脊柱侧凸患者肺功能影响因素的分析及临床意义

目的 对脊柱侧凸患者术前肺功能指标影响因素进行回顾性研究.方法 选取108例脊柱侧凸患者为研究对象,对患者术前肺功能参数相关因素进行分析.结果 脊柱侧凸患者Cobb角与VC、FVC、FEVl、PEF、FEF25-75、MMEF及MVV等肺功能参数的实测值占预计值的百分比呈显著负相关;与MV及FEVI/FVC无相关性;CS患者的肺功能损害程度较IS组严重;Cobb角≥90°组、顶椎位于T4-T8组、年龄<10岁组及受累椎体数目7个组的侧凸患者肺功能损害程度远高于其余相应组别的患者.结论 脊柱侧凸患者术前肺功能主要影响因素为侧凸发病年龄、侧凸畸形Cobb角、侧凸发生的部位及侧凸累积节段.发病年龄小、大角度、长节段的先天性胸弯(尤其是顶椎区位于T8以上)患者其肺功能损害程度将会明显加重.

Factors affecting the preoperative pulmonary function test in patients with scoliosis: a retrospective evaluation of 108 cases

Objectives To evaluate factors affecting the preoperative pulmonary function in patients with scoliosis. Methods Preoperative pulmonary function texts (PFTs) were performed on 108 patients with spinal deformities, 17 males and 91 females, aged (15.2±5.36) (7-27 ), 70 being with idiopathic scoliosis (IS) and 38 with congenital scoliosis (CS). The parameters affecting the preoperative pulmonary function were analyzed. Results The Cobb angle of scoliosis was negatively correlated with vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), forced expiratory flow between 25% to 75% of forced vital capacity ( FEF25-75 ), maxima mid-expiratory flow (MMEF), and maximal ventilatory volume (MVV), and not correlated with minute ventilation (MV) and ratio of forced expiratory volume in one second to forced vital capacity (FEVI/FVC%). The impairment of lung functions was more severe in the CS patients than in the IS patients. The degrees of impairment of lung functions in the groups of the Cobb angle ≥90° with the number of vertebrae involved ≥7 , with the age of onset < 10, and of cephalad location of the curve were more severe than those of the groups with different corresponding parameters. Conclusion The deterioration of pulmonary function mainly depends upon the age of onset, Cobb angle, location of the apex vertebra and the number of involved vertebrae.