下呼吸道感染再次住院及喘息的可能性越大。Objective To investigate the changes in tidal breathing lung function of severe pneumonia in recovery phase and correlation with the condition and prognosis in infants and the young children. Methods Tidal breathing lung function of 44 cases of severe pneumonia infants and 50 cases of mild pneumonia infants in their recovery phase were measured by infantile spirometer made in Germany. According to ratio of exhaled volume at peak tidal expiratory flow to total expiratory volume（VPTEF/VE）, severe pneumonia infants were divided into normal, mild, moderate and severe groups. All these children were followed up for the frequency of rehospitalization because of lower respiratory tract infections and the frequency of wheezing within 1 year after discharge. Statistical were analyzed by using t test and χ^2 test. Results Compared with the mild pneumonia infants,the respiratory rate（RR） of the severe pneumonia infants was significantly increased [ （ 36.31 ± 0.78 ） times/rain vs （ 30.83 ± 0.74 ） times/min ] （ P 〈 0.01 ） ; inspiratory time to expiratory time ratio（TI/TE） （0.65 ± 0.01 vs 0. 71 ± 0.01 ）, exhaled time at peak tidal expiratory flow （TPTEF） [ （ 0.24 ± 0.08 ） s vs （ 0.31 ± 0.04 ） s ] were significantly decreased （ all P 〈 0.01 ） ; ratio of TPTEF to expiratory time （TVTEF/TE） [ （19.15 ±0.77）% vs （23.00 ±0.51）% ] ,VPTEF/VE[ （21.28 ±0.86） vs （25.42 ±0.56）% ] were significantly decreased （ all P 〈 0.01 ）. The frequency of rehospitalization because of lower respiratory tract infections （ χ^2=30.50, P 〈 0.01 ） and the frequency of wheezing within 1 year after discharge （χ^2= 23.43,P 〈 0.01 ） in the severe pneumonia group were significantly higher than those of the mild pneumonia group;in the groups with different lung function damage by severe pneumonia, the frequency of rehospitalization because of lower respiratory tract infections （χ^2 = 10.64,P = 0. 033 ;χ^2 = 20.81, P = 0. 001 ） and the frequency of wheezing �

关 键 词：重症肺炎 婴幼儿 肺功能 

分 类 号：R725.6[医药卫生—儿科]