摘要
目的分析创伤性颈脊髓损伤(TCSCI)患者咳嗽音的一般特征,并探讨其与呼吸肌力量的相关性。方法选取南部战区总医院收治的29例TCSCI患者作为TCSCI组,并随机选取同时段的26例非TCSCI患者作为对照组。分别收集患者咳嗽音信号、呼吸肌力量指标最大吸气压力(MIP)和最大呼气压力(MEP),同时记录2组患者年龄、身高、体质量以及基础疾病等基线资料,记录TCSCI组ASIA分级、损伤节段以及呼吸衰竭发生情况。分析比较2组咳嗽音差异及其与MIP、MEP的相关性,并探讨咳嗽音指标对呼吸衰竭的预测价值。结果2组患者基线资料比较,差异无统计学意义(P>0.05)。TCSCI组咳嗽音评分高于对照组(P<0.01),MIP、MEP、咳嗽峰值流量(CPF)、最大强度、平均强度、有效声压及声压级均低于对照组(P<0.01)。相关性分析显示,咳嗽音评分与MIP、MEP呈负相关(P<0.01),CPF、最大强度、平均强度、有效声压、声压级与MIP、MEP均呈正相关(P<0.01)。亚组分析显示,咳嗽音评分能很好预测TCSCI患者是否发生呼吸衰竭,曲线下面积(AUC)为0.745。结论TCSCI患者咳嗽音指标会发生显著改变且同呼吸肌力量存在相关性,可用于评估TCSCI患者呼吸功能;咳嗽音评分可作为预测TCSCI患者是否发生呼吸衰竭的指标。
Objective To analyze the general characteristics of cough sound in patients with traumatic cervical spinal cord injury(TCSCI)and discuss the correlation between cough sound indicators and respiratory muscle strength.Methods Twenty-nine patients with TCSCI admitted into General Hospital of Southern Theater Command were selected as the TCSCI group,and patients with non-cervical spinal cord injury admitted at the same time were randomly selected as the control group.The cough sound signal and respiratory muscle strength indexes[maximum inspiratory pressure(MIP)and maximum expiratory pressure(MEP)]were collected,and the baseline data of age,height,BMI and underlying diseases of patients in the two groups were recorded.ASIA classification,injury segment and respiratory failure in the TCSCI group were recorded.The differences of cough sounds between the two groups and their correlation with MIP and MEP were analyzed and compared,and the predictive value of cough sound indicators in respiratory failure was discussed.Results There was no significant difference in baseline data between the two groups(P>0.05).The cough score of the TCSCI group was higher than that of the control group(P<0.01),MIP,MEP,cough peak flow(CPF),maximum intensity,average intensity,effective sound pressure and sound pressure level were lower than those of the control group(P<0.01).Correlation analysis showed that cough score was negatively correlated with MIP and MEP(P<0.01);while CPF,maximum intensity,average intensity,effective sound pressure and sound pressure level were positively correlated with MIP and MEP(P<0.01).The subgroup analysis showed that the cough score could predict whether TCSCI patients developed respiratory failure.The area under curve(AUC)was 0.745.Conclusion The cough sound indicators of patients with TCSCI will change significantly,and there is a correlation with respiratory muscle strength,which can be used to evaluate respiratory function of TCSCI patients;cough score can be used as a predictor of respiratory failure in patients with TCSCI.
作者
戴建强
陈坤
蔡学究
张亮达
黄显华
DAI Jian-qiang;CHEN Kun;CAI Xue-jiu;ZHANG Liang-da;HUANG Xian-hua(Department of Orthopedics,General Hospital of Southern Theater Command,Guangzhou Guangdong 510010,China)
出处
《局解手术学杂志》
2021年第2期152-156,共5页
Journal of Regional Anatomy and Operative Surgery
基金
广州市科技计划项目(201804010330)。
关键词
创伤性颈脊髓损伤
呼吸肌力量
最大吸气压
最大呼气压
咳嗽音
咳嗽峰值流量
traumatic cervical spinal cord injury
respiratory muscle strength
maximum inspiratory pressure
maximum expiratory pressure
cough sound
cough peak flow
作者简介
通信作者:戴建强,E-mail:djqysh@163.com。
