现代医药卫生
現代醫藥衛生
현대의약위생
MODERN MEDICINE HEALTH
2014年
10期
1443-1445
,共3页
舒俊华%黄娟%龙珍%周小勤
舒俊華%黃娟%龍珍%週小勤
서준화%황연%룡진%주소근
肺炎%糖皮质激素类%潮气量%呼吸功能试验%婴儿
肺炎%糖皮質激素類%潮氣量%呼吸功能試驗%嬰兒
폐염%당피질격소류%조기량%호흡공능시험%영인
Pneumonia%Glucocorticoids%Tidal Volume%Respiratory function tests%Infant
目的：观察及探讨吸入性糖皮质激素治疗对婴幼儿重症肺炎患儿潮气呼吸肺功能的影响及意义。方法选择该院儿科重症监护病房（PICU）2012年6月至2013年6月收治的婴幼儿重症肺炎患儿80例，年龄1~35个月，分为A、B组各40例。两组患儿均给予常规吸氧、抗感染对症支持等综合治疗，A组在综合治疗基础上于住院时以及出院后加用布地奈德混悬液（500μg，每天2次）吸入治疗，疗程3个月。另选择38例无呼吸系统疾病健康婴幼儿作为健康对照组（C组），其中男20例，女18例，平均月龄（18.1±0.7）个月。分别测定入院时、临床治愈时及出院后3个月三组患儿的潮气呼吸肺功能主要测定参数：潮气量（VT）、呼吸频率（RR）、吸气时间（TI）、呼气时间（TE）、吸呼比（TI/TE）、达峰时间比（TPTEF/TE）及达峰容积比（VPTEF/VE）。观察各组患儿肺功能指标变化及改善率的差异。结果入院时A、B组分别与C组比较，RR增快、TI缩短、TE缩短、TI/TE、TPTEF/TE、VPTEF/VE及VT明显降低，差异均有统计学意义（P＜0.05）；临床治愈时A、B组VT增加，RR下降，与入院时比较，差异有统计学意义（P＜0.05），两组TPEF/TE、VPEF/VE指标较治疗前增高，且A组改善明显优于B组，差异均有统计学意义（P<0.05），但两组仍明显低于C组，差异均有统计学意义（P＜0.05），A组TPEF/TE、VPEF/VE较B组明显增高，差异有统计学意义（P＜0.05）；出院后3个月A、B组RR、VT、TI、TE、TI/TE均与C组相当，A组TPTEF/TE、TPTEF/VE指标进一步改善，其水平与C组相当，且显著优于B组，差异有统计学意义（P＜0.05）；B组TPEF/TE、VPEF/VE仍显著低于C组，差异均有统计学意义（P＜0.05）。结论婴幼儿重症肺炎患儿潮气呼吸肺功能明显受损，临床症状缓解后其肺功能损害仍持续存在，吸入性糖皮质激素治疗可改善其肺功能损害。
目的：觀察及探討吸入性糖皮質激素治療對嬰幼兒重癥肺炎患兒潮氣呼吸肺功能的影響及意義。方法選擇該院兒科重癥鑑護病房（PICU）2012年6月至2013年6月收治的嬰幼兒重癥肺炎患兒80例，年齡1~35箇月，分為A、B組各40例。兩組患兒均給予常規吸氧、抗感染對癥支持等綜閤治療，A組在綜閤治療基礎上于住院時以及齣院後加用佈地奈德混懸液（500μg，每天2次）吸入治療，療程3箇月。另選擇38例無呼吸繫統疾病健康嬰幼兒作為健康對照組（C組），其中男20例，女18例，平均月齡（18.1±0.7）箇月。分彆測定入院時、臨床治愈時及齣院後3箇月三組患兒的潮氣呼吸肺功能主要測定參數：潮氣量（VT）、呼吸頻率（RR）、吸氣時間（TI）、呼氣時間（TE）、吸呼比（TI/TE）、達峰時間比（TPTEF/TE）及達峰容積比（VPTEF/VE）。觀察各組患兒肺功能指標變化及改善率的差異。結果入院時A、B組分彆與C組比較，RR增快、TI縮短、TE縮短、TI/TE、TPTEF/TE、VPTEF/VE及VT明顯降低，差異均有統計學意義（P＜0.05）；臨床治愈時A、B組VT增加，RR下降，與入院時比較，差異有統計學意義（P＜0.05），兩組TPEF/TE、VPEF/VE指標較治療前增高，且A組改善明顯優于B組，差異均有統計學意義（P<0.05），但兩組仍明顯低于C組，差異均有統計學意義（P＜0.05），A組TPEF/TE、VPEF/VE較B組明顯增高，差異有統計學意義（P＜0.05）；齣院後3箇月A、B組RR、VT、TI、TE、TI/TE均與C組相噹，A組TPTEF/TE、TPTEF/VE指標進一步改善，其水平與C組相噹，且顯著優于B組，差異有統計學意義（P＜0.05）；B組TPEF/TE、VPEF/VE仍顯著低于C組，差異均有統計學意義（P＜0.05）。結論嬰幼兒重癥肺炎患兒潮氣呼吸肺功能明顯受損，臨床癥狀緩解後其肺功能損害仍持續存在，吸入性糖皮質激素治療可改善其肺功能損害。
목적：관찰급탐토흡입성당피질격소치료대영유인중증폐염환인조기호흡폐공능적영향급의의。방법선택해원인과중증감호병방（PICU）2012년6월지2013년6월수치적영유인중증폐염환인80례，년령1~35개월，분위A、B조각40례。량조환인균급여상규흡양、항감염대증지지등종합치료，A조재종합치료기출상우주원시이급출원후가용포지내덕혼현액（500μg，매천2차）흡입치료，료정3개월。령선택38례무호흡계통질병건강영유인작위건강대조조（C조），기중남20례，녀18례，평균월령（18.1±0.7）개월。분별측정입원시、림상치유시급출원후3개월삼조환인적조기호흡폐공능주요측정삼수：조기량（VT）、호흡빈솔（RR）、흡기시간（TI）、호기시간（TE）、흡호비（TI/TE）、체봉시간비（TPTEF/TE）급체봉용적비（VPTEF/VE）。관찰각조환인폐공능지표변화급개선솔적차이。결과입원시A、B조분별여C조비교，RR증쾌、TI축단、TE축단、TI/TE、TPTEF/TE、VPTEF/VE급VT명현강저，차이균유통계학의의（P＜0.05）；림상치유시A、B조VT증가，RR하강，여입원시비교，차이유통계학의의（P＜0.05），량조TPEF/TE、VPEF/VE지표교치료전증고，차A조개선명현우우B조，차이균유통계학의의（P<0.05），단량조잉명현저우C조，차이균유통계학의의（P＜0.05），A조TPEF/TE、VPEF/VE교B조명현증고，차이유통계학의의（P＜0.05）；출원후3개월A、B조RR、VT、TI、TE、TI/TE균여C조상당，A조TPTEF/TE、TPTEF/VE지표진일보개선，기수평여C조상당，차현저우우B조，차이유통계학의의（P＜0.05）；B조TPEF/TE、VPEF/VE잉현저저우C조，차이균유통계학의의（P＜0.05）。결론영유인중증폐염환인조기호흡폐공능명현수손，림상증상완해후기폐공능손해잉지속존재，흡입성당피질격소치료가개선기폐공능손해。
