電子式和機(jī)械式兩種吸氣峰流速測(cè)量方法比較
發(fā)布時(shí)間：2018-08-10 20:38
【摘要】：目的吸入療法在呼吸疾病的診療中廣泛應(yīng)用,其中干粉吸入器(DPI)是最常用的吸入裝置,因吸氣驅(qū)動(dòng),須達(dá)到足夠的吸氣流量。本課題旨在利用In-Check DIAL吸氣峰流量?jī)x模擬各種DPI的內(nèi)部阻力,比較電子式和機(jī)械式兩種測(cè)量吸氣峰流量(PIF)的方法,觀察不同氣道阻塞程度患者的吸氣流量特征,為臨床選擇PIF測(cè)量方法提供客觀依據(jù)。方法采用自身對(duì)照試驗(yàn)的方法,以不同嚴(yán)重程度的氣道阻塞患者作為研究對(duì)象,均采用電子式和機(jī)械式兩種方法同步測(cè)量PIF。以串聯(lián)的形式將電子式測(cè)量?jī)x(PowerLab ML870的1000L流量頭)和機(jī)械式測(cè)量?jī)x(In-Check DIAL吸氣峰流量?jī)x)相連接,指導(dǎo)受試者先呼氣至殘氣位,然后口含咬口器,再?gòu)倪B接好的測(cè)定裝置中進(jìn)行用力快速吸氣,并吸氣至肺總量位,記錄電子式測(cè)量?jī)x和機(jī)械式測(cè)量?jī)x的同步測(cè)量值。一共測(cè)量3種不同阻力狀態(tài)下的PIF:無(wú)阻力狀態(tài)(Free)、模擬準(zhǔn)納器阻力狀態(tài)(Accuhaler)和模擬都保阻力狀態(tài)(Turbuhaler)。每一種阻力狀態(tài)下至少測(cè)定3次,重復(fù)性要求≤10%,分別取電子式和機(jī)械式測(cè)量的最佳值用于計(jì)算。結(jié)果共納入30例氣道阻塞患者,依肺功能障礙的程度,分為輕度、中度和重度阻塞3個(gè)組,年齡(67.7±7.6)歲。在Free和Accuhaler的阻力狀態(tài)下,分別有12例(40%)和1例(3.3%)因超過(guò)機(jī)械式流量?jī)x的量程,不能獲得測(cè)量值,其余均可獲得測(cè)量值用于統(tǒng)計(jì)。(1)輕度阻塞組,機(jī)械式和電子式測(cè)量法在Free、Accuhaler和Turbuhaler阻力下的PIF(PIF-F、PIF-A、PIF-T)分別為(80.00±34.52)L/min、(76.86±32.85)L/min(P=0.051);(73.00±31.29)L/min、(71.63±31.53)L/min(P=0.126);(61.50±23.10)L/min、(59.10±22.42)L/min(P=0.075),3種阻力下兩種方法間均無(wú)統(tǒng)計(jì)學(xué)差異。(2)中度阻塞組,機(jī)械式和電子式測(cè)量法的PIF-F、PIF-A、PIF-T分別為(86.00±26.32)L/min、(82.96±29.66)L/min(P=0.027);(79.50±24.66)L/min、(76.26±24.65)L/min(P=0.028);(67.00±18.59)L/min、(62.89±17.92)L/min(P=0.008),3種阻力下兩種方法間均有統(tǒng)計(jì)學(xué)差異。(3)重度阻塞組,機(jī)械式和電子式測(cè)量法的PIF-F、PIF-A、PIF-T分別為(85.00±20.25)L/min、(84.22±22.11)L/min(P=0.599);(75.56±24.81)L/min、(74.53±25.67)L/min(P=0.374);(68.50±21.09)L/min、(65.40±19.97)L/min(P=0.016),PIF-F和PIF-A兩種方法間無(wú)統(tǒng)計(jì)學(xué)差異,PIF-T兩種方法間有統(tǒng)計(jì)學(xué)差異。結(jié)論盡管兩種測(cè)量方法存在一定的差異,但差異小于患者的自身變異,因此兩種測(cè)量方法的結(jié)果均可用于指導(dǎo)臨床。通過(guò)比較,電子式測(cè)量方法量程大,精度高,可反復(fù)校正調(diào)零,準(zhǔn)確度更佳,并可記錄下呼吸波形,可計(jì)算吸氣時(shí)間以及吸氣容積等,適于深入開展科研。但電子式測(cè)量?jī)x價(jià)格昂貴,結(jié)構(gòu)復(fù)雜,體積較大,而機(jī)械式吸氣峰流量?jī)x價(jià)格便宜、輕便易帶,操作簡(jiǎn)單。如需外出調(diào)查或僅為患者在家自測(cè)PIF,則建議選擇機(jī)械式測(cè)量方法。
[Abstract]:Objective inhalation therapy is widely used in the diagnosis and treatment of respiratory diseases, in which dry powder inhaler (DPI) is the most commonly used inhaling device. The purpose of this study was to simulate the internal resistance of various DPI by In-Check DIAL peak inspiratory flow meter, compare the two methods of measuring the inspiratory peak flow (PIF) with electronic and mechanical methods, and observe the inspiratory flow characteristics of patients with different degree of airway obstruction. To provide objective basis for clinical selection of PIF measurement methods. Methods the PIFs of patients with different severity of airway obstruction were measured by both electronic and mechanical methods. The electronic meter (1000L flow head of PowerLab ML870) and the mechanical meter (In-Check