肺功能测试对脊柱侧弯矫正手术术中和术后心肺并发症的预测性：一项回顾性研究

Predictability of pulmonary function tests for intra- and post-operative cardiopulmonary complications of corrective surgery to treat scoliosis: a retrospective study.

作者信息

Kang Gi Run, Lee Il Ok

机构信息

Department of Anesthesiology and Pain Medicine, College of Medicine, Korea University, Guro Hospital, Seoul, Korea.

出版信息

Korean J Anesthesiol. 2009 Nov;57(5):590-596. doi: 10.4097/kjae.2009.57.5.590.

DOI:10.4097/kjae.2009.57.5.590

PMID:30625930

Abstract

BACKGROUND

This study was conducted to confirm the predictive power of preoperative pulmonary functions tests (PFTs) for intra- and post-operative cardiopulmonary complications during corrective surgery for scoliosis.

METHODS

A retrospective review of hospital charts of patients who underwent surgical correction for scoliosis and/or kyphosis at our medical center between September 2002 and September 2008 was performed.

RESULTS

A total of 141 patients were enrolled in this study. The overall intra- and post-operative cardiopulmonary complication rate was 33.3% (47/141). There were 32 and 19 complications related to pulmonary issues (22.7%) and cardiovascular complications (13.5%), respectively. The complication rate of neuromuscular scoliosis (NMS) was 47.3% (35/74), while that of non-neuromuscular scoliosis (NNMS) was 17.9% (12/67). The cardiopulmonary complication rates of groups with FEV1 volumes below 1 L, 1-1.5 L, 1.5-2 L and over 2 L were 66.7% (18/27), 43.3% (13/30), 20.0% (7/35) and 18.4% (9/49), respectively. The group with FEV1 volumes below 1 L showed a significantly increased risk when compared to the group with FEV1 volumes over 2 L (P<0.05, Odds ratio = 5.15, multivariate logistic regression test). The cardiopulmonary complication rates of groups with FVC volumes below 1 L, 1-1.5 L, 1.5-2 L and over 2 L were 70.8% (17/24), 37.5% (9/24), 33.3% (11/33) and 16.7% (10/60), respectively. Additionally, the group with FVC volumes below 1 L showed significantly increased risk when compared to a group with FVC volumes greater than 2 L (P<0.001, Odds ratio = 8.0, multivariate logistic regression).

CONCLUSIONS

The correction for NMS carries a higher complication rate than NNMS. Intra- and post-operative cardiopulmonary complication rates of a group with FEV1 or FVC volumes below 1 L were higher than the rates of groups with FEV1 and FVC volumes greater than 2 L.

摘要

背景

本研究旨在证实术前肺功能测试（PFTs）对脊柱侧弯矫正手术期间及术后心肺并发症的预测能力。

方法

对2002年9月至2008年9月间在我院医疗中心接受脊柱侧弯和/或后凸畸形手术矫正的患者病历进行回顾性分析。

结果

本研究共纳入141例患者。术中和术后总的心肺并发症发生率为33.3%（47/141）。与肺部问题相关的并发症有32例（22.7%），心血管并发症有19例（13.5%）。神经肌肉型脊柱侧弯（NMS）的并发症发生率为47.3%（35/74），而非神经肌肉型脊柱侧弯（NNMS）的并发症发生率为17.9%（12/67）。第一秒用力呼气容积（FEV1）低于1L、1 - 1.5L、1.5 - 2L和超过2L的组，其心肺并发症发生率分别为66.7%（18/27）、43.3%（13/30）、20.0%（7/35）和18.4%（9/49）。FEV1低于1L的组与FEV1超过2L的组相比，风险显著增加（P<0.05，比值比 = 5.15，多因素逻辑回归检验）。用力肺活量（FVC）低于1L、1 - 1.5L、1.5 - 2L和超过2L的组，其心肺并发症发生率分别为70.8%（17/24）、37.5%（9/24）、33.3%（11/33）和16.7%（10/60）。此外，FVC低于1L的组与FVC大于2L的组相比，风险显著增加（P<0.001，比值比 = 8.0，多因素逻辑回归）。