脊柱侧弯142例的肺功能障碍特征及相关因素分析

目的分析脊柱侧弯患者肺功能损害的特点,探讨导致脊柱侧弯患者肺功能障碍的临床因素。方法回顾性分析接受首次矫形术的142例侧弯患者的临床资料及术前肺功能检查情况,确定导致肺功能障碍的临床因素。结果男性患者重度侧弯较多,cobb角较大;随年龄增长,侧弯患者气道阻力呈增加趋势;肺功能异常与患者体质量、cobb角和顶椎位置有关,而与侧弯方向及是否伴有后凸无关。结论随着年龄的增长,肺功能的损害程度不断加重,且存在由单纯限制性通气障碍向伴随阻塞性通气障碍的混合性通气障碍变化;肺功能损害的程度与侧弯的程度正相关;侧弯顶椎位于胸椎者,更倾向于伴随有肺功能障碍。严重肺功能损害的患者,体质量发育受到影响,给围术期的管理带来更大的挑战。

Study on characteristics and relative factors of pulmonary function abnormality in 142 scoliosis patients

Objective To analyze the characteristics of pulmonary function abnormality in patients with scoliosis and to investigate it’s clinical factors.Methods A total of 142 scoliosis patients’ clinical data and preoperative pulmonary function were analyzed retrospectively,and the clinical factors of pulmonary function abnormality in patients with scoliosis were determined.Results The male patients had a higher severe scoliosis proportion and larger cobb’s degrees than females.Moreover,the airway resistance showed that there was an increasing trend with the increase of patients’ ages.Pulmonary function abnormality was related to the body weight of patients,cobb’s degree and apex vertebrae position,while the scoliosis direction or kyphosis were not.Conclusion Along with the increase of age,the damage of pulmonary function was exacerbated and showed a changing form simple restrictive ventilatory disorder to mixed ventilatory disorder with obstructive ventilatory disorder.There was a positive correlation between the damage of pulmonary function and scoliosis.The patients with apex vertebrae located in thoracic vertebra may be more vulnerable to pulmonary function abnormality.The body weight in severe pulmonary function damage patients are affected,this brought enormous challenge to perioperative management.