呼吸功能试验%婴儿,新生%肺发育
呼吸功能試驗%嬰兒,新生%肺髮育
호흡공능시험%영인,신생%폐발육
Respiratory function tests%Infant,newborn%Lung development
目的 探讨无肺部病变的足月儿及不同胎龄早产儿肺功能的动态变化.方法 回顾分析2010年7月至2012年8月在深圳市儿童医院新生儿科住院新生儿110例,按出生胎龄分为3组:足月儿(出生胎龄37 ～40周)组55例,其中男29例、女26例,平均出生体重(3.1 ±0.3)kg；晚期早产儿(出生胎龄34 ～ ＜37周)组30例,其中男18例、女12例,平均出生体重(2.1 ±0.3)kg；早期早产儿(出生胎龄＜ 34周)组25例,其中男16例、女9例,平均出生体重(1.4±0.3)kg.在生后1、14及28日龄,进行潮气呼吸检测,运用反复呼吸气体洗出法技术,进行功能残气量(FRC)及肺清除指数(LCI)测量.各指标采用单因素方差分析方法统计.结果 3组新生儿75％、50％、25％潮气量时呼气流速(TEF75、TEF50、TEF25)在第1、14及28天均逐渐升高,而呼吸频率则逐渐下降.足月儿组和晚期早产儿组在第28天TEF75、TEF50、TEF25、达峰时间比(TPTEF/TE)、达峰容积比(VPEF/VE)值均明显高于早期早产儿组[(71±21)、(66±16)比(55±19) ml/s,(70 ±20)、(62±17)比(51±16)ml/s,(54±17)、(51±13)比(38±10) ml/s,37％±8％、34％±9％比29％±6％,38％±6％、33％±8％比28％±7％,F =5.82、8.74、11.30、7.72、16.40,均P＜0.01],而呼吸频率、LCI值则低[(49±6)、(51±8)比(56±7)次/min,8.6±2.7、8.9±2.2比10.8±2.0,F=10.09、7.15,均P＜0.05].纠正胎龄40周时,足月儿组与晚期早产儿组TEF50、TEF25、TPTEF/TE、VPEF/VE仍均于早期早产儿组[(65±21)、(62±12)比(50±17)ml/s,(51±13)、(47±10)比(39±10) ml/s,36％ ±8％、31％±7％比30％±6％,37％±10％、32％±8％比29％±6％,F=4.41、8.23、9.08、7.35,均P＜0.05].结论 新生儿肺功能参数随日龄逐渐改善,早期早产儿组各项肺功能参数落后于足月儿组,在纠正胎龄40周时,仍不能达到足月儿水平.新生儿肺功能监测有助于评估新生儿特别是早产儿的肺脏发育.
目的 探討無肺部病變的足月兒及不同胎齡早產兒肺功能的動態變化.方法 迴顧分析2010年7月至2012年8月在深圳市兒童醫院新生兒科住院新生兒110例,按齣生胎齡分為3組:足月兒(齣生胎齡37 ～40週)組55例,其中男29例、女26例,平均齣生體重(3.1 ±0.3)kg；晚期早產兒(齣生胎齡34 ～ ＜37週)組30例,其中男18例、女12例,平均齣生體重(2.1 ±0.3)kg；早期早產兒(齣生胎齡＜ 34週)組25例,其中男16例、女9例,平均齣生體重(1.4±0.3)kg.在生後1、14及28日齡,進行潮氣呼吸檢測,運用反複呼吸氣體洗齣法技術,進行功能殘氣量(FRC)及肺清除指數(LCI)測量.各指標採用單因素方差分析方法統計.結果 3組新生兒75％、50％、25％潮氣量時呼氣流速(TEF75、TEF50、TEF25)在第1、14及28天均逐漸升高,而呼吸頻率則逐漸下降.足月兒組和晚期早產兒組在第28天TEF75、TEF50、TEF25、達峰時間比(TPTEF/TE)、達峰容積比(VPEF/VE)值均明顯高于早期早產兒組[(71±21)、(66±16)比(55±19) ml/s,(70 ±20)、(62±17)比(51±16)ml/s,(54±17)、(51±13)比(38±10) ml/s,37％±8％、34％±9％比29％±6％,38％±6％、33％±8％比28％±7％,F =5.82、8.74、11.30、7.72、16.40,均P＜0.01],而呼吸頻率、LCI值則低[(49±6)、(51±8)比(56±7)次/min,8.6±2.7、8.9±2.2比10.8±2.0,F=10.09、7.15,均P＜0.05].糾正胎齡40週時,足月兒組與晚期早產兒組TEF50、TEF25、TPTEF/TE、VPEF/VE仍均于早期早產兒組[(65±21)、(62±12)比(50±17)ml/s,(51±13)、(47±10)比(39±10) ml/s,36％ ±8％、31％±7％比30％±6％,37％±10％、32％±8％比29％±6％,F=4.41、8.23、9.08、7.35,均P＜0.05].結論 新生兒肺功能參數隨日齡逐漸改善,早期早產兒組各項肺功能參數落後于足月兒組,在糾正胎齡40週時,仍不能達到足月兒水平.新生兒肺功能鑑測有助于評估新生兒特彆是早產兒的肺髒髮育.
