潮气呼吸流速容量环对毛细支气管炎患儿肺功能的评价

目的:研究毛细支气管炎时小气道阻塞的程度及动态变化的情况,并探讨其临床意义。方法:采用德国耶格公司MasterScreen小儿肺功能仪,运用潮气呼吸流速容量环评价115例毛细支气管炎急性期婴儿(按月龄分为3组)肺功能。并对其中30例患儿进行临床恢复期肺功能复查。结果:115例患儿中肺功能正常5例,单纯限制性改变3例,余107例患儿均有不同程度的气道阻塞性改变,其中轻度阻塞(达峰时间比为28%-22%)25例,占23.3%,中度阻塞(达峰时间比为22%-16%)34例,占31.7%,重度阻塞(达峰时间比为<16%)48例,占44.8%。中度以上阻塞的患儿约达76%。107例患儿中有38例同时伴有限制性改变。临床恢复期上述异常指标明显好转。结论:毛细支气管炎急性期,肺功能大多呈中度以上阻塞性通气功能障碍,主要为小气道阻塞,恢复期有显著好转。潮气呼吸流速容量环检测能较好地反映小婴儿的肺功能。

Evaluation of pulmonary function in children with broncholitis by tidal breathing flow-volume

Objective To study the airway obstruction degree and the dynamic changes in broncholitis and probe into their clinical significance. Methods The pulmonary functions were examined in 115 infants with acute bronchiolitis using tidal breathing flow-volume(TBFV). According to the degrees of airway obstruction, the infants were divided into three groups (light, moderate and severe obstruction). The pulmonary functions were reexamined in 30 infants in convalescence stage. Results Among the 115 infants, the pulmonary function was normal in 5 cases,simple limit change in 3 and airway obstruction in 107. Among the 107 patients, slight obstruction (tPTEF/tE, 28%-22%) was found in 25 cases (23. 3%), moderate obstruction (tPTEF/tE, 22%-16%) in 34 (31. 7%), severe obstruction (tPTEF/tE<16%), and in 48(44. 8%). The infants with moderate or severe obstruction were associated with simple limit change. During the clinical recovery phase, the above abnormal indexes showed significant improvement. Conclusion In acute stage of broncholitis, the pulmonary functions present moderate or severe airway obstruction and mainly small airway obstruction, and the changes are significantly improved in convalescence stage. The TBFV examination can reflect infants' pulmonary functions, and tPTEF/tE can be used as a sensitive marker of airway obstruction.