CAJ | 학술논문

目的：初步探讨未接受机械通气的晚期早产儿在校正胎龄足月时潮气呼吸肺功能的情况。方法收集2013年4月至2013年12月在青岛市妇女儿童医院住院,且出院时校正胎龄达足月的未接受过机械通气的晚期早产儿(26例),为晚期早产儿组；以同期因高胆红素血症或新生儿ABO溶血症住院的足月儿为足月儿组(31例)；比较两组患儿潮气呼吸肺功能各项指标的差异。其中根据生后体重增长情况进一步将晚期早产儿分为宫外发育迟缓组(13例)与非宫外发育迟缓组(13例),比较两组的达峰时间比( ratio of time to peak tidal expiratory flow and total expiratory time,TPEF/TE)、达峰容积比( ratio of expiratory volume at peak tidal expiratory flow and total expiratory volume,VPEF/VE)有无差异；并进行非宫外发育迟缓组患儿出生体重与TPEF/TE的相关性分析。结果(1)晚期早产儿组和足月儿组在监测潮气呼吸肺功能时的胎龄差异无统计学意义( P>0．05)；晚期早产儿组在校正胎龄足月时体重[(2．39±0．44) kg vs．(3．21±0．43) kg]、身长[(46．51±3．22) cm vs．(50．16±2．14) cm]仍落后于足月儿组,差异有统计学意义(P均<0．05)。(2)晚期早产儿组、足月儿组潮气呼吸肺功能各项指标的比较：晚期早产儿组的TPEF/TE[(41．74±10．94)% vs．(48．17±11．79)%]、VPEF/VE[(42．66±9．66)% vs．(48．31±9．94)%]、达峰容积[(8．02±2．85) ml vs．(10．23±3．56) ml]、每分通气量[(0．76±0．23) L/min vs．(1．00±0．44) L/min]明显低于足月儿组,差异有统计学意义(P均<0．05)。(3)足月儿组、晚期早产儿组的TPEF/TE与VPEF/VE均有相关性(足月儿组：r=0．950,P=0．000；晚期早产儿组：r=0．958,P=0．000)。(4)晚期早产儿非宫外发育迟缓组的TPEF/TE、VPEF/VE更接近足月儿组,宫外发育迟缓组TPEF/TE、VPEF/VE均较非宫外发育迟缓组低,且差异有统计学意义( t=-2．775,-2．109,P=0．011,0．047)。结论未接受机械通气的晚期早产儿在校正胎龄足月时气道(尤其是小气道)的阻力仍高于足月儿。宫外发育迟缓对晚期早产儿的气道阻力有影响。目的：初步探討未接受機械通氣的晚期早產兒在校正胎齡足月時潮氣呼吸肺功能的情況。方法收集2013年4月至2013年12月在青島市婦女兒童醫院住院,且齣院時校正胎齡達足月的未接受過機械通氣的晚期早產兒(26例),為晚期早產兒組；以同期因高膽紅素血癥或新生兒ABO溶血癥住院的足月兒為足月兒組(31例)；比較兩組患兒潮氣呼吸肺功能各項指標的差異。其中根據生後體重增長情況進一步將晚期早產兒分為宮外髮育遲緩組(13例)與非宮外髮育遲緩組(13例),比較兩組的達峰時間比( ratio of time to peak tidal expiratory flow and total expiratory time,TPEF/TE)、達峰容積比( ratio of expiratory volume at peak tidal expiratory flow and total expiratory volume,VPEF/VE)有無差異；併進行非宮外髮育遲緩組患兒齣生體重與TPEF/TE的相關性分析。結果(1)晚期早產兒組和足月兒組在鑑測潮氣呼吸肺功能時的胎齡差異無統計學意義( P>0．05)；晚期早產兒組在校正胎齡足月時體重[(2．39±0．44) kg vs．(3．21±0．43) kg]、身長[(46．51±3．22) cm vs．(50．16±2．14) cm]仍落後于足月兒組,差異有統計學意義(P均<0．05)。(2)晚期早產兒組、足月兒組潮氣呼吸肺功能各項指標的比較：晚期早產兒組的TPEF/TE[(41．74±10．94)% vs．(48．17±11．79)%]、VPEF/VE[(42．66±9．66)% vs．(48．31±9．94)%]、達峰容積[(8．02±2．85) ml vs．(10．23±3．56) ml]、每分通氣量[(0．76±0．23) L/min vs．(1．00±0．44) L/min]明顯低于足月兒組,差異有統計學意義(P均<0．05)。(3)足月兒組、晚期早產兒組的TPEF/TE與VPEF/VE均有相關性(足月兒組：r=0．950,P=0．000；晚期早產兒組：r=0．958,P=0．000)。(4)晚期早產兒非宮外髮育遲緩組的TPEF/TE、VPEF/VE更接近足月兒組,宮外髮育遲緩組TPEF/TE、VPEF/VE均較非宮外髮育遲緩組低,且差異有統計學意義( t=-2．775,-2．109,P=0．011,0．047)。結論未接受機械通氣的晚期早產兒在校正胎齡足月時氣道(尤其是小氣道)的阻力仍高于足月兒。宮外髮育遲緩對晚期早產兒的氣道阻力有影響。
목적：초보탐토미접수궤계통기적만기조산인재교정태령족월시조기호흡폐공능적정황。방법수집2013년4월지2013년12월재청도시부녀인동의원주원,차출원시교정태령체족월적미접수과궤계통기적만기조산인(26례),위만기조산인조；이동기인고담홍소혈증혹신생인ABO용혈증주원적족월인위족월인조(31례)；비교량조환인조기호흡폐공능각항지표적차이。기중근거생후체중증장정황진일보장만기조산인분위궁외발육지완조(13례)여비궁외발육지완조(13례),비교량조적체봉시간비( ratio of time to peak tidal expiratory flow and total expiratory time,TPEF/TE)、체봉용적비( ratio of expiratory volume at peak tidal expiratory flow and total expiratory volume,VPEF/VE)유무차이；병진행비궁외발육지완조환인출생체중여TPEF/TE적상관성분석。결과(1)만기조산인조화족월인조재감측조기호흡폐공능시적태령차이무통계학의의( P>0．05)；만기조산인조재교정태령족월시체중[(2．39±0．44) kg vs．(3．21±0．43) kg]、신장[(46．51±3．22) cm vs．(50．16±2．14) cm]잉락후우족월인조,차이유통계학의의(P균<0．05)。(2)만기조산인조、족월인조조기호흡폐공능각항지표적비교：만기조산인조적TPEF/TE[(41．74±10．94)% vs．(48．17±11．79)%]、VPEF/VE[(42．66±9．66)% vs．(48．31±9．94)%]、체봉용적[(8．02±2．85) ml vs．(10．23±3．56) ml]、매분통기량[(0．76±0．23) L/min vs．(1．00±0．44) L/min]명현저우족월인조,차이유통계학의의(P균<0．05)。(3)족월인조、만기조산인조적TPEF/TE여VPEF/VE균유상관성(족월인조：r=0．950,P=0．000；만기조산인조：r=0．958,P=0．000)。(4)만기조산인비궁외발육지완조적TPEF/TE、VPEF/VE경접근족월인조,궁외발육지완조TPEF/TE、VPEF/VE균교비궁외발육지완조저,차차이유통계학의의( t=-2．775,-2．109,P=0．011,0．047)。결론미접수궤계통기적만기조산인재교정태령족월시기도(우기시소기도)적조력잉고우족월인。궁외발육지완대만기조산인적기도조력유영향。