DIAL peak inspiratory flow meter) were connected in series to guide the subjects to exhale to the residual air level first, and then to have the mouthbite device in their mouth. Then inhale quickly and forcefully from the connected measuring device and inhale to the total lung position and record the synchronous measurements of electronic and mechanical measuring instruments. A total of 3 PIFs were measured under different resistance states: no drag state (Free), simulation quasi-sensor resistance state (Accuhaler) and simulation both resistive state (Turbuhaler). At least 3 times in each resistance state, the repeatability requirement is less than 10. The optimum values of electronic and mechanical measurements are taken for calculation respectively. Results A total of 30 patients with airway obstruction were divided into 3 groups according to the degree of pulmonary dysfunction: mild, moderate and severe obstruction, aged (67.7 鹵7.6) years. Under the resistance state of Free and Accuhaler, 12 cases (40%) and 1 case (3.3%) could not obtain the measured value because they exceeded the measuring range of the mechanical flow meter. The PIF (PIF-FU) PIF-An PIF-T of mechanical and electronic methods were (80.00 鹵34.52) L / min, (76.86 鹵32.85) L/min (P0.051); (73.00 鹵31.29) L / min, (71.63 鹵31.53) L/min (P0.126); (61.50 鹵23.10) L / min, (59.10 鹵22.42) L/min (P0.075) and (59.10 鹵22.42) L/min (P0.075) L / min, respectively. The PIF-FU PIF-An PIF-T of mechanical and electronic methods were (86.00 鹵26.32) L / min, (82.96 鹵29.66) L/min (P0.027); (79.50 鹵24.66) L / min, (76.26 鹵24.65) L/min (P0.028); (67.00 鹵18.59) L / min, (62.89 鹵17.92) L/min (P0. 008), respectively. The PIF-FU PIF-An PIF-T of mechanical and electronic measurement methods were (85.00 鹵20.25) L / min, (84.22 鹵22.11) L/min (P0. 599); (75.56 鹵24.81) L / min, (74.53 鹵25.67) L/min (P0.374); (68.50 鹵21.09) L / min, (65.40 鹵19.97) L/min (P0.016) PIF-F and PIF-A respectively. Conclusion although there is a certain difference between the two methods, the difference is less than that of the patient's own variation, so the results of the two methods can be used to guide the clinical practice. By comparison, the electronic measurement method has the advantages of large measuring range, high precision, repeatable correction and zero adjustment, better accuracy, and the recording of respiratory waveform, calculation of inspiratory time and volume, etc., which is suitable for further scientific research. However, the electronic measuring instrument is expensive, complex in structure and large in volume, while the mechanical inspiratory peak flow meter is cheap, light and easy to take, and easy to operate. If you need to go out to investigate or only test PIFs at home, it is recommended to choose mechanical measurement methods.
