先天性脊柱侧弯合并肋骨畸形及其对肺功能影响的分析

Lung function in congenital scoliosis with ribs deformity

目的：比较先天性脊柱侧弯患者肺功能情况与脊柱畸形、肋骨畸形之间的关系，分析肺功能受损的相关因素。方法总结203例先天性脊柱侧弯患者肺功能检查结果和脊柱畸形、肋骨畸形情况，分析肺功能结果与脊柱侧弯和肋骨畸形等相关影像学因素之间的关联。结果先天性脊柱侧弯患者肺功能不同程度下降，均为限制性改变；Cobb 角与肺功能肺活量实测值／预计值（VCmax％）存在相关性（P ＜0.01）；去除 Cobb 角因素，胸段组脊柱侧弯患者肺功能低于胸腰段组（P ＜0．01）；203例中，肋骨畸形的发生率约45．8％，其中合并肋骨缺如26例，肋骨融合56例，肋骨缺如与融合11例；合并连续3根以上肋骨融合的患者25例，其肺功能较非合并严重肋骨畸形的患者差（P ＜0.05）。结论先天性脊柱侧弯患者肺功能不同程度降低，侧弯越严重，累计胸廓畸形的范围越大，尤其是合并广泛肋骨畸形时，其降低越明显。

Objetive To describe the respiratory compromise in congenital scoliosis patients with or without ribs deformity and analyse the relation between ribs deformity and lung function. Methods 203 pa-tients were retrospectively reviewed to document the clinical data including lung function results,spine deformi-ty and ribs deformity.The correlation between lung function results and Cobb’s angle and rib deformity were analyzed.Results The lung function results of patients were all decreased,which all of them were restrictive lung function impairment.Lung function VCmax% were correlate with Cobb’s angle （P 〈0.01 ）;despite Cobb’s angle’s affect,the lung fuction result of thorax group and whole spine group were below the thoracolum-bar group（P 〈0.01;P 〈0.01）;The incidence of rib deformity in 203 scoliosis patient was 45.8%.There were 26 patients with rib absence,56 with fused ribs,11 with both deformities.25 patients with at least 3 fused ribs,whose lung function were decresed than others（P 〈0.05）. Conclusions The lung function of congenital scoliosis are decreased with various degrees.The more scoliosis serious,range of deformity be,the more lung function decreased.Wide-range rib deformity will further damage the lung function of scoliosis patients.