脊柱侧凸患者术前肺功能、手术方式与术终气管拔管时间的相关性分析

Correlation between preoperative pulmonary function,method of surgical approach with postoperative time of tracheal extubation in patients with scoliosis

目的对脊柱侧凸患者术前肺功能指标、手术方式与术终拔管时间的相关性进行回顾性研究。方法选取我院脊柱外科于2000年9月至2005年6月收治的115例脊柱侧凸患者为研究对象,应用多元线性回归分析对患者术前肺功能及手术方式与拔管时间的关系进行相关性分析。结果术终气管拔管时间经胸组与未经胸组之间无显著差异,而行胸廓成形术组显著大于不行胸廓成形术组(P=0.009)。多元线性回归分析结果显示侧凸患者术终气管拔管时间与肺活量百分比、最大通气量百分比、第一秒最大呼气容积百分比、用力呼气中期流速百分比及是否行胸廓成形术之间呈显著负相关。结论肺活量百分比、最大通气量百分比、第一秒最大呼气容积百分比、用力呼气中期流速百分比及是否行胸廓成形术是影响术终气管拔管时间的主要因素。术前肺功能测定及术式的选择对术终气管拔管时间的判断有指导意义。

Objectives To evaluate the correlation between preoperative pulmonary function tests, surgical approach and postoperative time of tracheal extubation in patients with scoliosis. Methods The case records of 115 patients, who underwent anterior or posterior fusion, were reviewed. And we studied the relative factors on postoperative time of tracheal extubation by multiple linear regression analysis. Results Multiple linear regression showed that the time of tracheal extubation had negative correlation with the VC%, MVV% ,FEVI% ,FEF25% and thoracoplasty. On the other hand, the time of extubation in patients with thoracoplasty was larger than those without thoracoplasty, but the time of extubation in patients with or without thoracotomy had no statistical significance. Conclusions VC%, MVV%, FEV1%, FEF25% and thoracoplasty are the main determinants of the time of extubation in patients with scoliosis. Preoperative pulmonary function evaluation and surgical approach selection may play an important role in determining the time of tracheal extubation in patients with scoliosis.