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目的初步探讨早产儿在校正胎龄40周时的潮气呼吸肺功能状况。方法选择我院2011年1～9月新生儿科收治的早产儿,机械通气组和非机械通气组各入选20例,于校正胎龄40周时分别测定潮气呼吸肺功能的各项指标,与同期产科分娩、胎龄39～40周健康对照组(分别入选剖宫产组30例和阴道分娩组20例)生后5～7天时的潮气呼吸肺功能相比较。结果机械通气组吸气时间(TI,s)、呼气时间(TE,s)较阴道分娩组和非机械通气组明显延长[TI:(0.68±0.17)比(0.52±0.06)、(0.53±0.11),TE:(0.72±0.15)比(0.59±0.13)、(0.57±0.09),P<0.05],呼吸频率(RR,次/min)明显降低[(44.4±7.7)比(56.2±10.8)、(56.1±9.5),P<0.05)];两个早产儿组达峰时间比(TPEF/TE,%)、达峰容积比(VPEF/VE,%)、达峰容积(VPEF,ml)、达峰时间(TPEF,s)均低于阴道分娩组[TPEF/TE:(21.8±5.8)、(25.4±11.2)比(35.4±8.8),VPEF/VE:(24.4±2.9)、(26.8±8.1)比(33.8±7.3),VPEF:(5.5±1.2)、(6.0±1.1)比(6.7±1.2),TPEF:(0.15±0.10)、(0.14±0.04)比(0.20±0.05),P<0.05];剖宫产组平均吸气流速(MIF,ml/s)、平均呼气流速(MEF,ml/s)较阴道分娩组明显减低[MIF:(35.7±5.1)比(40.1±4.0),MEF:(31.8±6.7)比(36.4±7.0)P<0.05];各组TPEF/TE与VPEF/VE呈高度正相关,r值分别为剖宫产组0.990,阴道分娩组0.992,机械通气组0.933,非机械通气组0.990,P均<0.05。结论在校正胎龄40周时,早产儿潮气呼吸肺功能接近正常同胎龄足月儿,气道发育比足月儿慢,出生早期行机械通气早产儿可能存在肺组织的代偿能力受限和呼吸中枢调节功能不协调。
Objective To investigate the pulmonary function of premature infants at 40 weeks gestation. Methods 20 cases of premature infants, mechanical ventilation group and non-mechanical ventilation group admitted to neonatology department from January to September in 2011 were enrolled in this study. The indexes of pulmonary function of moisture were measured respectively at the corrected gestational age of 40 weeks, Obstetric childbirth, gestational age 39 to 40 weeks healthy control group (30 cesarean section were selected and vaginal delivery group of 20 cases) 5 to 7 days after birth when the respiratory function of the respiratory gas compared. Results Compared with the vaginal delivery group and the non-mechanical ventilation group, the inspiratory time (TI, s) and expiratory time (TE, s) in the mechanical ventilation group were significantly longer than those in the vaginal delivery group and the non-mechanical ventilation group (TI: 0.68 ± 0.17 vs 0.52 ± 0.06, (44.4 ± 7.7) vs (56.2 ± 10.8), and the respiratory rate (RR, bf / min) was significantly lower than that of the control group (0.72 ± 0.15 vs 0.59 ± 0.13 vs 0.57 ± 0.09, P < ), (56.1 ± 9.5), P <0.05). The peak time ratio (TPEF / TE,%), peak volume ratio (VPEF / VE,%), peak volume (TPEF / TE: (21.8 ± 5.8), (25.4 ± 11.2) vs (35.4 ± 8.8), VPEF / VE: (24.4 ± 2.9), and (P <0.01), (0.14 ± 0.04) vs (0.20 ± 0.05), (P <0.05) , P <0.05]. The average inspiratory flow rate (MIF, ml / s) and mean expiratory flow rate (MEF, ml / s) in the caesarean section group were significantly lower than those in the vaginal delivery group [MIF: (35.1 ± 5.1) ± 4.0), MEF: (31.8 ± 6.7) vs (36.4 ± 7.0) P <0.05]. There was a positive correlation between TPEF / TE and VPEF / VE in each group, r values were 0.990 in cesarean section group and 0.992 in vaginal delivery group 0.933 in the mechanical ventilation group and 0.990 in the non-mechanical ventilation group, P <0.05. Conclusion At 40 weeks of gestational age, the pulmonary function of premature infants with hyponatreal respiratory function is similar to that of full-term infants, and the airway development is slower than that of full-term infants. The compensatory ability of lung tissue in premature infants with mechanical ventilation may be limited And breathing center regulation function is not coordinated.