先天性唇、腭裂对患儿呼吸系统顺应性的影响

Influence of congenital cleft lip or cleft palate on total respiratary compliance in child

目的 探讨先天性唇、腭裂对患儿呼吸系统顺应性 (CT)的影响。方法 唇裂或腭裂病儿 2 40例 (观察组 ) ,非唇腭裂病儿 6 0例 (对照组 )均为择期手术患者 ,按年龄段 :1～ 12月、1～ 3岁、4～ 7岁、8～ 12岁 ,各分为 5个亚组。全麻诱导气管内插管后 ,行机械通气 ,保持PETCO2 4～ 4.6kPa ,用DatexUltima监测仪测定CT。结果 与非唇裂同一年龄组CT 值相比 ,唇裂各年龄组、腭裂 1～ 12月及 1～ 3岁组CT 值无显著性差异 ,而腭裂 4～ 7岁、8～ 12岁组明显下降 (P <0 .0 1)。非唇腭裂和唇裂各年龄组比顺应性值组间比较无显著性差异 ,与腭裂 1～ 12月组相比 ,腭裂 4～ 7岁、8～ 12岁组显著下降 (P <0 .0 1)。结论 先天性腭裂患儿 ,随年龄增长 ,CT 进一步下降 ,因而腭裂修复术宜早期进行。

Objective To investigate the influence of congenital cleft lip or cleft palate on total respiratary compliance (C T) in child.Methods Sixty children without congenital malformation (control group) and 240 children with congenital cleft lip or cleft palate (test group), scheduled for selected operation, were divided into 5 subgroups according to the age range: 1 12 months,1 3 years,4 7 years and 8 12 years,respectively. With the mechnical ventilation following intratracheal intubation after anesthesia induction, P ET CO 2 was maitained at 4 4.6kPa. The C T was measured with Datex Ultima monitor.Results Compared with the control level in the same age subgroup, C T remained unsignificant changes in all subgroups of cleft lip and in 1 12 months and 1 3 years subgroups of cleft palate, but decreased significantly in 4 7 years and 8 12 years subgroups of cleft palate(P<0.01). There were not significant differences in ratio of C T to functional residual capacity(FRC) among all control or cleft lip subgroups. As compared with that in 1 12 months subgroup of cleft palate , the C T/FRC ratio decreased markedly in 4 7 years and 8 12 years subgroups(P<0.01).Conclusions C T of child with cleft palate reduces progressively with increasing age , so the repair of the palate should be performed at its early stage.