中国综合临床
中國綜閤臨床
중국종합림상
Clinical Medicine of China
2015年
11期
1047-1049
,共3页
节段性支原体肺炎%肺功能%儿童
節段性支原體肺炎%肺功能%兒童
절단성지원체폐염%폐공능%인동
Segmental mycoplasma pneumonia%Pulmonary function%Children
目的 观察儿童节段性支原体肺炎肺功能动态变化及临床意义,并动态分析X线改变.方法 选择我院2013年6月至2014年12月收治的支原体肺炎患儿83例,监测患儿急性期、恢复期以及康复期肺功能变化及影像学检查.肺功能包括用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、用力呼气量占用力肺活量比值(FEV 1/FVC)、呼气峰流量(PEF)、最大呼气中期流量(FEF25-75).比较分析肺功能及影像学检查结果.结果 83例节段性支原体肺炎急性期患儿与恢复期、康复期相比,FVC[(1.58±0.49)、(1.76±0.62)、(2.08±0.84)L]、FEV1[(1.27±0.46)、(1.58±0.53)、(1.83±0.66)L]、FEV1/FVC[(79.64±6.61)％、(85.25±7.38)％、(87.24±8.61)％]、PEF[(2.61±0.84)、(3.15±0.92)、(3.52±1.06) L/s]、FEF25[(2.29±0.83)、(2.86±0.95)、(3.26±0.98) L/s]、FEF50[(1.51±0.52)、(2.12±0.64)、(2.26±0.63) L/s]、FEF75[(0.58±0.42)、(0.76±0.46)、(1.02±0.42) L/s]和FEF25-75[(0.61±0.33)、(0.87±0.36)、(1.01±0.41)L/s]均有所降低,差异有统计学意义(P均＜0.05).多部位病变节段性支原体肺炎患儿与单个叶段病变患儿比较,FVC[(1.51±0.44)、(1.31±0.36)L]以及FEV1[(1.46±0.56)、(1.21±0.48)L]比较差异有统计学意义(t值分别为2.27、2.18,P均＜0.05).急性期患儿X线显示多数为单侧病变,表现为肺叶或肺段密度增高,边缘模糊不清.14 d左右明显好转,少数于2周后仍可见纹理模糊、增粗.结论 节段性支原体肺炎患儿急性期大、小气道功能均有不同程度损伤,多表现为限制性通气障碍,小气道功能受损更明显,恢复期肺功能明显好转.多叶段病变大气道功能受损较单个叶段病变严重.
目的 觀察兒童節段性支原體肺炎肺功能動態變化及臨床意義,併動態分析X線改變.方法 選擇我院2013年6月至2014年12月收治的支原體肺炎患兒83例,鑑測患兒急性期、恢複期以及康複期肺功能變化及影像學檢查.肺功能包括用力肺活量(FVC)、第1秒用力呼氣容積(FEV1)、用力呼氣量佔用力肺活量比值(FEV 1/FVC)、呼氣峰流量(PEF)、最大呼氣中期流量(FEF25-75).比較分析肺功能及影像學檢查結果.結果 83例節段性支原體肺炎急性期患兒與恢複期、康複期相比,FVC[(1.58±0.49)、(1.76±0.62)、(2.08±0.84)L]、FEV1[(1.27±0.46)、(1.58±0.53)、(1.83±0.66)L]、FEV1/FVC[(79.64±6.61)％、(85.25±7.38)％、(87.24±8.61)％]、PEF[(2.61±0.84)、(3.15±0.92)、(3.52±1.06) L/s]、FEF25[(2.29±0.83)、(2.86±0.95)、(3.26±0.98) L/s]、FEF50[(1.51±0.52)、(2.12±0.64)、(2.26±0.63) L/s]、FEF75[(0.58±0.42)、(0.76±0.46)、(1.02±0.42) L/s]和FEF25-75[(0.61±0.33)、(0.87±0.36)、(1.01±0.41)L/s]均有所降低,差異有統計學意義(P均＜0.05).多部位病變節段性支原體肺炎患兒與單箇葉段病變患兒比較,FVC[(1.51±0.44)、(1.31±0.36)L]以及FEV1[(1.46±0.56)、(1.21±0.48)L]比較差異有統計學意義(t值分彆為2.27、2.18,P均＜0.05).急性期患兒X線顯示多數為單側病變,錶現為肺葉或肺段密度增高,邊緣模糊不清.14 d左右明顯好轉,少數于2週後仍可見紋理模糊、增粗.結論 節段性支原體肺炎患兒急性期大、小氣道功能均有不同程度損傷,多錶現為限製性通氣障礙,小氣道功能受損更明顯,恢複期肺功能明顯好轉.多葉段病變大氣道功能受損較單箇葉段病變嚴重.
