支具治疗对女性青少年特发性脊柱侧凸患者肺功能的影响

Effect of brace on the pulmonary function of female adolescent patients with idiopathic scoliosis

中文关键词:  青少年特发性脊柱侧凸  肺功能  支具治疗  女性

英文关键词:Adolescent idiopathic scoliosis  Pulmonary function test  Brace  Female

中文摘要:

  【摘要】 目的：观察支具治疗对女性青少年特发性脊柱侧凸（AIS）患者肺功能的影响。方法：2001年2月~2009年12月283例女性AIS患者在我院接受矫形手术治疗，术前检测患者用力肺活量（FVC）、第1秒用力呼气容积（FEV1），记录预计值、实测值及实测值占预计值百分比。根据术前是否曾接受支具治疗分为2组，支具治疗组80例（A组），未接受支具治疗组203例（B组）。分析2组患者术前肺功能参数的差异，同时对A组患者肺功能FVC及FEV1的实测值占预计值百分比（FVC%、FEV1%）与术时年龄、身高、主弯冠状面Cobb角、主侧凸累及节段数、主胸弯矢状面Cobb角、每日支具治疗时间、支具治疗总时长进行多元线性回归分析。结果：A、B组患者FVC预计值分别为3.23±0.40L和3.20±0.40L，FEV1预计值分别为2.76±0.40L和2.73±0.30L，A组与B组比较均无统计学差异（P>0.05）；A、B组FVC实测值分别为2.58±0.60L和2.72±0.60L，FEV1实测值分别为2.34±0.50L和2.49±0.50L，A、B组FVC%分别为（80.3±16.5）%和（85.4±16.5）%、FEV1%分别为（85.6±18.4）%和（91.3±16.9）%，A组FEV1实测值、FVC%及FEV1%较B组均明显降低（P<0.05），其中主弯为胸弯患者（173例）明显（P<0.05），而主弯为胸腰弯/腰弯患者（110例）不明显（P>0.05）。A组患者中，胸段侧凸矢状面Cobb角与FVC%、FEV1%呈正相关（P<0.05），支具治疗总时长与FEV1%呈负相关（P<0.05）；而术时年龄、身高、主弯冠状面Cobb角、主侧凸累及节段数、每日支具治疗时间（8~23h，平均18.7h）与FVC%及FEV1%均无显著相关性（P>0.05）。结论：支具治疗可使女性青少年特发性胸段脊柱侧凸患者肺功能FVC%及FEV1%下降，支具治疗总时长和胸段侧凸矢状面Cobb角可能是影响患者肺功能FVC%及FEV1%的相关因素。

英文摘要:

  【Abstract】 Objective：To investigate the effect of brace on the pulmonary function of female adolescent patients with idiopathic scoliosis（AIS）.Method：From February 2001 to December 2009，a total of 283 female AIS patients underwent correction surgery in our hospital.Preoperative pulmonary function tests（PFTs） were evaluated.The predicted value and actual value of forced vital capacity（FVC），forced expiratory volume in one second（FEV1） as well as the ratio of actual and predicted value of FVC（FVC%） and FEV1（FEV1%） were recorded respectively.The patients were classified into two groups according to brace-wearing：group A，preoperative brace，80 cases；group B，no preoperative brace，203 cases.The PFTs between the 2 groups were compared.Multiple linear regression analysis with respect to age，height，coronal Cobb angle of the major curve，number of the involved vertebrae in major curve，sagittal Cobb angle of the thoracic curve，everyday and total brace-wearing time，FVC% and FEV1% were measured finally.Result：The predicted values of FVC in group A and group B were 3.23±0.40L and 3.20±0.40L，and the predicted values of FEV1 were 2.76±0.40L and 2.73±0.30L respectively.No significant difference was noted between 2 groups（both P>0.05）.The actual values of FVC in group A and group B were 2.58±0.60L and 2.72±0.60L，and the actual values of FEV1 were 2.34±0.50L and 2.49±0.50L respectively.The FVC% in group A and group B were （80.3±16.5）% and （85.4±16.5）%，and the FEV1% were（85.6±18.4）% and（91.3±16.9）% respectively.The patients in group A had significantly lower FEV1，FVC% and FEV1%（all P<0.05） than group B，especially in patients with primary thoracic curve（173 cases）（P<0.05），however the contrary in patients with primary thoracolumbar/lumbar curve（110 cases）（P>0.05）.Group A showed significant positive correlations between sagittal Cobb angle of the thoracic curve and FVC% as well as FEV1%（both P<0.05），while negative correlation between total brace time and FEV1%（P<0.05）.The age，height，coronal Cobb angle of the major curve，number of the involved vertebrae of major curve，everyday brace-wearing time（8-23h，average 18.7h） were not associated with FVC% and FEV1%（all P>0.05）.Conclusion：Preoperative brace decreases FVC% and FEV1% in female thoracic AIS. The total brace-wearing time and sagittal Cobb angle of thoracic curve may be the risk factors of FVC% and FEV1%.