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        west china medical publishers
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        find Author "宋心月" 2 results
        • 成人超重和肥胖患者體重指數與肺功能的關系

          目的 探討成人超重和肥胖患者人體重指數(BMI)與肺功能的關系,并試圖分析極度肥胖(BMI>40 kg/m2)患者彌散功能的改變。 方法 回顧性收集2021年1月—2023年12月到四川大學華西醫院就診的超重和肥胖患者390例的一般資料和肺功能數據,根據患者身高和體重計算BMI。根據世界衛生組織肥胖分級,分為超重組(25 kg/m2≤BMI<30 kg/m2,n=37)、Ⅰ級肥胖組(30 kg/m2≤BMI<35 kg/m2,n=106)、Ⅱ級肥胖組(35 kg/m2≤BMI<40 kg/m2,n=110)和Ⅲ級肥胖組(BMI≥40 kg/m2,n=137)。采用方差分析或Wilcoxon配對符號秩檢驗比較根據BMI不同分組間患者的肺功能指標。Spearman或Pearson相關性分析判定BMI與肺功能各指標之間的相關性,并使用簡單線性回歸或分段線性回歸進行相關性分析。結果 不同BMI分組在超重和肥胖患者中年齡、性別和吸煙史的差異有統計學意義(P<0.05)。肺功能數據比較:Ⅲ級肥胖組用力肺活量占預計值百分比(FVC%pred)、肺總量占預計值百分比(TLC%pred)、肺活量占預計值百分比(VC%pred)、第1秒用力呼氣容積占預計值百分比(FEV1%pred)、最大呼氣流量占預計值百分比(PEF%pred)低于超重組和Ⅰ級肥胖組(P<0.05),超重組深吸氣量占預計值百分比(IC%pred)高于Ⅰ級肥胖組、Ⅱ級肥胖組和Ⅲ級肥胖組(P<0.05),超重組和Ⅰ級肥胖組肺一氧化碳彌散量占預計值百分比(DLCO%pred)低于Ⅱ級肥胖組(P<0.05),FEV1/FVC、峰值呼氣中段流量占預計值百分比(MMEF%pred)在四組之間沒有明顯差異。相關性分析顯示,VC%pred(r=–0.254,P<0.05)、TLC%pred(r=–0.151,P<0.05)與BMI呈負相關。BMI<40 kg/m2時,DLCO%pred與BMI正相關(r1=0.224,P<0.05);BMI≥40 kg/m2時,DLCO%pred與BMI呈負相關(r2=–0.176,P<0.05)。結論 隨著BMI升高,超重和肥胖患者肺通氣功能下降,主要表現為限制性通氣功能障礙。當BMI<40 kg/m2時,超重和肥胖患者彌散功能隨BMI增加而升高,可能原因是其肺血容量增加使DLCO%pred升高;但BMI≥40 kg/m2時,患者彌散功能隨BMI增加而下降,可能原因是極度肥胖時肺泡組織受脂肪浸潤或結締組織沉積導致的擴散障礙。

          Release date:2024-11-20 10:31 Export PDF Favorites Scan
        • Research progress of etiologies for C5 palsy after cervical decompression

          ObjectiveTo review the definition and possible etiologies for C5 palsy. MethodsThe literature on C5 palsy at home and abroad in recent years was extensively reviewed, and the possible etiologies were analyzed based on clinical practice experience. ResultsThere are two main theories (nerve root tether and spinal cord injury) accounting for the occurrence of C5 palsy, but both have certain limitations. The former can not explain the occurrence of C5 palsy after anterior cervical spine surgery, and the latter can not explain that the clinical symptoms of C5 palsy is often the motor dysfunction of the upper limb muscles. Based on the previous reports, combining our clinical experience and research, we propose that the occurrence of C5 palsy is mainly due to the instrumental injury of anterior horn of cervical spinal cord during anterior cervical decompression. In addition, the C5 palsy following surgery via posterior approach may be related to the nerve root tether caused by the spinal cord drift after decompression. ConclusionIn view of the main cause of C5 palsy after cervical decompression, it is recommended to reduce the compression of the spinal cord by surgical instruments to reduce the risk of this complication.

          Release date:2022-03-22 04:55 Export PDF Favorites Scan
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