【作者單位】： 廣州醫(yī)科大學(xué);廣州醫(yī)科大學(xué)附屬第一醫(yī)院廣州呼吸疾病研究所(呼吸疾病國(guó)家重點(diǎn)實(shí)驗(yàn)室呼吸疾病國(guó)家臨床研究中心);
【分類號(hào)】：R56
本文編號(hào)：2176137
[Abstract]:Objective inhalation therapy is widely used in the diagnosis and treatment of respiratory diseases, in which dry powder inhaler (DPI) is the most commonly used inhaling device. The purpose of this study was to simulate the internal resistance of various DPI by In-Check DIAL peak inspiratory flow meter, compare the two methods of measuring the inspiratory peak flow (PIF) with electronic and mechanical methods, and observe the inspiratory flow characteristics of patients with different degree of airway obstruction. To provide objective basis for clinical selection of PIF measurement methods. Methods the PIFs of patients with different severity of airway obstruction were measured by both electronic and mechanical methods. The electronic meter (1000L flow head of PowerLab ML870) and the mechanical meter (In-Check DIAL peak inspiratory flow meter) were connected in series to guide the subjects to exhale to the residual air level first, and then to have the mouthbite device in their mouth. Then inhale quickly and forcefully from the connected measuring device and inhale to the total lung position and record the synchronous measurements of electronic and mechanical measuring instruments. A total of 3 PIFs were measured under different resistance states: no drag state (Free), simulation quasi-sensor resistance state (Accuhaler) and simulation both resistive state (Turbuhaler). At least 3 times in each resistance state, the repeatability requirement is less than 10. The optimum values of electronic and mechanical measurements are taken for calculation respectively. Results A total of 30 patients with airway obstruction were divided into 3 groups according to the degree of pulmonary dysfunction: mild, moderate and severe obstruction, aged (67.7 鹵7.6) years. Under the resistance state of Free and Accuhaler, 12 cases (40%) and 1 case (3.3%) could not obtain the measured value because they exceeded the measuring range of the mechanical flow meter. The PIF (PIF-FU) PIF-An PIF-T of mechanical and electronic methods were (80.00 鹵34.52) L / min, (76.86 鹵32.85) L/min (P0.051); (73.00 鹵31.29) L / min, (71.63 鹵31.53) L/min (P0.126); (61.50 鹵23.10) L / min, (59.10 鹵22.42) L/min (P0.075) and (59.10 鹵22.42) L/min (P0.075) L / min, respectively. The PIF-FU PIF-An PIF-T of mechanical and electronic methods were (86.00 鹵26.32) L / min, (82.96 鹵29.66) L/min (P0.027); (79.50 鹵24.66) L / min, (76.26 鹵24.65) L/min (P0.028); (67.00 鹵18.59) L / min, (62.89 鹵17.92) L/min (P0. 008), respectively. The PIF-FU PIF-An PIF-T of mechanical and electronic measurement methods were (85.00 鹵20.25) L / min, (84.22 鹵22.11) L/min (P0. 599); (75.56 鹵24.81) L / min, (74.53 鹵25.67) L/min (P0.374); (68.50 鹵21.09) L / min, (65.40 鹵19.97) L/min (P0.016) PIF-F and PIF-A respectively. Conclusion although there is a certain difference between the two methods, the difference is less than that of the patient's own variation, so the results of the two methods can be used to guide the clinical practice. By comparison, the electronic measurement method has the advantages of large measuring range, high precision, repeatable correction and zero adjustment, better accuracy, and the recording of respiratory waveform, calculation of inspiratory time and volume, etc., which is suitable for further scientific research. However, the electronic measuring instrument is expensive, complex in structure and large in volume, while the mechanical inspiratory peak flow meter is cheap, light and easy to take, and easy to operate. If you need to go out to investigate or only test PIFs at home, it is recommended to choose mechanical measurement methods.
【作者單位】： 廣州醫(yī)科大學(xué);廣州醫(yī)科大學(xué)附屬第一醫(yī)院廣州呼吸疾病研究所(呼吸疾病國(guó)家重點(diǎn)實(shí)驗(yàn)室呼吸疾病國(guó)家臨床研究中心);
【分類號(hào)】：R56
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