生长棒治疗对早发性脊柱侧弯患者血红蛋白和血细胞比容水平的影响。

The Effect of Growing Rod Treatment on Hemoglobin and Hematocrit Levels in Early-onset Scoliosis.

作者信息

Barrett Kody K, Lee Christopher, Myung Karen, Johnston Charles, Shah Suken A, Akbarnia Behrooz A, Skaggs David L

机构信息

*Children's Orthopaedic Center, Children's Hospital of Los Angeles †Department of Orthopaedics, University of California Los Angeles, Los Angeles ∥San Diego Center for Spinal Disorders, La Jolla, CA ‡Department of Orthopaedic Surgery, Texas Scottish Rite Hospital for Children, Dallas, TX §Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE.

出版信息

J Pediatr Orthop. 2016 Sep;36(6):618-20. doi: 10.1097/BPO.0000000000000505.

DOI:10.1097/BPO.0000000000000505

PMID:25944296

Abstract

BACKGROUND

This study examines preoperative hemoglobin (Hgb) and hematocrit (Hct) levels in a group of early-onset scoliosis (EOS) patients and the effect of distraction-based growing rods (GRs) on these levels. Children with EOS are at risk for respiratory insufficiency and chronic hypoxemia. Increased Hgb and Hct levels have been identified as surrogate markers for chronic hypoxemia. A study of patients who underwent VEPTR surgery showed a significant decrease in Hgb levels following surgery.

METHODS

Data were retrospectively collected on 66 EOS patients without confounding respiratory issues or oxygen dependence who were treated with GRs at 5 institutions. Average age at initial surgery was 5.5 years. Patients were followed for a minimum of 2 years (average 3.7 y). Preoperative and postoperative Hgb and Hct levels were converted to Z-scores based on age-adjusted mean blood indices and were compared using a paired t test.

RESULTS

The prevalence of elevated Hgb and Hct levels (Z-score >2) preoperatively was 15% (10/66) and 19% (12/64), respectively. The average Hgb Z-score decreased from 0.20 to -0.31 (P=0.005) 6 to 24 months following surgery and the Hct Z-score decreased from 0.31 to -0.28 (P=0.002) 6 to 24 months following surgery.

CONCLUSIONS

Following distraction-based GR treatment of children with EOS there was a significant decrease in both their Hgb and Hct. This is a physiological marker of decreased hypoxemia and improved pulmonary function.

LEVEL OF EVIDENCE

Level III-therapeutic study.

摘要

背景

本研究检测了一组早发性脊柱侧凸（EOS）患者术前的血红蛋白（Hgb）和血细胞比容（Hct）水平，以及撑开式生长棒（GR）对这些水平的影响。EOS患儿有呼吸功能不全和慢性低氧血症的风险。Hgb和Hct水平升高已被确定为慢性低氧血症的替代标志物。一项对接受垂直可扩张钛肋骨植入术（VEPTR）的患者的研究显示，术后Hgb水平显著下降。