高海拔地区脊柱侧凸患者心肺功能变化

目的评估高寒缺氧环境对脊柱侧凸患者心肺功能的影响。方法回顾分析2006年1月~2012年12月本院收治的高海拔地区特发性脊柱侧凸患者31例,并选取同时期来自平原地区的其他特征(年龄、性别、侧凸角、后凸角)相似特发性脊柱侧凸患者31例作配对研究。收集并分析62例患者术前站立位全脊柱正侧位X线片、术前肺功能和心脏彩超检查结果。结果高海拔地区脊柱侧凸患者心脏彩超结果中每搏输出量(stroke volume,SV)、射血分数(ejection fraction,EF)、左房内径(left atrial internal diameter,LAID)、左室内径(left ventricular internal diameter,LVID)、右房内径(right atrial internal diameter,RAID)以及肺功能检查中肺活量(vital capacity,VC)、肺总量(total lung capacity,TLC)、用力肺活量(forced vital capacity,FVC)、一秒率(FEV1/FVC%)大小与平原地区脊柱侧凸患者检查结果相比差异无统计学意义(P0.05)。而高海拔地区与平原地区脊柱侧凸患者的右室内径(right ventricular internal diameter,RVID)、第一秒用力呼气容积(forced expiratory volume in one second,FEV1)实测值相比,差异具有统计学意义(P0.05)。结论高海拔地区与平原地区脊柱侧凸患者的心肺功能总体上无明显差异,在进行术前评估、准备和围手术期处理上,高海拔地区脊柱侧凸患者与平原地区脊柱侧凸患者相比并无特殊。

Cardiopulmonary function in patients affected by scoliosis in high altitude regions

Objective To evaluate the impacts of cold, hypoxic environment on cardiopulmonary function in patients with scoliosis in high altitude regions. Methods From January 2006 to December 2012, 31 cases of idiopathic scoliosis in high altitude regions with complete clinical datas were analyzed, retrospectively. The other 31 patients with idiopathic scoliosis in plain regions were chosen as control group with the similar age, sex and the main Cobb's angle. All the patients were evaluated by supine anteroposterior and lateral radiographs of the entire spine, pulmonary function test and echocardiography preoperatively. Results There were no significant differences in the values of left atrial internal diameter(LAID), left ventricular internal diameter(LVID), right atrial internal diameter(RAID), stroke volume(SV), ejection fraction(EF), forced vital capacity(FVC), the actual measured value of forced expiratory volume in one second accounted for the percentage of the reference values of FVC (FEV₁/FVC%), vital capacity(VC), total lung capacity(TLC) between the scoliotic patients in high altitude and plain regions. The actual measured value of forced expiratory volume in one second(FEV₁) and the value of right ventricular internal diameter(RVID) in scoliotic patients in high altitude areas were smaller than those in plain areas. Conclusion In general, scoliotic patients in high altitude areas have the similar cardiopulmonary function as those who live in plain areas. Compared with scoliotic patients in the plain regions, no more extra preparations are needed in the perioperative period.