生长棒技术治疗早发性脊柱侧凸术后的肺功能变化

Pulmonary function changes after growing rod surgery for progressive early-onset scoliosis

目的分析生长棒技术治疗早发性脊柱侧凸术后的肺功能变化。方法2002年9月至2011年7月，以生长棒技术治疗早发性脊柱侧凸患者10例，男3例，女7例；年龄6-9岁．平均（7．O±1．1）岁。9例为先天性脊柱侧凸，1例为神经肌肉型脊柱侧凸。4例已完成最终融合手术（已融合组），6例未完成最终融合手术（未融合组）。记录每次手术术前的用力肺活量（FVC）、一秒钟用力呼气容积（FEV1）、Cobb角、C7-S1距离，计算FVC、FVC／FVC预测值百分比、FEV1、FEV1／FEV1预测值百分比变化，分析FVC变化与Cobb角变化及C7-S1距离变化的相关性。结果已融合组中FVC与FEV1均增高，其中最终融合术前与生长棒置入术前FVC的差异有统计学意义。未融合组中FVC与FEV1均增高．末次延长术前与生长棒置入术前FVC、FEV1的差异均具有统计学意义。两组病例生长棒置入术前与末次手术前FVC／FVC预测值百分比及FEV1／FEV1预测值百分比的变化均无统计学意义。FVC变化与Cobb角变化及C7-S1距离变化值无相关性。结论生长棒技术治疗早发性脊柱侧凸术后肺功能得到改善，肺功能的改善与Cobb角变化及C7-S1距离变化无关。

Objective To retrospectively analyze pulmonary function changes after growing rod surgery for progressive early-onset seoliosis. Methods Ten cases of progressive early-onset scoliosis treated with growing rod technique from September 2002 to July 2011 were enrolled in the study. There were 3 males and 7 females, aged from 6 to 9 years （average, 7.0±1.1 years）. Four patients had finished the final fu-sion surgery （Group fusion）, and 6 patients （Group non-fusion） were in the process of periodic lengthening. Forced vital capacity （FVC）, FVC/predieted FVC ratio, forced expiratory volume in one second （FEV1）, FEV1/predicted FEV1 ratio, Cobb＇s angle, and C7-S1 distance before each surgery were recorded. Lung func-tion changes and correlations between lung function changes and radiographic changes （Cobb＇s angle and C7-S1 distance） were analyzed. Results In Group fusion, both FVC and FEV1 increased, and FVC showed a significant difference. In Group non-fusion, FVC and FEV1 also increased and both showed a significant dif-ference. FVC/predicted FVC ratio and FEV1/predicted FEV1 ratio both changed similarly and did not show statistical differences in the two groups. There were no significant correlations between lung function changes and radiographic changes （Cobb＇s angle and C7-S1 distance）. Conclusion Pulmonary function improves after growing rod surgery for progressive early-onset seoliosis. The pulmonary function changes do not correlate with changes of Cobb＇s angle and C7-S1 distance.