重度脊柱侧凸后路一期小切口矫形对肺功能的影响

目的:探讨采用脊柱后路分期矫形策略治疗重度脊柱侧后凸,一期小切口矫形术对患者肺功能的影响。方法:自2007年05月-2010年12月采用脊柱后路分期矫形策略中一期小切口矫形术治疗重度脊柱侧凸患者32例,其中男12例,女20例,年龄5～25(13.5±6.12)岁。一期小切口矫形术前侧凸主弯冠状面Cobb’s角为108°～150°(128.75°±13.51°),胸腰段矢状位后凸角60°～140°(97.78°±27.88°)。测量一期矫形术前及术后2周、3月、6月肺功能,包括肺活量(VC)、用力肺活量(FVC)、第一秒时间肺活量(FEV1)、最大呼气中段流速(MMEF)、最大通气量(MVV),计算其占预计值的百分比VC%、FVC%、FEV1%、MMEF%、MVV%]。观察患者术前与术后不同时期肺功能的变化。结果:术后3月时肺功能较术前有明显提高(P<0.05),术后6月较术后3个月无显著提高(P>0.05)。结论:对于严重的脊柱侧凸患者,后路一期小切口矫形术后3月肺功能即可获得明显改善,可行二期手术治疗。

The Changes of Pulmonary Function in Severe Scoliosis Treated with First Stage Minimal Incision Surgery

Objective: To investigate the improvement of pulmonary function in severe scoliosis patients treated with first stage minimal incision surgery of staged plastic surgery.Methods: From May.2007 to Dec.2010,32 patients with severe scoliosis including 12 males and 20 females aged 5 to 25(13.5± 6.12) years were treated with first stage minimal incision surgery of staged plastic surgery.The preoperative coronal cobb’s angle of the main curve was 108° ~ 150°(128.75°±13.51°).The preoperative thoracolumbar sagital cobb’s angle was 60～140°(97.78±27.88°).Parameters of pulmonary function,including vital capacity(VC) and forced vital capacity(FVC),forced expiratory volume in one second(FEV1),maximal mid-expiratory flow(MMEF),maximal voluntary ventilation(MVV),were measured before and 2 weeks,3 months,6 months after surgery.The percentage of each parameter to its expected value was calculated.Preoperative and postoperative pulmonary function was compared with compared t test.Results: The pulmonary function was significantly improved 3 months after surgery(P<0.05),but not pulmonary function were improved when have increased significantly postoperative June is 3 months after improve significantly(P>0.05).Conclusion: For severe scoliosis patients,the pulmonary function can be improved with first stage minimal incision surgery.