Measurement And Analysis On Breathing Lung Function Of Different Gestational Age Premature Infants

Respiratory diseases is one of the most common diseases and the importantcause of morbidity and mortality in neonatal, its prevalence rate has been high inrecent years. Along with the rapid development of the perinatal medicine and medicallevel, the incidence of premature infants in our country has risen to8.1%,the survivalrate of premature babies also increased significantly. Due to the immature lungs, lowweight, low immunity, they are easily suffering from respiratory disease, more andmore clinical studies have shown that the incidence of premature respiratory diseaseincreased year by year, its length of stay, high cost, bring huge economic burden andpsychological burden to the family and society, cause social attention in recent years.Lung function measurements is an important part of determining the severity ofthe respiratory disease, assist in the selection of appropriate respiratory parameters,respiratory disease identification, evaluating the effect of drugs, disease predictionand monitoring the illness, widely used in respiratory medicine, pediatrics, obstetricsand gynecology, thoracic surgery, occupational disease assessment, and other fields.The parameters of normal lung function is indispensable in diagnosis,treatment andjudging the curative effect. Routine lung function measurements need to be patientcooperate actively, thus limiting its application in pediatric especially in newborns.The determination of moisture breathing lung function just need calm breathing patients, it is suitable for newborns. Neonatal pulmonary function tests date back tothe1950s, but as a result of there small tidal volume, complex data processing, thepoor measurement accuracy and repeatability, its application in clinical is hindered.With the advent and development of computer, the research of neonatal pulmonaryfunction has been widely conducted, but the current domestic study of premature lungfunction is still less, and there are few randomized controlled studies of lung functionin premature infants.ObjectiveTo explore the moisture breathing lung function and the characteristics of theimportant respiratory parameters of premature infant born at different gestational ageswithout respiratory complications. To follow-up of premature infants after dischargeat the same time, discussing the moisture breathing lung function and the change ofimportant respiratory parameters when they are at a corrected gestational age of40weeks, compared with the term infant, and to analyze its influence factors, in order toimprove the understanding of clinician in premature lung function, and providereference for clinical reference value.Materials and methods1.MaterialsAll research object is derived from April2013to October2013in the thirdaffiliated hospital of zhengzhou university hospital,75cases of premature infants(PI)who are suitable for gestational age, cesarean birth, Apgar score at birth>7points; a total of55cases of term infant(TI) from the same period of hospitalizationare chosen as control group,39~40weeks gestational age.Exclusion criteria:1. Suffering from respiratory symptoms such as respiratorydistress when testing;2. The mother has a history of smoking;3. Has a history ofasthma in the first-degree relatives;4.The congenital diseases that have an impact on lung function;5.Having used drugs that have an effect on lung function beforetesting.2.MethodThis study chooses the moisture breathing, in neonatal medicine sleep (5%chloral hydrate enema or oral) or natural sleep,nose and mouth mask fasten, throughthe integration of the velocity sensor to the velocity signal into capacity, and thencalculate the measured value by the computer. Routine records neonatal gestationalage, gender, and measure the body length and weight before determined, theexperimental group and control group were determined its moisture breathing lungfunction when3to5days after birth.Each test three times, calculate the averageautomatically by the computer. Measurable parameters are tidal volume(VT)，tidalvolume/kg(VT/kg)，inspiratory time(tI)，expiratory time(tE)，Ratio tI to tE，respiratoryrate(RR)，time to PTEF(TPEF)，ratio of TPEF and total tE(TPEF/tE)，expiratoryvolume at PTEF(VPEF)，ratio of VPEF and total VE(VPEF/VE)。To follow-up of the experimental group, determine their moisture breathinglung function again when corrected gestational age at40weeks, using statisticalmethods to analysis, to explore the mainly change of respiratory parameters andinfluencing factors of premature infant born at different gestational ages when earlyafter birth and corrected gestational age of40weeks, and compare those with theterm infant.Results1. The comparison of lung function between each group when3to5daysafter bornCompared with term infant(TI),p1and p2had lower tI, lower TPEF, lowerTPEF/tE, lower VPEF and lower VPEF/VE because of low birth weight and theimmature lungs, RR is higher than that of TI (all P <0.05); compared with TI, p3hadlower tI, lower TPEF and lower TPEF/tE, the rest of the parameters of lung functionhad no significant difference (P>0.05); compared with p3, p1had significant differences in tI, TPEF,TPEF/tE, VPEF, VPEF/VE and RR (P <0.05);compared withp2, p1had significant differences in TPEF,TPEF/tE, VPEF, and VPEF/VE (P <0.05);p2had significant differences in RR, tI and TPEF with p3, the rest of the parametersof lung function had no significant difference (P>0.05).2. The comparison of lung function between each group when prematureinfants are at a corrected gestational age of40weeksCompared with TI, p1had lower TPEF/tE, lower VPEF/VE, lower TPEF,lowerVPEF and higher RR when at a corrected gestational age at40weeks (all P <0.05);TPEF/tE, VPEF/VE, TPEF and VPEF of p2were significantly lower than that of TI(P <0.05), there was no significant difference of other parameters; compared with TI,p3only show the differences in TPEF and TPEF/tE(P <0.05), the rest had nosignificant difference; compared with p3, p1had lower TPEF/tE, lower VPEF/VE,lower TPEF and lower VPEF,RR is higher than that of p3(P <0.05); compared withp2, p1had lower VPEF (P <0.05)，there was no significant difference of otherparameters;p2had no significant difference with p3except TPEF when at a correctedgestational age at40weeks.Conclusion1. The moisture breathing is suitable for the determination of breathing mechanicsindex of newborn.2. Breathing lung function of newborn is mainly influenced by gestational age andbody weight, the breathing lung function of premature infants is obviously impaired,the smaller the gestational age, the more obvious of the change.