本文選題：早產(chǎn)兒 + 支氣管肺發(fā)育不良��； 參考：《重慶醫(yī)科大學(xué)》2012年碩士論文

【摘要】：目的:探討無肺部并發(fā)癥的不同孕周早產(chǎn)兒肺功能的動態(tài)變化,以及比較在糾正胎齡37-41周期間時支氣管肺發(fā)育不良(Bronchopulmonary dysplasia, BPD)患兒和非BPD早產(chǎn)兒間肺功能的差別,評估早產(chǎn)和支氣管肺發(fā)育不良對肺功能的影響。 方法：對34名健康足月兒，30名晚期新生兒和25名出生胎齡小于34周非支氣管肺發(fā)育不良早產(chǎn)兒在生后平均7、14、28日齡和糾正胎齡在37-41周期間，在安靜自然睡眠狀態(tài)下，取仰臥位，運(yùn)用超聲流量儀，氦氣（He）作為示蹤惰性氣體，采用反復(fù)呼吸氣體洗出法進(jìn)行潮氣呼吸和肺功能殘氣量及代表通氣效率的肺清除指數(shù)（Lung ClearIndex，LCI）測量,同時，對發(fā)生BPD的患兒，在糾正胎齡37-41周期間按上述方法進(jìn)行相關(guān)肺功能指標(biāo)測試。 結(jié)果：三組患兒肺功能均隨著日齡的增加而改善，流速容量環(huán)呈不典型橢圓型，出生胎齡越小越明顯；在糾正胎齡37-41周期間，晚期新生兒各項(xiàng)肺功能參數(shù)接近足月新生兒水平，而小于34周早產(chǎn)兒未能實(shí)現(xiàn)肺功能的追趕式生長。BPD組、出生胎齡小于34周的非BPD早產(chǎn)兒組與足月兒組相比較，功能殘氣量（FRC/kg）降低，差別具有統(tǒng)計(jì)學(xué)意義，（分別為16.45±3.03，18.61±1.84，20.67±2.24，F(xiàn)=14.59，P0.001）,代表肺通氣均勻性的肺清除指數(shù)(LCI)增高，（分別為7.92±1.05，7.18±0.70，，6.56±0.75，F(xiàn)=17.99, P0.001）;呼吸頻率（RR）增快,(分別為50.91±3.57，47.00±6.04，39.21±5.39F=38.55, P0.001);呼氣達(dá)峰時間比（TPTEF/TE）降低（分別為23.41±3.90，26.64±4.12，30.82±4.27，F(xiàn)=22.38,P0.001）；糾正胎齡37-41周期間， BPD組大部分患兒及部分非BPD早產(chǎn)兒流速-容量環(huán)形態(tài)變窄，高峰提前，同時下降支傾斜，甚至凹向容量軸，即流速容量環(huán)呈現(xiàn)特征性阻塞圖形，以BPD改變較為明顯。 結(jié)論：總之，不同胎齡早產(chǎn)兒，無論發(fā)生BPD與否，在新生兒期其肺功能逐步改善，在糾正胎齡37-41周時，BPD及非BPD極度早產(chǎn)兒均存在功能殘氣量和通氣均勻性降低及小氣道阻塞，以BPD患兒更為顯著。
[Abstract]:Objective: to investigate the dynamic changes of pulmonary function in premature infants with different gestational weeks without pulmonary complications, and to compare the pulmonary function between children with bronchopulmonary dysplasia (BPDD) and non-preterm infants with bronchopulmonary dysplasia (BPDD) at 37 to 41 weeks of gestational age. To evaluate the effects of premature delivery and bronchopulmonary dysplasia on lung function. Methods: in 34 healthy term infants, 30 late neonates and 25 non-bronchopulmonary dysplasia preterm infants with gestational age less than 34 weeks were selected for supine position at the mean age of 7 ~ 14 ~ 28 days after birth and the corrected gestational age at 37-41 weeks under the condition of quiet natural sleep. Using ultrasonic flow meter and helium gas as tracer inert gas, repeated breath gas washing method was used to measure tidal breathing, lung function residual volume and lung clearance index (ClearLung Index LCI) representing ventilation efficiency. At the same time, the children with BPD were tested. During 37-41 weeks of corrected gestational age, lung function indexes were measured according to the above method. Results: the pulmonary function of the three groups improved with the increase of the age of day, the flow volume loop was atypical elliptical, the smaller the gestational age was, the more obvious the pulmonary function was, and the pulmonary function parameters of the late neonates were close to the level of full-term neonates during the period of 37-41 weeks of corrected gestational age. However, compared with the term group, the functional residual capacity of premature infants less than 34 weeks was lower than that of full-term infants in the catch-up growth. Bpd group and the non BPD premature infants with less than 34 weeks gestational age, compared with those in the term infants group. 宸埆鍏鋒湁緇熻瀛︽剰涔

本文編號：1789064