扁平胸廓青少年自发性气胸发病原因的生物力学研究

The biomechanical analysis of the etiologies of spontaneous pneumothorax in flat-chest teenagers

目的 探讨扁平型胸廓青少年易发生自发性气胸的原因。方法 139例扁平型胸廓青少年自发性气胸病人作为研究组,15 2例同期非自发性气胸青少年病人作为对照组,在CT图像上测量胸廓横径与前后径和气管长度与气管横径的比值。取开胸手术的4 7例自发性气胸病人的肺组织和4 7例非自发性气胸原因开胸手术切除的肺组织分别做拉伸、压缩和弯曲试验。两组所测数据利用t检验进行统计分析。结果 研究组胸廓横径与前后径、气管长度与气管横径比值明显大于对照组,差异有统计学意义(P <0 0 5 ) ;研究组肺组织抗牵拉、挤压和弯曲能力明显低于对照组,差异有统计学意义(P <0 0 5 )。结论 胸廓和肺发育异常引起的胸廓和肺组织生物力学改变,可能是扁平型胸廓青少年易发生自发性气胸的一个主要原因。

Objective To investigate the etiologies of spontaneous pneumothorax in fiat-chest teenagers. Methods 139 teenagers with fiat chest and spontaneous pneumnothorax were designed as the study group, while 152 teenagers without spontaneous pneumothorax during the same period were taken as control. The ratio of thoracic transverse diameters to anterior-posterior diameters, and the ratio of tracheal length to transverse diameters were measured respectively by CT scan. The resected pulmonary tissues in 47 cases with spontaneous pneumonthorax and in 47 cases without spontaneous pneumonthorax underwent various examinations, including tension, compression, and bending tests. Student t-test was employed to perform the statistical analysis. Results The ratios of thoracic transverse diameters to anterior-posterior diameters and the ratios of tracheal length to transverse diameters in the study group were remarkably higher than those were in the control group, with significant statistical difference （P〈 0.05）. The anti-tension, anti-compression and anti-bending capacity in the study group was markedly lower than in the control group, with significant statistical differonce （P 〈 0.05）. Conclusion The biomechanical variations of thorax and lungs due to their abnormal development may play an important role in the occurrence of spontaneous pneumothorax in fiat-chest teenagers.