Jat Kana Ram
Department of Pediatrics, Government Medical College and Hospital, Sector 32, Chandigarh 160030, India.
Prim Care Respir J. 2013 Jun;22(2):221-9. doi: 10.4104/pcrj.2013.00042.
Respiratory disorders are responsible for considerable morbidity and mortality in children. Spirometry is a useful investigation for diagnosing and monitoring a variety of paediatric respiratory diseases, but it is underused by primary care physicians and paediatricians treating children with respiratory disease. We now have a better understanding of respiratory physiology in children, and newer computerised spirometry equipment is available with updated regional reference values for the paediatric age group. This review evaluates the current literature for indications, test procedures, quality assessment, and interpretation of spirometry results in children. Spirometry may be useful for asthma, cystic fibrosis, congenital or acquired airway malformations and many other respiratory diseases in children. The technique for performing spirometry in children is crucial and is discussed in detail. Most children, including preschool children, can perform acceptable spirometry. Steps for interpreting spirometry results include identification of common errors during the test by applying acceptability and repeatability criteria and then comparing test parameters with reference standards. Spirometry results depict only the pattern of ventilation, which may be normal, obstructive, restrictive, or mixed. The diagnosis should be based on both clinical features and spirometry results. There is a need to encourage primary care physicians and paediatricians treating respiratory diseases in children to use spirometry after adequate training.
呼吸系统疾病在儿童中导致了相当高的发病率和死亡率。肺功能测定对于诊断和监测多种儿科呼吸系统疾病是一项有用的检查，但在治疗患有呼吸系统疾病儿童的初级保健医生和儿科医生中，其使用并不充分。我们现在对儿童呼吸生理学有了更好的理解，并且有了更新的计算机化肺功能测定设备以及适用于儿科年龄组的区域参考值。这篇综述评估了当前关于儿童肺功能测定的适应症、测试程序、质量评估和结果解读的文献。肺功能测定对于儿童哮喘、囊性纤维化、先天性或后天性气道畸形以及许多其他呼吸系统疾病可能有用。文中详细讨论了儿童肺功能测定的操作技术。大多数儿童，包括学龄前儿童，都能完成可接受的肺功能测定。解读肺功能测定结果的步骤包括通过应用可接受性和重复性标准识别测试过程中的常见错误，然后将测试参数与参考标准进行比较。肺功能测定结果仅描绘通气模式，其可能是正常、阻塞性、限制性或混合性的。诊断应基于临床特征和肺功能测定结果。有必要鼓励治疗儿童呼吸系统疾病的初级保健医生和儿科医生在接受充分培训后使用肺功能测定。
