颈胸段脊髓损伤康复期患者肺功能评价

Evaluation of pulmonary function in 71 cervical or thoracic SCI patients in rehabilitating period

目的:探讨颈、胸段完全性脊髓损伤(SCI)康复期患者肺功能下降程度及比较不同损伤节段肺功能差异。方法:测定71例颈、胸段完全性SCI患者肺活量(VC)、用力肺活量(FVC)、最大通气量(MVV)、第一秒用力肺活量(FEV1.0)。按损伤平面将SCI患者分为C3—8、T1—6、T7—12共3组,另收集30例手外伤、四肢骨折患者行肺功能检查,作为非SCI组。结果:SCI患者肺功能有不同程度下降,损伤平面越高,肺功能下降越明显;其中C3—8组、T1—6组的VC%、FVC%、MVV%、FEV1.0%与非SCI组比较差异有显著性意义(P<0.01),C3—8组的VC%、FVC%、MVV%、FEV1%与T7—12组比较也有显著性差异(P<0.01),T7—12组的MVV%、FEV1%与非SCI组比较有显著性差异(P<0.05)。SCI组的VC%、FVC%、MVV%、FEV1%与非SCI组比较差异有显著性意义(P<0.01)。结论:SCI患者肺功能有不同程度下降,颈段和上胸段SCI患者肺功能下降显著。

Objective： To explore and compare the descended degree of pulmonary function of patients with complete cervical or thoracic spinal cord injury （SCI） during rehabilitating period. Method： Seventy one SCI patients were enrolled and divided into three groups in terms of their injured level： C3-8,T1-6 and T7-12 group. Four variables： vital capacity （VC）,foreed vital capacity （FVC）,maximum voluntary ventilation（MVV）,foreed expiratory volume in the first second （FEV1） were captured during the evaluation process. Furthermore, 30 arms or legs injured patients＇ VC, FVC, MVV, FEV1 were also recruited as control group. One-way ANOVA was used for the data analysis. Result： Pulmonary function of patients with SCI declined in different extent. The higher level the spinal cord injured, the more patients＇ pulmonary function decline. VC%, FVC%, MVV% and FEV1% in C3-8 group and T1-6 group had significant difference （P〈0.01） compared with those in control group. There were significant difference （P〈0.01） of VC%,FVC%,MVV%,FEV1% between C3-8 group and T7-12 group. There were significant difference （P〈0.05） of MVV%,FEV1% between T7-12 group and control group. There were significant difference （P〈0.01）of VC%,FVC%,MVV%,FEV1% between SCI group and control group. Conclusion： The pulmonary function of patients with SCI decline in different extent. It descended sharply when the patient was injured at cervical or upper thoracic spinal cord.