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目的:评价肺表面活性物质(Pulmonary surfactant,PS)对支气管肺发育不良(bronchopulmonary dysplasia,BPD)婴幼儿肺功能的影响。方法:胎龄<32周,出生体重<1 500 g,出院时诊断为BPD的早产儿40例,按有无使用PS分为PS组(20例)和非PS组(20例)。动态监测两组患儿1岁、2岁、3岁时的肺功能情况,主要是潮气呼吸参数中的达峰时间比(TPTEF/TE)、达峰容积比(VPEF/VE)、吸气时间(Ti)、呼气时间(Te)、潮气量(VT)、身高、体重、出院后3年中因呼吸系统疾病再入院次数。结果:1岁时PS组与非PS组的肺功能参数值、身高、体重、均无明显差异(P均>0.05)。2岁及3岁时PS组的各项肺功能参数、身高、体重均优于非PS组,(P均<0.05),差异有统计学意义。出院后3年中因患呼吸系统疾病再入院次数的比较中发现,PS组平均住院(2.63±0.80)次,而非PS组为(4.57±1.22)次,差异有统计学意义(P<0.05)。结论:PS替代治疗可以改善BPD患儿2岁及3岁时的生长发育状况、肺功能状况、并降低BPD患儿再入院次数。
Objective: To evaluate the effect of Pulmonary surfactant (PS) on pulmonary function in infants and young children with bronchopulmonary dysplasia (BPD). Methods: Forty gestational weeks, birth weight <1500 g, 40 premature infants diagnosed with BPD at discharge were divided into PS group (20 cases) and non-PS group (20 cases) by PS. The pulmonary function of 1, 2 and 3 years old children were monitored dynamically, mainly including the peak time ratio (TPTEF / TE), peak volume ratio (VPEF / VE), inspiratory time (Ti), expiration time (Te), tidal volume (VT), height, weight, number of hospitalizations due to respiratory diseases within 3 years after discharge. Results: There was no significant difference in the parameters of lung function, height and weight between PS group and non-PS group at 1 year (all P> 0.05). The parameters of pulmonary function, height and weight of PS group were superior to those of non-PS group at 2 years and 3 years (all P <0.05), and the difference was statistically significant. In the three years after hospital discharge, the average number of hospitalizations for respiratory diseases was 2.63 ± 0.80 in the PS group and 4.57 ± 1.22 in the PS group (P <0.05) ). CONCLUSIONS: PS replacement therapy can improve the growth and development status, lung function status and reduce the number of hospitalized children with BPD at 2 and 3 years of age.