PULMONARY FUNCTION OF SEVERE CERVICAL SPINAL CORD INJURY:ACUTE MANAGEMENT AND LONG TERM FOLLOW UP RESULT

概要

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15 severe cervical spinal cord injury patients were treated actively in Isesaki City Hospital from eight years ago. Injured cord levels were C2 1 case, C4 6 cases, C6 6 cases, C6 2 cases. The age distribution of the patients ranged from 16 to 74, with an average of 46 years. Thirteen were males, two females. In acute stage, all patients were of the abdominal respiratory type and slight hypoxia (PaO2 ranged from 38 to 80mmHg) in blood gas analysis. In pulmonary function test, the majority of patients showed restrictive pattern and four cases occurring pulmonary complications were of the mixed pattern. We were able to set up the critical level predicting the occurrence of pneumonia and atelectasis as follows : PaO2, % vital capacity and % forced expiratory volume were under 66mmHg, 50% and 70%, respectively. At the follow up time, two cases died and thirteen cases still remained to be the abdominal respiratory type and the restrictive pulmonary pattern. Five walking cases were capable of using intercostal muscles when doing deep breathing exercises and were nearing normal pulmonary function. We have concluded that the pulmonary function test was essential to the management of acute severe cervical spinal cord injury adding blood gas analysis and one of the quantitative analyses of muscle strength of extremities in chronic state.
北関東医学会の論文