Objective To investigate pulmonary function of tidal respiration in late premature infants with non-mechanical ventilation treatment at corrected gestational age of full term. Methods A total of 26 late premature infants with non-mechanical ventilation treatment at corrected gestational age of full term were collected from Qingdao Women and Children′s Hospital between April and December 2013,and saved as the late premature infant group. Also, a total of 31 full term infants with hyperbilirubinemia or neonatal ABO hemolytic disease were recruited and treated as the full term group. Then the parameters of pulmonary func-tion of tidal respiration were compared between the two groups. The late premature infant group was equally allocated into extrauterine growth retardation and non-extrauterine growth retardation groups according to the increase in weight and the ratio of time to peak tidal expiratory flow and total expiratory time(TPEF/TE) and the ratio of expiratory volume at peak tidal expiratory flow and total expiratory volume( VPEF/VE) were respectively compared in these two groups. Another correlation analysis between body weight and TPEF/TE was carried out in the non-extrauterine growth retardation group. Results (1)Gestational age difference had no significant significance between late premature infant group and full term group ( P <0. 05 ) . The body weight[(2. 39 ± 0. 44)kg vs. (3. 21 ± 0. 43) kg] and height[(46. 51 ± 3. 22) cm vs. (50. 16 ± 2. 14) cm] in late premature infant group were still lag behind that in full term group and the difference had significant significance(P<0. 05,respectively). (2)The comparison of parameters of pulmonary function of tidal respi-ration:the TPEF/TE [ ( 41. 74 ± 10. 94 )% vs. ( 48. 17 ± 11. 79 )%] , VPEF/VE [ ( 42. 66 ± 9. 66 )% vs. (48. 31 ± 9. 94)%],VPEF[(8. 02 ± 2. 85) ml vs. (10. 23 ± 3. 56) ml] and minute ventilation[(0. 76 ± 0. 23) L/min vs. (1. 00 ± 0. 44) L/min] in late premature infant group were significantly lower than those in full term group(P<0. 05,respectively). (3)The TPEF/TE and VPEF/VE all had significant significance in both late premature infant group and full term group(late premature infant group:r=0. 958,P=0. 000; full term group:r=0. 950,P=0. 000). (4)The TPEF/TE and VPEF/VE in non-extrauterine growth retardation group were closer to those in full term group. The TPEF/TE and VPEF/VE in extrauterine growth retardation group were lower than those in non-extrauterine growth retardation group(t= -2. 775,-2. 109,P=0. 011, 0. 047). Conclusion Airway(especially small airway) resistance of late preterm infant group is higher than that of term infants. Extrauterine growth retardation influences the airway(especially small airway) resist-ance.