最大呼氣流量計在氣喘病兒之應用

Use of Peak Flow Meter in Children with Bronchial Asthma

黃焜璋(Kung-Chang Hwang)

《Acta Paediatrica Sinica》 29卷1期 (1988/02) Pp. 21-29

摘要

最大呼氣流速（Peak expiratory flow rate 簡稱PEFR）係小孩最常被用來測定呼吸道阻塞的檢查。本研究使用改良的mini-Wrlght peak flow meter來則PEFR以比較正常孩童與氣喘病兒的各項差異。
我們的結果顯示：(1)428位桃園地區6至14歲學童之PEFR預測正常值可由性別及身高求出。(2)21例氣喘初診的病兒吸入Berotec後有13例(62%)PEFR值上升超過15%。(3)10例氣喘病兒在兩次運動誘發支氣管收縮試驗中，有9例可得陽性反應。(4)居家使用Peak flow meter判定病人之diurnal variation超過15%之陽性率不高，但病人之PEFR值下降至預測正常值80%以下會感不適，而降至預測正常值之20～60%時會有氣喘現象發生。(5)氣喘發作病人在急診治療復，PEFR值上升至預測正常值之61～73%時症狀可消失，尤其是病人PEFR值上升超過預測正常值之60%時，5分鐘內病人的發作可停止。因此我們認為PEFR在預測正常值60%處，可能是氣喘發作與否的轉換點。
本研究顯示mini-Wright peak flow meter對氣喘病兒的診斷及處置監視為一個快速、易操作、且十分有用的儀器。

並列摘要

Tests employing the peak expiratory flow rate (PEFR) are commonly used to quantitate airway obstruction particularly in asthmatic children. In our study, the PEFR was measured by a mini-Wright peak flow meter and we did several tests between asthmatic children and normal controls.
The results of the study were the following:
1) We examined 428 children and established the PEFR in normal children in Tao-Yuan area and we also found the predicted normal PEFR value varied with sex and height.
2) Sixty-two percent of the new patients in our asthma special clinic showed increased PEFR after inhaling the bronchodiator ”Berotec” and 90% of our asthma patients responded to EIB after repeated test in one week.
3) The diurnal variation of asthmatic children was not easily identified. But we found if the PEFR decreased under 80% of the predicted normal value, the patient complained of chest tightness and if PEFR decreased to 20-60% of the predict normal value, wheezing and dyspnea were noted.
4) The asthma attack will wears off if the PEFR increases to 61-73% of predicted normal value and its an interesting finding that the attack will stop within 5 minutes after the PEFR increases above 60% of the predicted PEFR value. Therefore we suggest 60% of the predicted PEFR value is a critical point in management of an acute asthma attack.
In conclusion, the mini-Wright Peak flow meter is a useful tool for both the physicians and the patients, measurement of the PEFR provides a rapid objective means of diagnosing and monitoring asthma.

並列關鍵字

mini-Wright peak flow meter ； PEFR ； asthmatic children