唐山地震中截瘫伤员康复12年肺功能检查分析(附239例告报)

AN INVESTIGATION OF THE PULMONARY FUNCTION TESTS OF 239 CASES OF PARAPLEGIC PATIENTS IN TANGSHAN EARTHQUAKE AFTER 12 YEARS REHABILITATION

本文研究239例截瘫伤员经过12年康复的肺功能。胸、腰胸损伤235例。颈椎损伤3例,胸椎损伤1例。结果发现胸腰椎损伤组 VC、FVC、FEV_l.0、FEV_1.0％、(?)75,、(?)50、(?)25、(?)25/HT 均值均在正常范围以内。而 PEFR 稍有下降。颈椎损伤组主要表现为限制性通气障碍。116例病人提供了截瘫前身高数据。截瘫后身高较截瘫前缩短3.81土2.34cm。VC、FVC、FEV_1.0受身高影响最明显。按截瘫前身高计算的预计值高于按截瘫后身高计算的预计值。病人受伤时胸、肺已发育完全,截瘫使身高缩短不会使肺功能变化,因此应以截瘫前身高计算预计值为宜。用轮椅或手摇车进行运动的运动组肺现能结果明显优于无运动组。说明截瘫康复期进行上肢运动对改善肺功能非常必要。

Pulmonary function tests of 239 paraplegic patients were investi- gated.Among them,235 cases were of thoracic and lumbar spinal cord lesion, 3 cases of cervical spinal cord lesions and ] case thoracic.The mean values of VC,FVC,FEV_(1.0),V_(75),V_(50),V_(25),V_(25)/ HT were within mormal limits in thor- acic and lumbar spinal cord lesion,and slight reduction in PEFR.The cervicat lesion group showed restrictive ventila- tory defect. 116 patients offered the data of height before paraplegia.The height shortened on an average of 3.8+2.4 cm (mean+SD) after paraplegia than that before.VC,FVC,FEV_(1.0) were ef- fected most motably by height.The predicted values based on the height before paraplegia was higher than that after paraplegia.When they were woun- ded,their thorax and lung had already developed completely.The paraplegia which shortened the heights correspon- dingly affected the pulmouary function. Hence it was more resonable to use the predicted value according to the height before paraplegia The pulmonary function results of the exercise group by using wheel-chair and arm crank were better than that without exercise.It indicates that arm execise in paraplegic rehabilitatinn is beneficial for improving the pulmonary function.