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目的观察剖宫产儿潮气呼吸肺功能各项指标的动态变化。研究剖宫产儿与阴道分娩儿肺功能的差异。为足月新生儿早期肺功能提供参考数值。方法研究对象:剖宫产儿144例,阴道分娩儿116例;采用潮气呼吸法测定两组新生儿出生后第1小时内、第1224小时内(第1天)、第3天、第5天的潮气呼吸肺功能的各项指标。主要参数为:每分通气量(MV),呼吸频率(RR),潮气量(VT/kg),吸气时间(TI),呼气时间(TE),吸呼比(TI/TE),达峰时间(TPEF),达峰时间比(TPEF/TE),达峰容积(VPEF),达峰容积比(VPEF/VE),潮气呼吸呼气峰流速(PTEF),25%,50%或75%潮气量时呼气流速(TEF25%,TEF50%,TEF75%)。结果在1h内剖宫产组潮气量较自然分娩组小,每分通气量较小(P<0·05),达峰时间比和达峰容积比高于阴道分娩组(P<0·05),而呼吸频率、吸呼比、达峰时间两组差异无统计学意义(P>0·05)。在1、3、5d剖宫产组较自然分娩组各潮气呼吸肺功能指标比较,差异均无统计学意义(P>0·05)。剖宫产组中:第1h组呼吸频率较第1天组增快,潮气量较第1天组缩小,而每分通气量较第1天组增大。而吸呼比、达峰时间、两组差异无统计学意义(P>0·05)。第1天组与第3天组、第3天组与第5天组各潮气呼吸肺功能指标比较,差异均无统计学意义(P>0·05)。结论剖宫产儿1h内存在较阴道分娩儿更明显的限制性通气功能障碍、大气道的阻塞。这一改变在12h内可以自限。潮气呼吸肺功能可作为新生儿呼吸监护重要的无创手段。
Objective To observe the dynamic changes of various indexes of pulmonary function in children with cesarean section. To study the difference of lung function between cesarean section and vaginal delivery. Provide reference value for early lung function of full-term newborn. Methods Study objects: 144 cases of cesarean section and 116 cases of vaginal delivery. The infants were divided into two groups according to the tidal breathing method: the first hour after birth, the first 1224 hours (day 1), the third day, the fifth day The moisture index of lung function. The main parameters were: MV, RR, VT / kg, TI, TE, TI / TE, TPEF, TPEF / TE, VPEF, VPEF / VE, PTEF, 25%, 50% or 75% % Tidal expiratory flow rate (TEF25%, TEF50%, TEF75%). Results The tidal volume in cesarean section was smaller than that in spontaneous delivery group (P <0.05), and the ratio of peak time to peak volume was higher than that in vaginal delivery group (P <0.05) ), While there was no significant difference in respiratory rate, respiration rate and peak time between the two groups (P> 0.05). There were no significant differences in the indexes of lung function between the 1,3,5 d cesarean section and the spontaneous delivery group (P> 0.05). In the cesarean section, the respiratory rate in group 1h was faster than that in group 1, the tidal volume was smaller than that in group 1, and the ventilation per minute was higher than that in group 1. The respiratory rate, peak time, there was no significant difference between the two groups (P> 0.05). There were no significant differences in the indexes of pulmonary function between the first day and the third day, the third day and the fifth day (P> 0.05). Conclusion There is more restrictive ventilatory dysfunction and blockage of airway in cesarean section than in vaginal delivery within 1 hour. This change can be self-limited within 12h. Tidal breathing lung function can be used as an important neonatal respiratory monitoring non-invasive means.