
气管支气管软化患儿潮气呼吸肺功能特征的研究
李岚, 陈强, 张帆, 朱双桂, 胡次浪, 吴爱民
中国当代儿科杂志 ›› 2017, Vol. 19 ›› Issue (12) : 1248-1251.
气管支气管软化患儿潮气呼吸肺功能特征的研究
Characteristics of tidal breathing pulmonary function in children with tracheobronchomalacia
目的 探讨气管支气管软化(TBM)患儿潮气呼吸肺功能的特征,为TBM患儿的诊断、疗效评估、预后判断提供新的思路。方法 选取30例经电子支气管镜诊断为TBM的患儿作为研究组,30例健康儿童作为正常对照组。正常对照组和TBM组初诊时以及确诊后3个月、6个月、9个月、12个月进行潮气呼吸肺功能测定。结果 TBM确诊时与对照组在潮气量及吸气时间、呼气时间、吸呼比的差异无统计学意义(P > 0.05);与对照组比,TBM组确诊时的呼吸频率较快,达峰时间比和达峰容积比较低,差异具有统计学意义(P < 0.01);TBM患儿初诊时及确诊后3、6、9、12个月的潮气呼吸肺功能达峰时间比、达峰容积比逐渐增大。结论 TBM患儿潮气呼吸肺功能具有特征性改变,而且随着年龄增大,潮气呼吸肺功能逐渐接近正常。
Objective To investigate the characteristics of tidal breathing pulmonary function in children with tracheobronchomalacia (TBM). Methods In this study, 30 children who were diagnosed with TBM using electronic bronchoscopy were enrolled in the observation group; 30 healthy children were recruited in the normal control group. For individuals in each group, the assessment of tidal breath pulmonary function was performed at diagnosis and 3, 6, 9, and 12 months after diagnosis. Results There were no significant differences in tidal volume, inspiratory time, expiratory time, and inspiratory to expiratory ratio between the two groups (P > 0.05). Compared with the control group, the observation group had a significantly higher respiratory rate and significantly lower ratio of time to peak tidal expiratory flow to total expiratory time (TPTEF/TE) and ratio of volume to peak tidal expiratory flow to total expiratory volume (VPTEF/VE). There was a time-dependent increase in TPTEF/TE and VPTEF/VE for TBM children from the time of initial diagnosis to 12 months after diagnosis. Conclusions Tidal breathing pulmonary function has characteristic changes in children with TBM. Tidal breathing pulmonary function tends to be recovered with increased age in children with TBM.
Tidal breathing pulmonary function / Tracheobronchomalacia / Child
[1] Boogaard R, Huijsmans SH, Pijnenburg MW, et al. Tracheomalacia and bronchomalacia in children:Incidence and patient characteristics[J]. Chest, 2005, 128(5):3391-3397.
[2] Hysinger EB, Panitch HB. Paediatric tracheomalacia[J]. Paediatr Respir Rev, 2015, 17:9-15.
[3] Tan JZ, Ditchfield M, Freezer N. Tracheobronchomalacia in children:review of diagnosis and definition[J]. Pediatr Radiol, 2012, 42(8):906-915.
[4] Majid A, Guerrero J, Gangadharan S, et al. Tracheobronchoplasty for severe tracheobronchomalacia:a prospective outcome analysis[J]. Chest, 2008, 134(4):801-807.
[5] Pardali D, Adamama-Moraitou KK, Rallis TS, et al. Tidal breathing flow-volume loop analysis for the diagnosis and staging of tracheal collapse in dogs[J]. J Vet Intern Med, 2010, 24(4):832-842.
[6] van der Wiel EC, Hofhuis W, Holland WP, et al. Predictive value of infant lung function testing for airway malacia[J]. Pediatr Pulmonol, 2005, 40(5):431-436.
[7] Lagisetty KH, Gangadharan SP. Tracheobronchoplasty for the treatment of tracheobronchomalacia[J]. J Thorac Cardiovasc Surg, 2012, 144(3):S58-59.
[8] 邵洁, 赵建琴, 高茹.潮气呼吸分析参数评价哮喘儿童气道阻塞的意义和应用[J].中华儿科杂志, 1999, 37(12):724-726.
[9] Beydon N, Pin I, Matran R, et al. Pulmonary function tests in preschool children with asthma[J]. Am J Respir Crit Care Med, 2003, 168(6):640-644.
[10] Dessoffy KE, Modaff P, Pauli RM, et al. Airway malacia in children with achondroplasia[J]. Am J Med Genet A, 2014, 164 A(2):407-414.
[11] 张渊博, 苏苗赏, 李昌崇. 儿童气管支气管软化症的临床研究进展[J]. 国际呼吸杂志, 2016, 36(20):1596-1598.
[12] Carden KA, Boiselle PM, Waltz DA. Tracheomalacia and tracheobronchomalacia in children and adults, an in-depth review[J]. Chest, 2005, 127(3):984-1005.
[13] Pan W, Peng D, Luo J, et al. Clinieal features of airway malacia in children:a retrospective analysis of 459 patients[J]. Int J Clin Exp Med, 2014, 7(9):3005-3012.