急性支气管炎患儿通气功能及气体交换储备的变化

Ben Otmen Mabrouk, Y. Nechytailo, Tetiana M. Mikheeva, D. Nechytailo
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摘要

在儿童下呼吸道疾病中,以急性支气管炎为主,常伴有阻塞性综合征和通气障碍。为了评估阻塞性综合征的严重程度,使用肺量测定法,这是该目的的“金标准”。它结合了两组测试:肺活量描记术——呼吸运动时肺容量变化的描记术和气相描记术——潮汐呼吸和强迫呼吸时空气流速的描记术。在现代方法中,脉搏血氧仪无创测定血氧饱和度越来越受欢迎。肺活量测定法和脉搏血氧测定法的联合应用,可以准确测定大范围病理变化中心肺系统的状态和储备。了解急性支气管炎患儿通气功能及气体交换特点。材料和方法。本文对59例急性支气管炎患儿的调查结果进行分析。患者行临床检查、肺活量测定、脉搏血氧饱和度测定;进行了屏气试验。将肺活量测定和脉搏血氧测定结果与临床健康儿童(23例)进行比较。小儿支气管炎严重程度按bss评分(7.79±0.19)分为中度,有30例出现阻塞性综合征症状。肺活量测定法记录了用力呼吸量、用力呼气流量峰值和吸气流量的减少。脉搏血氧仪显示患者的血氧饱和度相对较低,在屏气测试期间恶化。所获得的结果表明,呼吸和气体交换受损的儿童支气管炎,即使是轻度病程,特别是在存在阻塞性现象。维持血饱和度的代偿机制主要基于心率增加引起的全身血流量增加。在儿童急性支气管炎中,通气和气体交换率降低,即使在那些病程较轻的患者中也是如此。维持血饱和度的代偿机制主要基于心率增加引起的全身血流量增加。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
CHANGES IN VENTILATION FUNCTION AND RESERVES OF GAS EXCHANGE IN CHILDREN WITH ACUTE BRONCHITIS
Among the diseases of the lower part of respiratory system in children, acute bronchitis dominates, often with obstructive syndrome and ventilation disorders. To assess the severity of the obstructive syndrome spirometry is used, which is the "gold standard" for this purpose. It combines two groups of tests: spirography – graphical recording of changes in lung volumes during respiratory movements and pneumotachography – graphical recording of the air flow velocity during tidal and forced breathing. Among modern methods, non-invasive determination of blood oxygen saturation with pulse oximetry is becoming increasingly popular. The combined use of spirometry and pulse oximetry makes it possible to determine accurately the state and reserves of the cardiorespiratory system in a wide range of pathological changes. Objective. To learn the features of ventilation function and gas exchange in children with acute bronchitis. Materials and methods. The paper analyzes the results of a survey of 59 children with acute bronchitis. Patients underwent a clinical examination, spirometry, pulse oximetry; breath-hold tests were performed. The results of spirometry and pulse oximetry were compared with the data of clinically healthy children (23 children). Results. In children, the severity of bronchitis was moderate according to the BSS-7.79 ± 0.19 points, 30 patients had symptoms of obstructive syndrome. Spirometry recorded a decrease in forced respiratory volumes, peak forced expiratory flow and inspiratory flow. Pulse oximetry showed a relatively lower level of oxygen saturation in patients, which worsened during breath-hold tests. The obtained results indicate impaired ventilation and gas exchange in children with bronchitis, even with a mild course of the disease, especially in the presence of obstructive phenomena. Compensatory mechanisms for maintaining blood saturation based mainly on an increase in systemic blood flow due to an increase in heart rate. Conclusions. In acute bronchitis in children, ventilation and gas exchange rates decrease, even in those patients with a mild course. Compensatory mechanisms for maintaining blood saturation are based mainly on increased systemic blood flow due to increased heart rate.
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