仰俯卧位对新生儿肺炎患儿肺功能的影响(英文)

Influence of the supine or the prone position on the lung function of neonates with pneumonia

摘要:

目的 探讨仰、俯卧位对足月新生儿肺炎患儿肺功能的影响 ,寻求足月新生儿肺炎患儿的合理体位。方法 应用美国BicoreCP 10 0新生儿肺功能仪分别检测 30例新生儿肺炎患儿仰、俯卧位时的呼吸频率、潮气量、每分通气量、气道阻力、动态肺顺应性和呼吸功。结果 俯卧位呼吸频率和气道阻力明显低于仰卧位 [(4 4 .3±9.2bpm min)vs (4 8.0± 10 .6bpm min) ;(15 3.1± 5 0 .4 )cmH2 O (L .sec)vs (2 11.9± 6 3.1)cmH2 O (L .sec) ,差异有极显著性意义 ,P <0 .0 1];俯卧位潮气量、每分通气量、动态肺顺应性和呼吸功明显高于仰卧位 [(2 .2 9±0 .4 6ml kg)vs (1.6 5± 0 .5 0ml kg) ;(0 .0 95± 0 .0 2 4 )L (min .kg)vs (0 .0 75± 0 .0 2 2 )L (min .kg) ;(0 .6 2 1±0 .2 14 )ml (cmH2 O .kg)vs (0 .389± 0 .115 )ml (cmH2 O .kg) ;(8.9± 3.5 )gm (cm .kg)vs (5 .9± 2 .7)gm (cm .kg) ,差异有极显著性意义 ,P <0 .0 1]。结论 俯卧位可改善新生儿肺炎患儿潮气量、每分通气量和动态肺顺应性 ,降低呼吸频率和气道阻力 ,提示俯卧位是改善新生儿肺炎患儿肺功能的适宜体位。

Abstract:

Objective To study the influence of the supine or the prone position on the lung function in the neonates with pneumonia in order to find a suitable position for neonates with pneumonia. Methods Respiratory rate, tidal volume, minute ventilation, airway resistance, dynamic pulmonary compliance and work of breathing in the supine or prone position were measured by American Biocore CP-100 Neonatal Pulmonary Apparatus in 30 neonates with pneumonia. Results Respiratory rate ( 44.3± 9.2 bpm/min) and airway resistance [( 153.1± 50.4) cmH 2O/(L.sec)] in neonates with a prone position were significantly lower than those in the supine position [( 48.0± 10.6 bpm/min) and ( 211.9± 63.1) cmH 2O/(L.sec), respectively] (P< 0.01). Tidal volume ( 2.29± 0.46 ml/kg), minute ventilation [( 0.095± 0.024) L/(min.kg)], dynamic pulmonary compliance [( 0.621± 0.214) ml/(cmH 2O.kg)] and work of breathing ( 8.9± 3.5) gm/(cm.kg)] in the prone position were significantly higher than those in the supine position [( 1.65± 0.50 ml/kg), ( 0.075± 0.022) L/(min.kg), ( 0.389± 0.115) ml/(cmH 2O.kg) and ( 5.9± 2.7) gm/(cm.kg), respectively] (P< 0.01). Conclusions A prone position may increase the tidal volume, minute ventilation and dynamic pulmonary compliance and decrease respiratory rate and airway resistance. It suggests that a prone position is the suitable one for neonates with pneumonia.