Halo重力牵引联合康复干预对Ⅰ型神经纤维瘤病伴重度脊柱侧凸患者肺功能的影响

Effect of Halo gravity traction combined rehabilitation nursing on lung function of typeⅠneurofibromatosis patients with severe scoliosis

目的探讨Halo重力牵引联合康复干预在Ⅰ型神经纤维瘤病伴重度脊柱侧凸患者中的应用效果。方法选取于2018年8月至2019年8月河北省唐山市第二医院收治的Ⅰ型神经纤维瘤病伴重度脊柱侧凸患者38例,采用随机数字表法分为对照组(18例)和干预组(20例)。两组均在术前进行8周的Halo重力牵引,对照组在牵引过程中接受常规安全管理,干预组在对照组的基础上实施康复干预,比较两组患者的牵引效果及肺功能恢复情况。结果两组治疗后侧凸主弯Cobb角、全脊柱Cobb角、脊柱柔韧性均较治疗前明显改善,差异有显著性(P<0.05),但两组间比较差异无显著性(P>0.05)。干预组治疗后用力肺活量、第1秒用力呼气容积均明显优于治疗前,且明显优于对照组,差异有显著性(P<0.05)。结论术前行Halo重力牵引联合康复干预可改善Ⅰ型神经纤维瘤病伴重度脊柱侧凸患者的脊柱侧凸情况,并在一定程度上改善患者的肺功能。

Objective To explore the application effect of halo gravity traction combined with rehabilitation intervention in patients with type I neurofibromatosis and severe scoliosis.Method A total of 38 NF1 patients with severe scoliosis admitted to the second hospital of Tangshan City,Hebei Province from August 2018 to August 2019 were randomly divided into control group(18 cases)and intervention group(20 cases).Halo gravity traction was performed in both groups for 8 weeks before operation.The control group received routine safety management during the traction process,and the intervention group received rehabilitation intervention on the basis of the control group.The traction effect and pulmonary function recovery of the two groups were compared.Result The Cobb angle of the main curve,Cobb angle of the whole spine and spinal flexibility of the two groups were significantly improved after treatment(P<0.05),but there was no significant difference between the two groups(P>0.05).After treatment,the forced vital capacity and forced expiratory volume in the first second in the intervention group were significantly better than those before treatment,and were significantly better than those in the control group(P<0.05).Conclusion Preoperative halo gravity traction combined with rehabilitation intervention can improve the scoliosis of patients with neurofibromatosis type I with severe scoliosis,and improve the lung function of patients to a certain extent.