布地奈德吸入治疗对毛细支气管炎患儿潮气呼吸肺功能的影响及意义

Effect of inhalation of budesonide on tidal breathing lung function in children with bronchitis

目的探讨布地奈德吸入治疗对毛细支气管炎患儿潮气呼吸肺功能的影响及应用价值。方法以2018年1-9月在我院三病区住院的65例毛细支气管炎患儿为研究对象,观察组34例,常规对照组31例,分别记录患儿相应临床资料。常规对照组入院后予止咳化痰、补液等常规治疗,病情需要者予吸氧、静脉甲强龙输注、抗生素等治疗;观察组在上述治疗的基础上加用布地奈德雾化吸入1~2周,分别在急性期(治疗前)及恢复期(规范治疗后1~2周,出院前)进行潮气呼吸肺功能检查;选取同期同年龄健康体检儿童20例作为健康对照组,进行上述检查。比较各组患儿检测结果。结果与健康对照组比较,毛细支气管炎组患儿急性期潮气量(VT/kg)、吸呼比(Ti/Te)、达峰时间比(TPTEF/TE)、达峰容积比(VPEF/VE)均降低,呼吸频率(RR)升高,差异均有统计学意义(P<0.05)。治疗后,两组患儿VT、TPTEF/TE、VPEF/VE均高于急性期,差异均有统计学意义(P<0.05)。两组患儿缓解期TPTEF/TE、VPEF/VE升高,RR降低,与健康对照组比较差异仍有统计学意义(P<0.05)。治疗后,观察组患儿VT、VPEF/VE高于常规对照组,RR低于常规对照组,差异均有统计学意义(P<0.05)。结论潮气呼吸肺功能可反映毛细支气管炎病情严重程度。布地奈德吸入能有效改善儿童毛细支气管炎的潮气呼吸肺功能。

Objective To explore the effect of inhalation of budesonide on tidal breathing lung function in children with bronchitis.Methods Sixty-five children with bronchitis diagnosed by third ward of our hospital were enrolled in the study from January to December in 2018,34 cases in observation group and 31 cases in routine control group.Routine control group received routine treatment such as cough relieving,phlegm resolving,fluid replacement,oxygen inhalation,intravenous methylprednisolone infusion,and antibiotics after admission;observation group received budesonide aerosol inhalation for 1~2 weeks on the basis of the above treatment.The tidal breathing lung function was tested in bronchiolitis group during the acute stage(before treatment)and at remission stage(1~2 weeks after treatment,before discharge from hospital);at the same time,20 healthy children of the same age were selected as healthy control group.The same examination was carried out,and all the test results were compared.Results The respiratory rate(RR)of bronchitis group at acute stage was higher than that of healthy control group,while VT/kg,inspiratory time/expiratory time(Ti/Te),time to peak tidal expiratory flow as a proportion of expiratory time(TPTEF/TE)and volume to peak tidal expiratory flow as a proportion of exhaled volume(VPEF/VE)were lower than those of healthy control group(P<0.05).After treatment,the VT/kg,TPTEF/TE and VPEF/VE at remission stage in bronchitis groups were higher than those at acute stage(P<0.05);the TPTEF/TE and VPEF/VE of pediatric patients at admission stage in bronchitis groups were increased,while RR was decreased,but there were still significant differences compared with healthy control group(P<0.05);the VT and VPEF/VE in observation group were higher than those in routine control group,while RR was lower than that in routine control group(P<0.05).Conclusion The severity degree of respiratory tract lesion of bronchitis can be reflected by tidal breathing lung functionthat can be improved by budesonide effectively.