婴幼儿肺炎治疗前、后肺功能检测及临床分析

目的:观察并评价婴幼儿肺炎治疗前、后患儿的潮气呼吸流速-容量曲线测定结果,为临床诊断及判定转归情况提供依据。方法:选择婴幼儿肺炎患儿92例,应用婴幼儿肺功能测试仪对患儿治疗前、后行潮气呼吸流速容量环测定,同时选择健康对照组婴幼儿80例进行潮气呼吸测定,对肺功能各项指标进行比较分析。结果:肺炎组患儿肺功能指标V_T/kg、ME/MI、PTEF、t_PTEF/t_E、VPTEF/V_TE、TEF25/PTEF呈现明显减少,与对照组婴幼儿有显著差异(P<0.01或P<0.05),提示肺炎患儿大小气道均有阻塞,但以小气道阻塞为主。治疗后大气道阻塞改善明显,ME/MI指标差异不明显(P>0.05)。但反映小气道阻塞的肺功能指标仍低于健康儿童,PTEF、t_PTEF/t_E、VPTEF/V_TE、TEF25/PTEF差异显著(P<0.01),需要跟踪观察。结论:潮气呼吸肺功能检测能够准确反映出婴幼儿气道阻塞、气管痉挛的病情轻重程度,对婴幼儿肺炎治疗效果及随访具有重要评价作用,可成为呼吸系统疾病临床诊断,评估疗效,判断预后的重要补充,应广泛推广于儿科临床。

Lung Function Test of Infants with Pneumonia before and after Treatment and Clinical Analysis

Objective：To observe and evaluate the results of tidal breathing flow volume with infants before and after treatment of pneumonia,and provide the evidence for clinical diagnosis and prognosis.Methods：92 cases of infants with pneumonia were selected.Tidal breathing flow volume was measured by lung function testing instrument for children before or after treatment.At the same time,80 cases of healthy children were selected to determinate the value of tidal breathing.And these indexes of lung function would be compared and analyzed.Results：The lung function of pneumonia group present significant decreased（P0.01 or P0.05）in the ratio of tidal volume to kilogram（V_T/kg）,the ratio of mean tidal expiratory flow to mean tidal inspiratory flow（ME/MI）,peak tidal expiratory flow（PTEF）,the ratio of time taken to reach peak expiratory flow to expiratory time（t_PTEF/t_E）,the ratio of peak expiratory volume to total expiratory volume（VPTEF/V_TE）,the ratio of 25% tidal volume of expiratory flow to peak tidal expiratory flow（TEF25/PTEF）.It suggested that big airway and small airway are both obstruction but lesion occur mainly in small airway.After treatment of big airway obstruction improved significantly,the ratio of mean tidal expiratory flow to mean tidal inspiratory flow（ME/MI）index had no significant difference（P0.05）.But the reflection of small airway obstruction of lung function index is still lower than those in healthy children.And the index of PTEF,t_PTEF/t_E,VPTEF/V_TE,TEF25/PTEF is significant difference（P0.01）that means the infants need to be track observation.Conclusion：The testing of lung function with tidal breathing can accurately reflect the infant airway obstruction,airway spasm,asthma and other symptoms of the pathological characteristics.It has an important role in infantile pneumonia treatment evaluation and used as important supplement index for clinical diagnosis and prognosis of respiratory diseases.So it should be used in clinic widely.