新生儿期潮气呼吸参数、功能残气量及肺清除指数的动态研究

Dynamic study on tidal breathing parameters,functional residual capacity and lung clearance index in the neonatal period

目的探讨不同孕周新生儿潮气呼吸参数、功能残气量及肺清除指数参数值随日龄变化的规律,探讨新生儿期肺功能变化与肺发育的关系。方法深圳市儿童医院新生儿科2010年2月至2014年11月住院新生儿中,选取足月儿55名,晚期新生儿30名和胎龄小于34周的早产儿25名,剔除标准为肺部感染、氧依赖、先天性心脏病、隔疝等影响肺功能的疾病。在生后第1、7、14、28日龄时,检测肺功能参数。结果三组新生儿RR值均随日龄增长而逐渐下降,VT/kg、MV/kg、TEF75值均随日龄增长而逐渐上升(均P<0.05);FRC/kg值随日龄增长而上升,LCI值随日龄增长而下降(均P>0.05);TPTEF/TE、VPEF/VE值则无明显的趋势变化(均P>0.05)。结论足月儿及早产儿在新生儿期肺功能指标变化基本一致,均随日龄增长而逐步改善。肺容量指标变化较快,通气功能指标则改变较慢,提示肺发育在新生儿期以容量增长为首选。证明新生儿肺功能检测是评价肺发育的重要手段。

Objective To understand the changes of tidal breathing parameters,functional residual capacity（ FRC/Kg） and lung clearance index（ LCI） in infants of different gestational age over days. Methods According to pulmonary infectious disease,oxygen- dependent,congenital malformations and other diseases,the study selected 55 healthy full-term infants,30 late preterm infants and 25 preterm infants（ 34w） from February 2010 to November2014. Their lung function was determined on the 1st,7th,14 th,and 28 th day after birth. Results The respiratory rate（ RR） decreased gradually on the 1st,7th,14 th,and 28 th days in the three groups,and the value of VT / kg,MV / kg and TEF75 increased gradually（ P〈0.05）. FRC / kg increased and LCI decreased gradually in the three groups（ P〈0.05）. There was no obvious change in TPTEF / TE and TPTEF / TE（ P〉0.05）. Conclusion In general,the trends of lung function index in full term and preterm infants are basically identical. Their lung volume changes quickly throughout the neonatal period,but the pulmonary ventilation changes slowly,which proves an important means of evaluating lung development.