潮气呼吸支气管舒张试验在婴儿毛细支气管炎中的应用

目的探讨潮气呼吸肺功能支气管舒张试验在婴儿毛细支气管炎诊疗中的应用价值。方法选择2009年1月—2010年12月就诊于河北省儿童医院呼吸科的毛细支气管炎婴儿60例,给予潮气呼吸肺功能测定并行支气管舒张试验,分别记录舒张试验前后潮气呼吸肺功能指标,比较：1患儿雾化前后的肺功能指标每千克潮气量（VT/kg）、25%潮气量时呼气流速（TEF25%remaining）、达峰时间比（tPTEF/TE）、最大呼气峰流量（PEF）变化;2上述4种指标之间改善率的差异;3观察雾化前后潮气呼吸流速容量环（TBFV）的变化。结果 1患儿雾化后4种指标均值较雾化前均有改善,但仍较低,且雾化前后比较差异均无统计学意义（P〉0.05）;2雾化后TPEF/TE改善率较其他3种指标改善率低,阳性率为20%,4种指标比较差异有统计学意义（P〈0.05）;3雾化前患儿TBFV环呈现用力呼气曲线图形,雾化后环增宽,潮气量增加,呼气高峰后移。结论潮气呼吸支气管舒张试验在婴儿毛细支气管炎诊断中具有一定价值,其指标TPTEF/TE在毛细支气管炎诊疗中存在局限性,其意义应与临床相结合综合分析。

Utility of Bronchodilation test during tidal breathing in diagnosis of infants with bronchiolitis

Objective To explore the value of bronchodilation test during tidal breathing in the diagnosis of infants with bronchiolitis. Methods A total of 60 infants with bronchiolitis were involved in the study from January of 2009 to December of 2010. The tidal breathing parameters were measured before and after a bronchodilation test. The changes of VT /kg,TEF 25,TPEF /TE and PEF were recorded,and their improvement ratios were compared. The changes of tidal breathing flow volume（ TBVF） loops before and after the inhaled bronchodilators were also observed. Results 1 The average of VT /kg,TEF 25,TPEF /TE and PEF increased after inhaling bronchodilator,but the difference were not significant（ P 〉0. 05）. 2 The improvement ratio of TPEF /TE was low as compared with other parameters,the positive rate was 20%,and there were significant difference among them. 3TBFV loops showed forced expiratory curve graphic before the inhaling,but the slope of descending branch of the TBFV loop was depressed,the capacity curve broadening,tidal volume increased,and the expiratory peak backwards after inhaling bronchodilator. Conclusion The bronchodilation test during tidal breathing in the diagnosis of infants with bronchiolitis can be referenced. TPEF /TE has its limitations in diagnosis and treatment,and should be read in conjunction with the clinical.