台灣漏斗胸(凹胸)病友協會

此次日本的太平洋小兒外科醫學會中,, 有一篇由兩岸的華人資料合併所做的分析報告.是由北京兒童醫院, 長庚醫院, 及朱志純醫師的病人們的資料分析得出, 僅在此列出摘要, 由於是華人的跨兩岸資料, 可供大多數病友們參考


A Cross-sectional Study of Lung Volume Development in Pectus Excavatum Patients: Estimating the Total Lung Volume from Chest CT using Three-dimensional Volumetric Reconstruction

(跨機構漏斗胸病人肺容積發育評估--以胸部電腦斷層三度容積重建來估算全肺容積)


這一篇是由 我, 北京兒童醫院, 及長庚醫院的病人電腦斷層分析, 計算其肺容量的結果


Background/Purpose: This study quantified the lung volume development of pectus excavatum (PE) patients using chest computed tomography (CT) three-dimensional volumetric reconstructions. The technique permits current and retrospective analyses of data from different institutions.



Patients and Methods: We analyzed the records of PE patients who underwent chest CT preoperatively between 2005 and 2009 at three institutions. All patients were Chinese. A window of –992 to –198 Hounsfield units was chosen for calculating the CT total lung volume (TLV). The data were compared with the data for 73 microtia and other chest-wall tumor patients studied during the same period as a control group.

所有納入評估的病人均為2005至2009年間接受胸部電腦斷層之有漏斗胸之華人, 以其胸部電腦斷之三度空間重組計算, 與同時期非漏斗胸的病人對照組比較.

Results: In total, 377 PE patients with Haller pectus index (PI) ≥3.2 were identified for this study. Compared with reported TLV data for 1050 normal children and our control group, we found little evidence of a decreased TLV in PE patients at any age for either sex. The mean PI did not change significantly between the ages of 3 and 27 years. The PI was inversely correlated with the TLV (p < 0.001).

凹陷指數在3.2以上者377人納入評估; 對照組則有1050人, 全肺容積(Total Lung Capacity, TLC), 不論男女, 在3至27歲間, 皆無明顯差別.

Conclusion: Our cross-sectional study provides evidence that the TLV of PE patients is within the normal range in children and adolescents.


結論: 兒童及青春期之漏斗胸患者之全肺容積在正常範圍.



感言:


一. 即使臨床上有明顯的生長遲滯, 呼吸困難, 呼吸道感染不易健癒等等肺功能問題, 但僅憑胸部電腦斷層, 只能有解剖學上的評估, 只要橫膈向下壓迫腹部, 造成腹部凸起, 在全肺容量的減少則可由代償, 在電腦斷層上則不會呈現明顯變化,所以即使兒童病患不易配合肺功能檢查的, 也不能依賴電腦斷層來評估肺功能

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二. TLC全肺容量, 即使在明顯凹陷的病人, 仍不會有明顯變化, 最好用FVC(forced vital capacity)來評估, 可是不幸的是, 我國兵役檢查漏斗胸部分, 就是以TLC來評斷.