先天性脊柱侧弯合并肋骨畸形患儿肺功能损伤的临床观察

目的 探讨先天性脊柱侧弯合并肋骨畸形的患儿肺功能受损程度。方法回顾性分析本院2011年6月~2016年4月收治的58例先天性脊柱侧弯合并肋骨畸形的患儿肺功能检查结果与脊柱侧弯、肋骨畸形等影像学检查资料的相关性。结果58例患儿中,有34发生肋骨畸形,其中合并肋骨融合16例,肋骨缺如14例,肋骨融合与缺如4例；先天性脊柱侧弯患儿肺功能均有不同程度的损伤,肺功能最大肺活量实测值/预计值(Vcmax%)与Cobb角呈负相关(P<0.05)；除去Cobb角因素,胸腰段组脊柱侧弯患儿肺功能好于胸段组(P<0.05),非合并肋骨畸形先天脊柱侧弯患儿肺功能好于合并连续3根以上肋骨融合的患儿(P<0.05)。结论先天脊柱侧弯患儿肺功能不同程度降低,侧弯越严重的患儿胸廓畸形的范围越大,特别是合并广泛肋骨畸形时,肺功能损伤更加明显。

Preliminary study on the influence factors of pulmonary function in children with congenital scoliosis combined with rib deformity

Objective To investigate the degree of pulmonary function impairment in children with congenital scoliosis associated with rib deformity.Methods58 cases of congenital scoliosis associated with rib deformity were recruited in our hospital from June 2011 to December 2015.Pulmonary function tests were tested.ResultsIn this group of patients,there were 34 cases of rib deformity,16 cases of fused ribs,14 cases of rib agenesis,4 cases of rib fusion as well as absence.Vcmax%(measured value of lung function) and the Cobb angle were negatively correlated (P<0.05).When the influence of Cobb angle was excluded,pulmonary function was better in thoracolumbar group than that in thoracic group (P<0.05).The lung function was better for non-fused rib deformities than the condition with more than three consecutive fused ribs (P<0.05).ConclusionDecreased pulmonary function in children with congenital scoliosis is associated with the severity of scoliosis,especially when fused rib deformities exist.