毛细支气管炎患儿潮气呼吸肺功能的变化

目的:观察婴儿毛细支气管炎的潮气呼吸肺功能动态变化情况并探讨其临床意义.方法:采用德国耶格公司婴幼儿肺功能仪,对50例毛细支气管炎婴儿急性期、恢复期及15例正常组婴儿进行肺功能检查.结果:毛细支气管炎急性期组与恢复期组及正常组比较,每千克体重潮气量(Vt/kg)、达峰时间(tPTEF)、达峰时间比(tPTEF/tE)、达峰容积(vPTEF)及达峰容积比(vPTEF/vE)均明显下降,呼吸频率(RR)明显增高,差异有显著意义.而恢复期与正常组比较在达峰时间上有明显下降外,余指标均差异无显著性.同时,在毛细支气管炎急性期时,潮气呼吸容量环(TFV环)其形态明显改变.结论:毛细支气管炎急性期,肺功能呈现小气道阻力增高、阻塞性通气障碍改变,临床恢复期小气道功能明显好转,说明小气道功能异常还是能在较短时间内恢复.潮气呼吸肺功能是监测本病病程及预后较理想的方法.Vt/kg、tPTEF/tE、vPTEF/vE可作为观察本病病情变化的敏感指标.

Study on the changes of tidal breath pulmonary function in infants with bronchiolitis

Objective: To observe the dynamics of tidal breath pulmonary function in infants with bronchiolitis and to explore the clinical significance. Methods: The pulmonary function of 50 infants with bronchiolitis during acute phase and during admission phase,and the pulmonary function of 15 normal infants were tested. Results: During the acute phase of bronchiotitis, the respiratory rate(RR)was significantly increased, the tidal inspiatory volume per kilogram (Vt/kg),the time to peak tidal expiratory flow(tPTEF),the time to peak tidal expiratory flow/expiratory time (tPTEF/tE), tidal volume to peak tidal expiratory flow (vPTEF) tidal volume to peak tidal expiratory flow/expiratory tidal volume(vPTEF/vE) were significantly decreased as compared with those in admission phase and normal group. While during acute phase, the tidal breathing flow volume (TFV) loop were changed also. In admission phase,the time to peak tidal expiratory flow (PTEF) was decreased as compared with those in normal group. The other targets showed no statistically significant differences as compared with normal group. Conclusions: In the acute phase of bronchiolitis, higher resistance in small airway and obstructive ventilation disturbance can be seen. All targets were improved during admission phase,it shows the abnormalities can be improved in a short time. Pulmonary function test is a valuable way for surveillance of the course and prognosis of bronchiolitis, and tPTEF/tE, vPTEF/vE are more sensitively targets in this test.