婴幼儿毛细支气管炎运用负压呼气流量技术的研究

Application of negative expiratory pressure technique in diagnosis and treatment of bronchiolitis in infants

目的探讨小儿毛细支气管炎运用负压呼气流量技术(negative expiratory press,NEP)检测的临床意义。方法选择杭州地区2013年6月—2014年10月在浙江省中西医结合医院就诊的100例毛细支气管炎患儿作为研究对象,进行详细的个人信息临床分度评分登记;选择同期的体检婴幼儿50例作为对照组,使用麦迪肺功能仪进行肺功能NEP技术检测及潮气量检测,并记录结果,将先前未用NEP的F-V曲线与应用NEP后潮气F-V曲线比较即呼气流量受限制(EFL)值,并与该阶段正常儿童潮气值及EFL值进行对照。结果 100例毛支患儿进入分析,轻度组40例,中度组30例,重度组30例。EFL轻度组(22.75±10.06)%,中度组(30.46±10.27)%,重度组(77.39±10.72)%,对照组(12.73±10.01)%,P<0.01,EFL差异有统计学意义,病情越重EFL值越高;VT/kg轻度组(10.52±2.00)ml/kg,中度组(8.88±2.52)ml/kg,重度组(10.13±2.71)ml/kg,对照组(9.54±2.11)ml/kg,P>0.05,差异无统计学意义;RR轻度组(30.46±10.27)次/min,中度组(33.00±9.06)次/min,重度组(37.00±9.06)次/min,对照组(31.46±8.27)次/min,P>0.05,RR差异无统计学意义。结论运用负压呼气流量技术检测毛支患儿EFL值,EFL值与病情密切相关,病情越重,EFL值越高,通过EFL值可以早期进行病情的判断,为婴幼儿毛细支气管炎早期诊断和治疗提供依据。

Objective To investigate the clinical significance of negative expiratory press （NEP） test in the diagnosis and treatment of bronchiolitis in infants. Methods A total of 100 infants with bronchiolitis （ observation group） and 50 normal infants undergoing the medical examination（ control group） in our hospital from June 2013 to October 2014 were selected and documented. NEP technique was performed by using Use McGrady spirometer, and the expiratory flow limited（EFL） was calculated with NEP tidal flow-volume curves and the same flow-volume curve during quiet. Then the tidal value and EFL value were compared with the national norm of normal children. Results One hundred cases of bronchiohtis accord- ing to their condition were divided into three groups, including mild group（40 cases）, moderate group（30 cases）, and se- vere group （30 cases）. EFL in the mild group was （22.75 ± 10.06） %, in the moderate group was （ 30.46 ± 10.27） %, and in the severe group was （77.39 ± 10.72） %, while in the control group was （ 12.73 ± 10.01 ） %, the difference in EFL was statistical significant （P 〈 0. 01 ） ; EFL value rose with the severity of the disease. VT/kg in the mild group was （10.52±2.00）ml/kg, in the moderate group was （8.88 ± 2.52）ml/kg, in the severe group was（ 10.13± 2.71 ） ml/kg, while in the control group was （9.54±2.11 ） ml/kg,the difference among the groups was not statistical significant,P 〉 0.05. RR in the mild group was （30.46±10.27 ） times/min, in the moderate group was （33.00 ± 9.06 ） times/min, in the severe group was（37. 00 ± 9.06） times/min, and in the control group was （31.46 ± 8.27 ） times/min, there was no statistical significance among the groups,P 〉 0.05. Conclusion NEP technique can be used to detect the EFL value in infants with bronchiolitis. EFL is closely related with the condition of disease, and raise with the severity. Itg possible to e- valuate the disease at early stage through the EFL value ,which can be used to support early diagnosis and treatment for in- fant bronchiolitis.