窒息对新生儿肺功能影响的临床研究

Assessment of Pulmonary Function in Neonatal Asphyxia

目的探讨窒息对新生儿肺功能的影响。方法设立观察组（100例）和对照组（60例），对研究对象在生后3天内病情许可下应用Vmax26型婴儿肺功能仪测定各项肺功能指标：每公斤体重潮气量（Vt／kg）、达峰时间比（到达潮气呼气峰流速的时间／呼气时间，Tptef／Te）、呼吸频率（RR）、呼吸系统阻力（RrS）、每公斤体重功能残气量（Frc／kg）及顺应性（CrS／kg）。结果①足月儿：窒息组Vt／kg、FrC／kg较对照组下降，RR较对照组增加，尤其重度窒息组与对照组比较差异有统计学意义（P〈0．05）；窒息组Tptef／Te、Rrs、Crs／kg与对照组比较差异无统计学意义（P〉0．05）。②早产儿：窒息组Vt／kg、Tptef／Te、CrS／kg、FrC／kg较对照组下降，RrS较对照组增加，与对照组比较差异均有统计学意义（P〈0．05）；窒息组RR与对照组比较差异无统计学意义（P〉0．05）。结论窒息对新生儿肺功能有影响，主要表现为：重度窒息可致足月新生儿潮气量及功能残气量减少；对于早产儿不仅潮气量及功能残气量减少，肺顺应性亦减少，同时气道阻力增加。

Objective The objective of this study was to determine the effects of pulmonary function in neonatal asphyxia. Methods Pulmonary function was measured in 100 infants with asphyxia（study group） and 60 healthy controls（normal group）. The parameters included tidal volume per kilogram（VT/Kg）, the respiratory rate（RR）, the ratio of time to reach peak tidal expiratory flow to total expiratory time （Tptef/Te）, respiratory system resistance（Rrs）, functional residual capacity per kilogram（Frc/Kg） and respiratory system compliance per kilogram（Crs/Kg）. Results （1） mature infant： Vt/kg, Frc/kg were significantly lower in study group compared with the controls （P〈0.05）, while RR was significantly higher than normal group （P〈0.05）,but no differences could be found between the two groups with regards to the other pulmonary funtion（P〉0.05）. （2） premature infant： Vt/kg, Tptef/Te, Crs/kg, Frc/kg were significantly lower in study group compared with the controls （P〈0.05）, but Rrs was significantly higher than normal group（P〈0.05） and RR was no differences could be found between the two groups. Conclusion The pulmonary function in neonatal asphyxia may be suffered, tidal volume and functional residual capacity were decreased in severe asphyxia of mature infants. In premature infants, tidal volume , functional residual capacity and respiratory system compliance Were decreased in severe asphyxia while respiratory system resistance were increased.