Objective To observe the influence and significance of inhaled corticosteroids on tidal breathing lung func-tion of infants with severe pneumonia. Methods Totally 80 infants with severe pneumonia aged 1-35 months ,who were in Pedi-atric Intensive Care Unit(PICU) of Maternal and Child Hospital of Hubei Province from June 2012 to June 2013 ,were selected and randomized into group A and group B,40 cases in each group. The patients in both groups were given comprehensive treatment of conventional oxygen inhalation,anti-infection,symptomatic treatment and so on,while group A was added with budesonide sus pension(500μg,twice daily) for inhalation therapy when admitted and discharged from the hospital with the treatment course of three months. Another 38 infants without respiratory diseases were taken as the healthy control group (group C). To measure the tidal breathing lung functions in the three groups at pre-treatment,clinical cured and 3 months after discharging from hospital re-spectively mainly including:tidal volume (VT),respiratory rate (RR),inspiration time (TI),expiratory time (TE),inspiration to expiratory ratio(TI/TE),time to peak ratio(TPTEF/TE) and peak volume ratio(VPTEF/VE). To observe the change of infants′lung functional parameter and improvement rate in all the groups. Results Compared with the group C on admission,the RR in group A and group B increased,TI and TE shortened,TI/TE,TPTEF/TE,VPTEF/VE and VT reduced obviously,and difference of each index had statistical significance(P<0.05);the VT in the group A and group B increased and RR reduced when clinical cured, comparing with the VT and RR on admission,the difference was statistically significant(P<0.05);the TPTEF/TE and VPTEF/VE after treatment were higher than those before treatment,and the group A improved were significantly than the group B(P<0.05),but which were significantly lower than those in group C(P<0.05);the TPEF/TE and VPEF/VE of group A were obviously higher than those of group B with statistically significant difference(P<0.05);3 months after discharge,the RR,VT,TI,TE and TI/TE of group A and group B were equal to those of the group C,the TPTEF/TE,TPTEF/VE of group A were further improved and equaled to those of the group C,which were significantly better than those of group B(P<0.05);the TPEF/TE,VPEF/VE of group B were still significantly lower than those of the group C (P<0.05). Conclusion The tidal breathing lung function in infants with severe pneumonia is signifi- cantly impaired even after clinical remission,inhalation therapy of budesonide suspension can improve the lung function.