목적 탐토무폐부병변적족월인급불동태령조산인폐공능적동태변화.방법 회고분석2010년7월지2012년8월재심수시인동의원신생인과주원신생인110례,안출생태령분위3조:족월인(출생태령37 ～40주)조55례,기중남29례、녀26례,평균출생체중(3.1 ±0.3)kg；만기조산인(출생태령34 ～ ＜37주)조30례,기중남18례、녀12례,평균출생체중(2.1 ±0.3)kg；조기조산인(출생태령＜ 34주)조25례,기중남16례、녀9례,평균출생체중(1.4±0.3)kg.재생후1、14급28일령,진행조기호흡검측,운용반복호흡기체세출법기술,진행공능잔기량(FRC)급폐청제지수(LCI)측량.각지표채용단인소방차분석방법통계.결과 3조신생인75％、50％、25％조기량시호기류속(TEF75、TEF50、TEF25)재제1、14급28천균축점승고,이호흡빈솔칙축점하강.족월인조화만기조산인조재제28천TEF75、TEF50、TEF25、체봉시간비(TPTEF/TE)、체봉용적비(VPEF/VE)치균명현고우조기조산인조[(71±21)、(66±16)비(55±19) ml/s,(70 ±20)、(62±17)비(51±16)ml/s,(54±17)、(51±13)비(38±10) ml/s,37％±8％、34％±9％비29％±6％,38％±6％、33％±8％비28％±7％,F =5.82、8.74、11.30、7.72、16.40,균P＜0.01],이호흡빈솔、LCI치칙저[(49±6)、(51±8)비(56±7)차/min,8.6±2.7、8.9±2.2비10.8±2.0,F=10.09、7.15,균P＜0.05].규정태령40주시,족월인조여만기조산인조TEF50、TEF25、TPTEF/TE、VPEF/VE잉균우조기조산인조[(65±21)、(62±12)비(50±17)ml/s,(51±13)、(47±10)비(39±10) ml/s,36％ ±8％、31％±7％비30％±6％,37％±10％、32％±8％비29％±6％,F=4.41、8.23、9.08、7.35,균P＜0.05].결론 신생인폐공능삼수수일령축점개선,조기조산인조각항폐공능삼수락후우족월인조,재규정태령40주시,잉불능체도족월인수평.신생인폐공능감측유조우평고신생인특별시조산인적폐장발육.
Objective To explore the dynamic changes of lung function in infants born at different gestational ages without respiratory complications.Methods A total of 110 cases of hospitalized neonatal patients were retrospectively recruited and analyzed at Shenzhen Children's Hospital from July 2010 to August 2012.By gestational age they were divided into 3 groups of full term (37-40 weeks,n =55,29 males and 26 females) with an average birth weight (3.1 ± 0.3) kg,late preterm group(34-＜37 weeks,n =30,18 males and 12 females)with an average birth weight (2.1 ± 0.3) kg and early preterm (＜ 34 weeks,n =25,16 males and 9 females)with an average birth weight (1.4 ± 0.3) kg.At Days 1,14 and 28,lung function parameters of functional residual capacity (FRC) and lung clear index (LCI) were measured by multiple breath washouts with an ultrasonic flow meter and tidal breathing.One-way ANOVA was used for each index.Results Tidal expiratory flow 75％ remaining tidal volume (TEF75),tidal expiratory flow 50％ remaining tidal volume (TEF50) and tidal expiratory flow 25％ remaining tidal volume (TEF25) gradually increased at Days 1,14 and 28 in 3 groups.However respiratory rate (RR) gradually decreased.Compared with full term and late preterm,the early preterm infants had lower TEF75,TEF50 and TEF25,lower the ratios of time to peak expiratory flow and expiratory time (TPTEF/TE),lower ratios of volume to peak expiratory flow and expiratory volume (VPEF/VE) ((71 ±21) and (66 ± 16) vs (55 ± 19)ml/s,(70 ±20) and (62 ± 17) vs (51 ± 16) ml/s,(54 ± 17) and (51 ± 13) vs (38 ± 10) ml/s,37％ ±8％ and 34％±9％ vs 29％ ±6％,38％ ±6％ and 33％ ±8％ vs 28％ ±7％,F=5.82,8.74,11.30,7.72,16.40,all P ＜ 0.01),higher RR and LCI at Day 28 ((49 ± 6) and (51 ± 8) vs (56 ±7)/min,8.6 ±2.7 and 8.9 ±2.2 vs 10.8 ±2.0,F =10.09,7.15,both P ＜0.05).At a matched post-menstrual age of 40 weeks,compared with full term and late preterm,the early preterm group had lower TEF50,TEF25,TPTEF/TE,VPEF/VE ((65 ± 21) and (62 ± 12) vs (50 ± 17) ml/s,(51 ± 13) and (47±10) vs (39±10)ml/s,36％ ±8％ and 31％ ±7％ vs30％ ±6％,37％ ±10％ and 32％ ±8％ vs 29％ ±6％,F=4.41,8.23,9.08,7.35,all P＜0.05).Conclusions Lung function improves with the elongation of days.The parameters of lung function in early infants are worse than those in full and late-preterm counterparts.At a corrected gestational age of 40 weeks,early preterm infants fail to achieve catch-up growth in lung function.Dynamic monitoring of lung function in preterm infants of different gestational ages is of vital importantance for gauging respiratory maturity and assessing lung development especially for preterm infants.
