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脊髓损伤患者的肺功能变化 被引量:11

Changes of the pulmonary function in patients with spinal cord injury(SCI)
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摘要 目的探讨脊髓损伤患者肺功能变化的特点及影响因素。方法共分析86例脊髓损伤患者的肺功能指标,比较颈髓损伤(48例)及胸腰髓损伤(38例)患者的肺活量(VC)、用力呼气肺活量(FVC)、最大通气量(MVV)、1秒钟最大呼气量(FEV_(1.0))预测百分比(分别记作VC%,FVC%,MVV%,FEV_(1.0))间的差异;并应用多元逐步回归分析研究患者性别、年龄、病程、体重指数、损伤部位(颈髓或胸髓损伤)、ASIA感觉/运动评分以及残损分级与脊髓损伤患者VC,FVC,MVV及FEV_(1.0)间的相关性。结果颈髓和胸腰段脊髓损伤患者VC%,FVC%,MVV%及FEV_(1.0)%均有不同程度下降,以颈髓损伤患者各项肺功能指标的下降幅度较为显著(P<0.01);多元逐步回归分析显示,影响VC,FVC,MVV及FEV_(1.0)的主要因素包括损伤部位、运动评分和性别。结论脊髓损伤患者(特别是颈髓损伤患者)均存在不同程度通气功能障碍;ASIA运动评分是影响脊髓损伤患者肺功能的主要指标之一。 Objective To investigate the features and influencing factors associated with pulmonary function in subjects with spinal cord injury (SCI). Methods The pulmonary function data of 86 patients obtained by spirometry, including 48 at cervical and 38 at thoracolumbar level were analyzed. The values of vital capacity(VC) , forced vital capacity (FVC) , maximal voluntary ventilation (MVV) , forced expiratory volume( FEV1-0 ) expressed as percentage of those of the normal subjects (VC% , FVC% , MVV% ,FEVI.0% respectively) were obtained and compared between cervical and thoracolumbar spinal cord injuries by independent-samples t-tests,then the muhivariable stepwise regression analysis was performed to study the relationship between such factors as age, gender, duration of SCI, body weight index(BMI) ,the level of lesion (cervical or thoracolumbar injury), motor/sensory index score and ASIA (American Spinal Injury Association) impairment scale and the pulmonary function parameters including VC, FVC, MVV and FEV1-0. Results VC% , FVC% , MVV% , FEVl-0% decreased in all the subjects with cervical and thoracolumbar spinal cord injuries, and were lower in patients with cervical injuries than those with thoracolumbar spinal cord injury significantly. The multivariable stepwise regression analysis showed that the common powerful influencing parameters to the VC, FVC, MVV, FEV1-0 were the level of lesion, gender and the motor index score. Conclusion The SCI patients demonstrated ventilation impairment, especially those with spinal cord injuries at the cervical level ,and the motor index score of ASIA was one of the main factors related to the pulmonary function of SCI patients.
出处 《中华物理医学与康复杂志》 CAS CSCD 北大核心 2007年第12期811-814,共4页 Chinese Journal of Physical Medicine and Rehabilitation
关键词 脊髓损伤 呼吸功能试验 肺活量 用力呼气量 最大通气量 Spinal cord injury Respiratory function Vital capacity Forced expiratory volume Maximal voluntary ventilation
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参考文献13

  • 1McMichan JC, Michel L, Westbrook PR. Pulmonary dysfunction following traumatic quadriplegia. Recognition, prevention and treatment. JAMA, 1980,243:528-531.
  • 2DeVivo MJ,Blaek KJ,Stover SL. Causes of death during the first 12 years after spinal cord injury. Arch Phys Med Rehabil, 1993,74: 248 -254.
  • 3Winslow C, Bode RK, Fehon D, et al. Impact of respiratory complications on length of stay and hospital costs in acute cervical spine injury. Chest, 2002,121 : 1548-1554.
  • 4Urdaneta F, Layon AJ. Respiratory complications in patients with traumatic cervical spine injuries : case report and review of the literature. J Clln Anesth,2003,15:398-405.
  • 5孙岚,徐基民,徐知非.颈段脊髓损伤患者肺功能分析[J].中国康复理论与实践,2006,12(4):293-294. 被引量:17
  • 6汪丽惠 许广润 等.现代内科诊疗手册[M].北京:北京医科大学.中国协和医科大学联合出版社,1994.54.
  • 7Estenne M, De Troyer A. The effects of tetraplegia on chest wall statics. Am Rev Respir Dis, 1986,134 : 121-124.
  • 8Baydur A,Adkins RH, Milic-Emili J. Lung mechanics in individuals with spinal cord injury: effects of injury level and posture. J Appl Physiol,2001,90 :405 -411.
  • 9Spungen AM, Diepinlgaltis PV, Almenoff PL,et al. Pulmonary obstruction in individuals with cervical spinal cord lesions unmasked by bronehodilator administration. Paraplegia, 1993,31:404-407.
  • 10Feln ED, Grimm DR, Lesser M, et al. The effects of ipratropium bromide on histamine-induced bronchoconstrictlon in subjects with cervical spinal cord injury. J Asthma, 1998,35:49-55.

二级参考文献33

  • 1陈莉,赵明,韩少梅,李仲铭,朱广瑾.河北省正常人群肺功能检测分析[J].中国医学科学院学报,2004,26(4):463-466. 被引量:37
  • 2赵红梅,郭险峰,孟申,关骅.急性颈髓损伤合并肺部感染的临床研究[J].中国康复理论与实践,2004,10(12):776-777. 被引量:19
  • 3刘世琬 孙可谆 柯以恕 见:穆魁津 刘世琬主编.华北地区常规肺功能正常值测定[A].见:穆魁津,刘世琬主编.全国肺功能正常值汇编[C].北京:北京医科大学、中国协和医科大学联合出版社,1990.1-21.
  • 4罗炎杰 袁玉如 见:陈文彬 程德云主编.临床常用肺功能测定[A].见:陈文彬,程德云主编.呼吸系统疾病诊疗技术[C].北京:人民卫生出版社,2000.29-51.
  • 5林友华.呼吸功能检查[A].见:罗慰慈主编.现代呼吸病学[C].北京:人民军医出版社,1997.295-319.
  • 6周永增 见:王继先 陈如松编著.肺功能正常值及ICRP呼吸道模型[A].见:王继先,陈如松编著.中国参考人解剖生理和代谢数据[C].北京:原子能出版社,1998.158-176.
  • 7Winslow C, Bode RK, Felton D, et al. Impact of respiratory complications on length of stay and hospital costs in acute cervical spine injury. Chest, 2002, 121:1548-1554.
  • 8Claxton AR, Wong DT, Chung F, et al. Predictors of hospital mortality and mechanical ventilation in patients with cervical spinal injury. Can J Anaesth, 1998, 45:144-149.
  • 9Lu K, Lee T, Liang C, et al. Delayed apnea in patients with mid- to lower cervical spinal cord injury. Spine, 2000, 25:1332-1338.
  • 10Davis K Jr, Campbell RS, Johannigman JA, et al. Changes in respiratory mechanism after tracheotomy. Arch surg, 1999, 134:59-62.

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