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与儿科呼吸评估指标和呼气峰值流速测量相比,洛杉矶呼吸声量测定技术作为一种评估哮喘急性发作严重程度的新技术。

LA phonospirometry technique compared to pediatric respiratory assessment measure and peak expiratory flow measurement as a novel technique to assess the severity of an asthma exacerbation.

作者信息

Ochoa Kelly, Richman Jori, Wang Vincent J

机构信息

a Department of Pediatrics, Division of Emergency Medicine, Valley Children's Hospital , Madera , CA , USA.

b Division of Emergency and Transport Medicine, Department of Pediatrics, Children's Hospital Los Angeles, Keck School of Medicine of the University of Southern California , Los Angeles , CA, USA.

出版信息

J Asthma. 2019 Sep;56(9):959-963. doi: 10.1080/02770903.2018.1514046. Epub 2018 Sep 12.

Abstract

: Asthma is a common chronic disease treated in emergency departments. The measurements of Peak Expiratory Flow (PEF) and Pediatric Respiratory Assessment Measure (PRAM) scores have been recommended as objective techniques in the assessment of acute asthma exacerbations, but have multiple barriers limiting their use. The Los Angeles phonospirometry technique is an easier, trans-cultural technique. The technique assesses dyspnea by measuring how many seconds a child is able to chant "LA LA LA" in a single breath. The objective of this study is to determine the correlation of this technique with PEF measurements and PRAM scores in children with acute asthma exacerbations, both before and after nebulized bronchodilator treatment. : A convenient sample of children aged 5-17 years being treated for asthma in the ED was enrolled. Phonospirometry, PRAM, and PEF measurements were obtained through pre and post inhaled bronchodilator treatments. The highest values from each measurement were correlated using Spearman's correlation coefficient. : A total of 91 children were enrolled. The correlations at pre-treatment, after first, second, and third treatments between phonospirometry and PEF were 0.38 ( < 0.001), 0.60 ( < 0.001), 0.54 ( < 0.001), 0.52 ( < 0.01), respectively; between phonospirometry and PRAM were -0.37 ( < 0.001), -0.42 ( < 0.001), -0.26 ( < 0.05), and -0.06 ( > 0.05), respectively; and between PEF and PRAM were -0.6 ( < 0.01), -0.54 ( < 0.001), -0.38 ( < 0.01), and -0.36 ( - 0.05), respectively. : This novel technique correlates mild to moderately with PEF, and shows promising aide in the assessment of children with acute asthma exacerbations.

摘要

哮喘是急诊科常见的慢性疾病。呼气峰值流速(PEF)测量和儿科呼吸评估量表(PRAM)评分已被推荐作为评估急性哮喘加重的客观技术,但存在多种限制其使用的障碍。洛杉矶肺音测量技术是一种更简便、跨文化的技术。该技术通过测量儿童一口气能唱出“啦啦啦”的时长来评估呼吸困难程度。本研究的目的是确定该技术与急性哮喘加重患儿在雾化支气管扩张剂治疗前后的PEF测量值及PRAM评分之间的相关性。

选取了在急诊科接受哮喘治疗的5至17岁儿童作为便利样本。在吸入支气管扩张剂治疗前后进行肺音测量、PRAM和PEF测量。使用Spearman相关系数对每次测量的最高值进行相关性分析。

共纳入91名儿童。治疗前、第一次、第二次和第三次治疗后,肺音测量与PEF之间的相关性分别为0.38(<0.001)、0.60(<0.001)、0.54(<0.001)、0.52(<0.01);肺音测量与PRAM之间的相关性分别为-0.37(<0.001)、-0.42(<0.001)、-0.26(<0.05)和-0.06(>0.05);PEF与PRAM之间的相关性分别为-0.6(<0.01)、-0.54(<0.001)、-0.38(<0.01)和-0.36(-0.05)。

这项新技术与PEF呈轻度至中度相关,在评估急性哮喘加重患儿方面显示出有前景的辅助作用。

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