儿童先天性肺囊性疾病肺功能损害初步研究  

Preliminary Study on Lung Function Damage in Children with Congenital Lung Cystic Lesions

作　　者：蒋茂林 李洪波[1] 宋冀硕 吴春[1] 潘征夏[1] 龚财惠[1] 刘莎[1] 李勇刚[1] 王刚[1] 代江涛[1] Jiang Maolin;Li Hongbo;Song Jishuo;Wu Chun;Pan Zhengxia;Gong Caihui;Liu Sha;Li Yonggang;Wang Gang;Dai Jiangtao(Children’s Hospital of Chongqing Medical University,Ministry of Education Key Laboratory of Child Development and Disorders,China International Science and Technology Cooperation Base of Child Development and Critical Disorders,Chongqing Key Laboratory of Pediatrics,Chongqing 400014,China)

机构地区：[1]重庆医科大学附属儿童医院儿童发育疾病研究教育部重点实验室儿童发育重大疾病国家国际合作基地儿科学重庆市重点实验室

出　　处：《儿科药学杂志》2020年第2期7-10,共4页Journal of Pediatric Pharmacy

基　　金：重庆市卫计委2015年科研课题，项目编号2015XMGS

摘　　要：目的:探讨儿童先天性肺囊性疾病对肺功能的影响,为临床手术治疗提供参考。方法:选取2014年1月至2018年9月重庆医科大学附属儿童医院确诊并拟行手术治疗的先天性肺囊性疾病患儿49例,术前测定患儿肺功能,并进行统计分析。其中<42月龄23例,采用潮气呼吸法测定肺功能;≥42月龄26例,采用常规通气法测定肺功能。结果:支气管源性囊肿(BC)18例(36.8%),其中<42月龄组5例,TPTEF/TE、VPEF/VE、PF/V25、TI/TE存在异常,提示存在小气道中度阻塞及大气道轻度阻塞;≥42月龄组13例,FVC、FEV1、FEF75、MMEF存在异常,提示存在轻度混合型通气功能障碍。先天性肺囊性腺瘤样畸形(CCAM)15例(30.6%),其中<42月龄组8例,TPTEF/TE、PF/V25、TI/TE存在异常,提示大、小气道轻度阻塞;≥42月龄组7例,肺功能正常。肺隔离症(PS)10例(20.4%),其中<42月龄组7例,TEF50/TIF50、TI/TE存在异常,提示大气道轻度阻塞;≥42月龄组3例,肺功能正常。先天性大叶性肺气肿(CLE)6例(12.2%),其中<42月龄组3例,TPTEF/TE、VPEF/VE、PF/V25、TEF50/TIF50、TI/TE存在异常,提示小气道中度阻塞及大气道轻度阻塞;≥42月龄组3例,肺功能正常。在临床表现上,<42月龄组中有肺部感染史者11例(47.8%),≥42月龄组有肺部感染史者20例(76.9%)。结论:先天性肺囊性疾病对儿童造成了以不同程度大小气道通气功能障碍为主要表现的肺功能损害,小年龄组肺功能受损程度更为明显,年长儿更易出现肺部反复感染,早期手术是优先的治疗选择。Objective:To probe into the effects of congenital lung cystic lesions on children’s lung function,so as to provide reference for clinical surgical treatment.Methods:From Jan.2014 to Sept.2018,totally 49 children diagnosed with congenital lung cystic lesions in Children’s Hospital of Chongqing Medical University were extracted,preoperative lung function was measured and statistically analyzed.Among them,23 children were<42 months,and the lung function was measured by tidal breathing method;26 children were≥42 months,and the lung function was measured by conventional ventilation method.Results:There were 18 cases(36.8%)of bronchogenic cysts(BC),among which 5 cases(<42 months)had abnormalities in TPTEF/TE,VPEF/VE,PF/V25 and TI/TE,indicating moderate obstruction of small airway and mild obstruction of large airway;and 7 cases(≥42 months)had abnormalities in FVC,FEV1,FEF75 and MMEF,suggesting mild mixed ventilation dysfunction.There were 15 cases(30.6)%of congenital cystic adenomatoid malformation(CCAM),among which 8 cases(<42 months)had abnormalities in TPTEF/TE,PF/V25 and TI/TE,suggesting mild obstruction of large and small airway;7 cases(≥42 months)had normal lung function.There were 10 cases(20.4%)of pulmonary sequestration(PS),among which 7 cases(<42 months)had abnormalities in TEF50/TIF50 and TI/TE,suggesting mild obstruction of large airway;3 cases(≥42 months)had normal lung function.There were 6 cases(12.2%)of congenital lobar emphysema(CLE),among which 3 cases(<42 months)had abnormalities in TPTEF/TE,VPEF/VE,PF/V25,TEF50/TIF50 and TI/TE,suggesting moderate obstruction of small airway and mild obstruction of large airway;3 cases(≥42 months)had normal lung function.In terms of clinical manifestations,11 cases(47.8%)in the<42-month group had the history of lung infection,and 20 cases(76.9%)in the≥42-month group had the history of lung infection.Conclusion:Congenital lung cystic lesions causes lung function impairment in children,mainly manifested by airway dysfunction at different degree.The degr

关 键 词：儿童 先天性肺囊性疾病 肺功能 

分 类 号：R725.6[医药卫生—儿科]