Study On Dynamic Changes Of Tidal Breathing Pulmonary Function With Capillary Bronchitis In Children

Objective:To study the effect of capillary bronchitis on lung function by tidal breath analysis and to observe the dynamic changes of lung function and a gas ring(tidal breath flow volume curve TBFV,ring)in children with capillary bronchitis and to explore its clinical significance.Methods:Selected 107 cases(13cases lost follow-up)admitted from the First Affiliated Hospital of Anhui Medical University from October 2015 to February 2017 as observation group.And exclude cases that do not meet the requirements according to certain exclusion criteria.Methods 40 healthy infants with normal physical examination in our hospital were selected as the healthy control group.The clinical data of children,including age,sex,height and weight,were analyzed by statistical methods.A tidal-breathing pulmonary function test was run on the patients with bronchiolitis before treatment(acute stage),after treatment(remission stage),3 months after follow-up began,6 months after follow-up began and on the healthy control group in order to analyze the difference in parameter indexes of tidal-breathing pulmonary function and their changing features.Results:1.Out of the 94 patients who were successfully followed,8 cases of child patient in acute stage in observation group were pure restrictive ventilatory disorder,and all of the remaining 86 cases had obstructive ventilation disorder(of which 16 cases were accompanied by restrictive changes,namely,mixed ventilatory disorder).Among them,21 cases were mild obstruction,49 cases were moderate obstruction and 16 cases were severe obstruction.2.Comparison of indexes of lung function before and after treatment: the RR,TV/kg,VPTEF/VE,TPTEF/TE,TEF25%of the child patients were significantly improved after treatment as compared to before treatment,the difference was statistically significant(P<0.05),while TEF50% and TEF75% hardly changed before and after treatment,the difference was not statistically significant(P>0.05)3.During the follow-up: only the TV/kg index of patient before treatment was better than it was after treatment 3 months after the follow-up began(P<0.05);when it had been 6 months since the follow-up began,the lung function index TPTEF/TE ?VPTEF/VE of the patient was better than they were when it had been 3 months since the follow-up began(P<0.05),however,they still didn't fully return to normal.When the follow-up was continued for 3 months and 6 months,the number of patients who had a recurrence of pant was respectively 51 and 65,the TPTEF/TE and VPTEF/VE of patients in the group without recurrence was clearly better than those of the ones in the group with recurrence(P<0.05),the difference in other indexes was not statistically significant(P > 0.05).4.As compared to the healthy children in control group,the TBFV of patients in observation group showed a pyknic type before treatment,at the same time,the peak expiratory flow tended to drop,the breathing flow peak was shifted forward,the slope of expiratory descending branch increased,and bent inwards,the TBFV ring tended to be plump gradually after treatment,the expiratory peak was slightly shifted backward,the peak value decreased,the sinking of descending branch is reduced,but not fully returned to close to oval shape.Conclusions:1.The tidal-pulmonary function in acute stage of bronchiolitis in child patients is often manifested as obstructive ventilation disorder,and the treatment of tidal breathing pulmonary function parameters and indexes before and after treatment shows corresponding characteristics,although the clinical symptoms are relieved after treatment,but TPTEF/TE,VPEF/VE still have not returned to normal,the small airway obstruction is still present.2.The parameter indexes are improved gradually during the six months of follow-up,but they are still not as ideal as those of the healthy infants and young children in the control group,and TPTEF/TE,VPTEF/VE and other tidal-breathing pulmonary function measurements could better reflect the patient's condition and evaluate the changes of airway obstruction in children.3.The tidal breathing flow rate(TBFV ring)in children with bronchiolitis---capacity ring(TBFV ring): There were different changes in the acute and remission stages before and after the treatment,so that the location of airway obstruction and the degree of obstruction could be known to evaluate the final curative effect.