肺炎患儿膈肌疲劳的诊断研究

Diagnosis study of diaphragmatic muscle fatigue in children with pneumonia

目的探讨电阻抗呼吸图仪对肺炎患儿膈肌疲劳的诊断价值。方法用2K-V1型智能电阻抗呼吸图仪分别测定126例肺炎患儿和60例正常小儿的膈肌功能,并根据其一维图中胸腹运动曲线的变化及二维图中M值与α角度的变化判断其膈肌疲劳的程度。结果126例患儿中98例有膈肌疲劳,其中68例为Ⅰ型膈肌疲劳,30例为Ⅱ型膈肌疲劳。Ⅰ型膈肌疲劳患儿M值为(46.1±8.4)%,α角为(136.7±12.0)°;Ⅱ型膈肌疲劳M值为(17.2±3.2)%,α角为(48.2±9.5)°;对照组M值为(4.3±1.0)%,α角为(31.7±5.2)°(P<0.01)。膈肌疲劳的程度与临床诊断呼吸衰竭呈高度相关,与年龄的大小呈负相关。结论电阻抗呼吸图仪可作为肺炎膈肌疲劳的临床诊断方法,膈肌疲劳与肺炎患儿呼吸衰竭有相关性。

Objective To understand the value of the electric impedance respirograph（IRG） detection in the diagnosis of diaphragmatic muscle fatigue（DMF） with pneumonia. To study the correlation between diaphragmatic muscle fatigue and respiratory failure with pneumonia. Methods 126 cases of pneumonia and 60 cases of normal children were studied with ZK-VI type intelligence electric impedance respirograph to measure diaphragmatic function. According to the changes of chest-abdominal curve in one-dimensional chart, and the changes of M value and a angle, the degree of the diaphragmatic muscle fatigue was decided. Results There were 98 cases of DMF in 126 children with pneumonia. There were significant differences in mean（SD） T/C radio between group with DMF （DMF type Ⅰ ： （46.1±8.4）%;DMF type Ⅱ ：（17.2±b3.2）° respectively and normal controls （4.3±10）%（P 〈0.01）;α angle DFM type Ⅰ：136.7±12.0）°;MF type Ⅱ：（48.2±9.5） ° respectively and normal controls （31.7±5.2）°（P 0.01）. The degree of DMF was positive related with the clinical diagnosis of respiratory failure, but negative with the age. Conclusion IRG is a very valuable diagnostic method for DMF of pneumonia. There is a significant correlation between DMF and respiratory failure.