Application Research Of The Negative Expiratory Pressure (NEP) Method In Asthmatic Children

Objective: Lung function tests as an important examination method, on children asthma diagnosis, differential diagnosis and condition monitoring and evaluation plays an irreplaceable role.Currently using traditional methods of lung function requires the patients high cooperation. Because the children's age is small, ability of cooperation is poor, the applicated in pediatric patients is limited. Therefore, we urgently need to find a method to detect the lung function of asthmatic children,which doesn't require special cooperqtion, the method is simple, the conclusion is accurate. Negative Expiratory Pressure (NEP) is a newpulmonary function testing method,which has been gradually clinical applicating in recent years,available in tidal breathing, various postures, and doesn't need active cooperation. NEP method in adult has beensuccessfully applied ,in children the application is less.In our study, we select asthma Outpatients in Dalian Children's Hospitall, In order to understand the feasibility of NEP method in pediatrics clinical application, Use NEP method to detect the reversibilityof expiratory flow limitation of asthmatic children in bronchial dilation test,and find NEP method to positive bronchodilation test criteria,two lung functions detect the positive rate of expiratory flow limition with acute and stable asthmatic children ,and compare with each other in methodology.Methods: we select 46 asthmatic Outpatients in Dalian Children's Hospitall from 2009 November to March 2010 , 16 cases at acute stage,30 cases at stable stage, respectively Use NEP method and conventional force method in each patient to detect the ventilatory disturbance of pulmonary function and bronchodilatation test.Results:1.NEP method feasibility in clinical applications of pediatrics The degree of cooperation of NEP method in asthmatic children is 100%. 2..NEP method in the application of astmatic children:⑴NEP method to detect 16 acute asmatic children,4 of 16 was no expiratory flow limition,25%,12 of 16 was expiratory flow limition,75%,three score method mean was 1.25 + 0.86 points.⑵NEP method to detect 30 stable asmatic children,16 of 30 was no expiratory flow limition,53%,14 of 30 was expiratory flow limition,47%,three score method mean was 0.73±0.86 points.⑶EFL value of NEP detection in asthmatic children before and after bronchodilation test was statistical difference, expiratory flow limitation was reversible, and EFL value improve≥1 as the NEP method bronchodilation test positivet Judgement Standard is feasible.3.The completion rate of NEP method in asthmatic children. Is higher than in the conventional force pulmonary function method.4.Detection of two pulmonary function methods in acute asthmatic children, the positive rate of the ventilatory disturbance of pulmonary function and comparison: The positive rate of NEP method is 75%, The positive rate of conventional force method is 75%,Two kinds of pulmonary function method to detect the acute asmatic children the ventilatory disturbance of pulmonary function with the same positive rate.5.Detection of two pulmonary function methods in stable asthmatic children, the positive rate of the ventilatory disturbance of pulmonary function and comparison: The positive rate of NEP method is 46.67%, The positive rate of conventional force method is 10%,the positive tate of ventilatory disturbance of pulmonary function in NEP method is higer than in the conventional force method.Conclusions:1.NEP method is in clinical applications of pediatrics cooperation with good feasibility,compared with the forced expiratory pulmonary function,the feasibility of NEP method with asthmastic children is stronger.2.NEP method detect acute asthmatic children showed significant expiratory flow limitation,the two pulmonary function methods tested positive rate was the same,also can detect patients pulmonary ventilation function.3.NEP method detect stable asthmatic children showed mild to severe expiratory flow limitation, NEP method tested positive rate was higer than forced expiratory pulmonary function.4.NEP method detection, expiratory flow limitation of asmatic children was reversible, and EFL value improve≥1 as the NEP method bronchodilation test positive judgement Standard is feasible.