台灣漏斗胸(凹胸)病友協會

The Journal of pediatrics. 2011 Mar 21;


Increasing Severity of Pectus Excavatum Is Associated with Reduced Pulmonary Function.

隨著凹胸程度嚴重, 肺功能降低

Lawson ML, Mellins RB, Paulson JF, Shamberger RC, Oldham K, Azizkhan RG, Hebra AV, Nuss D, Goretsky MJ, Sharp RJ, Holcomb GW, Shim WK, Megison SM, Moss RL, Fecteau AH, Colombani PM, Moskowitz AB, Hill J, Kelly RE

OBJECTIVE: To determine whether pulmonary function decreases as a function of severity of pectus excavatum, and whether reduced function is restrictive or obstructive in nature in a large multicenter study.

STUDY DESIGN: We evaluated preoperative spirometry data in 310 patients and lung volumes in 218 patients aged 6 to 21 years at 11 North American centers. We modeled the impact of the severity of deformity (based on the Haller index) on pulmonary function.

RESULTS: The percentages of patients with abnormal forced vital capacity (FVC), forced expiratory volume in 1 second (FEV(1)), forced expiratory flow from 25% exhalation to 75% exhalation, and total lung capacity findings increased with increasing Haller index score. Less than 2% of patients demonstrated an obstructive pattern (FEV(1)/FVC <67%), and 14.5% demonstrated a restrictive pattern (FVC and FEV(1) <80% predicted; FEV(1)/FVC >80%). Patients with a Haller index of 7 are >4 times more likely to have an FVC of ≤80% than those with a Haller index of 4, and are also 4 times more likely to exhibit a restrictive pulmonary pattern.
結果:不正常的肺功能指標的比率, 如用力肺活量(FVC), 第一秒FVC, 25~75%用力呼氣速度 , 及全肺容量(TLC)等等肺功能指標, 皆隨凹陷指數(Haller index)之增加而增加. 如凹陷指數大於7, 則有大於四倍的機會有限制性肺功能障礙.



CONCLUSIONS: Among patients presenting for surgical repair of pectus excavatum, those with more severe deformities have a much higher likelihood of decreased pulmonary function with a restrictive pulmonary pattern.