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新生儿通气八年后的肺功能

Lung function eight years after neonatal ventilation.

作者信息

Andréasson B, Lindroth M, Mortensson W, Svenningsen N W, Jonson B

机构信息

Department of Paediatrics, University Hospital, Lund, Sweden.

出版信息

Arch Dis Child. 1989 Jan;64(1):108-13. doi: 10.1136/adc.64.1.108.

Abstract

Forty children who had had artificial ventilation during the neonatal period were studied at the age of 8-10 years with spirometry, the nitrogen washout test, bicycle exercise test, pulse oximetry, electrocardiogram, vectorcardiogram, and chest radiography. The median gestational age at birth was 29 weeks, and the median birth weight was 1310 g. Hyaline membrane disease was the indication for neonatal ventilation in 25 children. Bronchopulmonary dysplasia was diagnosed from radiographs in 11 infants (27%). Airway obstruction was observed in 10 of 11 children who had had bronchopulmonary dysplasia and in nine of 29 children who had not. After inhalation of terbutaline, the forced expiratory volume in one second (FEV1) was significantly increased. General hyperinflation was found in 16 of 17 children with abnormal chest radiographs (eight who had had bronchopulmonary dysplasia and nine who had not). Functional residual capacity was significantly higher in children with abnormal radiographs. Each child had a normal maximum working capacity and a normal electrocardiogram, and all but two had normal vectorcardiograms. Oxygen saturation at maximum work load decreased significantly in both groups of children. The risk of future respiratory problems calls for further follow up of lung function and chest radiography.

摘要

对40名在新生儿期接受过人工通气的儿童在8至10岁时进行了肺活量测定、氮洗脱试验、自行车运动试验、脉搏血氧饱和度测定、心电图、向量心电图和胸部X线摄影检查。出生时的中位胎龄为29周,中位出生体重为1310克。25名儿童因透明膜病接受新生儿通气。11名婴儿(27%)经X线片诊断为支气管肺发育不良。在11名患有支气管肺发育不良的儿童中有10名以及在29名未患支气管肺发育不良的儿童中有9名观察到气道阻塞。吸入特布他林后,一秒用力呼气量(FEV1)显著增加。17名胸部X线片异常的儿童中有16名(8名患有支气管肺发育不良,9名未患支气管肺发育不良)发现有普遍性肺过度充气。胸部X线片异常的儿童功能残气量显著更高。每个儿童的最大工作能力和心电图均正常,除两名儿童外所有儿童的向量心电图均正常。两组儿童在最大工作负荷时的血氧饱和度均显著下降。未来发生呼吸问题的风险需要对肺功能和胸部X线摄影进行进一步随访。

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