便携式肺功能仪对社区儿童哮喘诊断价值探讨  

Application of portable pulmonary function equipment in diagnosing asthma children in the community hospital

作　　者：姚培燕 周冬梅[2] 姚泽忠 YAO Peiyan;ZHOU Dongmei;YAO Zezhong(Department of Pediatrics,Shanghai Minhang District Xinzhuang Community Health Service Center,Shanghai 201199,China;Clinical Teaching and Research Section,Shanghai Medical College of Health,Shanghai 201318,China;Department of Pediatrics,Shanghai Minhang District Central Hospital,Shanghai 201199,China)

机构地区：[1]上海市闵行区莘庄社区卫生服务中心儿科,上海201199 [2]上海健康医学院临床教研室,上海201318 [3]上海市闵行区中心医院儿科,上海201199

出　　处：《社区医学杂志》2023年第8期416-420,共5页Journal Of Community Medicine

摘　　要：目的 探讨社区医院采用便携式肺功能仪对哮喘儿童进行诊断的可行性和有效性。方法 采用目的取样法,选择2021-06-01-2022-08-31上海市闵行区莘庄社区卫生服务中心就诊的慢性咳嗽或有反复喘息史的25例6~11岁患儿作为研究对象,使用PF680优呼吸便携式肺功能仪对其进行肺功能测定,采用改良哮喘预测指数(mAPI)对患儿婴幼儿期哮喘发作危险因素进行回顾性调查,分析便携式肺功能仪诊断社区儿童哮喘的可行性和有效性。结果 便携式肺功能检测仪检测结果显示,25例患儿中质量等级不达标5例,结果有效20例。肺功能通气功能正常5例,轻度阻塞性通气功能障碍12例,轻度限制性通气功能障碍1例,中度阻塞性通气功能障碍1例,中重度混合性通气功能障碍1例。符合哮喘诊断阳性14例,阳性率为70.0%。mAPI调查结果显示,25例患儿均没有婴幼儿期1年反复发作咳喘史4次,预测指数表无符合阳性病例,但是湿疹史16例,嗜酸性粒细胞高7例,有过喘息史16例,做过过敏源检测12例。结论 便携式肺功能仪应用于社区儿童哮喘的诊断阳性率较高,可行有效,可作为儿童哮喘诊断的依据,有助于临床结合病情变化,更加合理规范诊治哮喘。Objective To explore the feasibility and effectiveness of portable pulmonary function equipment in diagnosing asthma children in the community hospital.Methods Using objective sampling method, 25 children aged 6 to 11 years old with chronic cough or history of repeated wheezing who were treated by Xinzhuang Community Health Service Center from June 1, 2021 to August 31, 2022 were selected as the study subjects. Their pulmonary function was measured with the PF680 breathing portable portable pulmonary function equipment. The modified asthma prediction index(mAPI) was used to review the risk factors of asthma attack in infants, and to analyze the feasibility and effectiveness of portable pulmonary function instrument in diagnosing asthma in children in community. Results The results of the portable pulmonary function equipment detector showed that among the 25 children, 5 were unqualified, and 20 were effective. There were 5 cases with normal pulmonary function, 12 cases with mild obstructive ventilation dysfunction, 1 case with mild restrictive ventilation dysfunction, 1 case with moderate obstructive ventilation dysfunction, and 1 case with moderate and severe mixed ventilation dysfunction. Among 20 cases whose outcome were effective, 14 could diagnose with asthma with a rate of 70.0%. mAPI survey results showed that, none of all children had a history of recurrent cough and pant 4 times per year in infancy and all of them the modified asthma prediction index was negative. However, 16 cases had a history of eczema,7cases had a history of eosinophil elevation,16cases had wheezing,and 12cases did allergen detection in infant.Conclusion The application of portable lung function instrument in the diagnosis of children's asthma in community is feasible and effective,and can be used as the basis for the diagnosis of children's asthma,which is helpful to make the diagnosis and treatment of asthma more reasonable and standardized in clinical.

关 键 词：儿童 便携式肺功能仪 肺功能测定 哮喘 湿疹 嗜酸性粒细胞 

分 类 号：R725.6[医药卫生—儿科]