목적 관찰인동절단성지원체폐염폐공능동태변화급림상의의,병동태분석X선개변.방법 선택아원2013년6월지2014년12월수치적지원체폐염환인83례,감측환인급성기、회복기이급강복기폐공능변화급영상학검사.폐공능포괄용력폐활량(FVC)、제1초용력호기용적(FEV1)、용력호기량점용력폐활량비치(FEV 1/FVC)、호기봉류량(PEF)、최대호기중기류량(FEF25-75).비교분석폐공능급영상학검사결과.결과 83례절단성지원체폐염급성기환인여회복기、강복기상비,FVC[(1.58±0.49)、(1.76±0.62)、(2.08±0.84)L]、FEV1[(1.27±0.46)、(1.58±0.53)、(1.83±0.66)L]、FEV1/FVC[(79.64±6.61)％、(85.25±7.38)％、(87.24±8.61)％]、PEF[(2.61±0.84)、(3.15±0.92)、(3.52±1.06) L/s]、FEF25[(2.29±0.83)、(2.86±0.95)、(3.26±0.98) L/s]、FEF50[(1.51±0.52)、(2.12±0.64)、(2.26±0.63) L/s]、FEF75[(0.58±0.42)、(0.76±0.46)、(1.02±0.42) L/s]화FEF25-75[(0.61±0.33)、(0.87±0.36)、(1.01±0.41)L/s]균유소강저,차이유통계학의의(P균＜0.05).다부위병변절단성지원체폐염환인여단개협단병변환인비교,FVC[(1.51±0.44)、(1.31±0.36)L]이급FEV1[(1.46±0.56)、(1.21±0.48)L]비교차이유통계학의의(t치분별위2.27、2.18,P균＜0.05).급성기환인X선현시다수위단측병변,표현위폐협혹폐단밀도증고,변연모호불청.14 d좌우명현호전,소수우2주후잉가견문리모호、증조.결론 절단성지원체폐염환인급성기대、소기도공능균유불동정도손상,다표현위한제성통기장애,소기도공능수손경명현,회복기폐공능명현호전.다협단병변대기도공능수손교단개협단병변엄중.
Objective To study the dynamic changes and clinical significance of pulmonary function (PF) in segmental mycoplasma pneumonia (SMPP) children and make the dynamic analysis of X-ray features.Methods Eighty-three SMPP children treated from June 2013 to December 2014 in Jinshan Institute of the Sixth People's Hospital of Shanghai were selected and the PF changes at acute phase, recovery phase and rehabilitative period was monitored and all the patients received the imageological diagnosis.The Pulmonary function includes forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), forced expiratory volume ratio(FEV1/FVC), peak expiratory flow(PEF), and maximum expiratory flow (FEF25-75).Pulmonary function and imageological diagnosis of two groups was compared.Results Compare the acute phase and recovery phase and rehabilitative period of 83 SMPP Children, at acute phase, FVC ((1.58±0.49), (1.76 ±0.62),(2.08±0.84) L),FEV1((1.27±0.46),(1.58±0.53),(1.83±0.66) L),FEV1/FVC((79.64±6.61)％,(85.25±7.38)％,(87.24±8.61)％),PEF((2.61±0.84),(3.15±0.92),(3.52±1.06) L/s), FEF25 ((2.29±0.83), (2.86± 0.95), (3.26± 0.98) L/s), FEF50 ((1.51 ± 0.52), (2.12 ± 0.64), (2.26±0.63) L/s),FEF75((0.58±0.42),(0.76±0.46),(1.02±0.42) L/s) and FEF25-75 ((0.61±0.33),(0.87±0.36), (1.01 ±0.41) L/s) of two groups were reduced, especially FEF25, FEF50, FEF75 and FEF25-75.At recovery phase and rehabilitative period ,the indicators were significantly better than those of acute phase (P＜ 0.05);for SMPP children at acute phase, FVC ((1.51 ± 0.44), (1.31 ± 0.36) L) and FEV 1 ((1.46±0.56), (1.21±0.48) L) in the lesions of multiple parts was significantly lower than that of lesions of single part(P＜0.05).At acute phase, X-ray majorly showed the unilateral lesion with increased density and blurring edges in lung lobe or segment.After 14 d, the condition was obvious improved;a few cases still had the blurring textures and thickening conditions after 2 weeks.Conclusion For SMPP children at acute phase,the major and micro airway function is damaged in different extent.It is majorly expressed as restrictive ventilation dysfunction,especially micro airway function.At recovery phase, PF is obviously improved.The damage of major airway function in the multiple parts of lung lobe is more serious than that of lesions in the single part.
