İDYOPATİK SKOLYOZ TANILI HASTALARDA SOLUNUM FONKSİYONLARI

İdyopatik skolyoz, omurların yana doğru eğilmesi ve kendi etrafında rotasyonundan kaynaklanır. En yaygın olarak büyüme çağında görülmekte olup solunum fonksiyonları üzerinde birçok etkiye sahiptir. Skolyoz intratorasik organların yerini değiştiren, kaburga hareketini engelleyen ve solunum kaslarının mekanik etkilerini etkileyen, kısıtlayıcı-restriktif akciğer hastalığına neden olur. Skolyoz, göğüs duvarını ve akciğer kompliyansını azaltırak dinlenme egzersiz ve uyku esnasında solunum yükünün artması ile sonuçlanır. İlerlemiş hastalıkta pulmoner hipertansiyon ve solunum yetmezliği gelişebilir. Bu derlemede idiyopatik skolyozun solunum fonksiyonları üzerindeki patofizyolojisi ve etkileri tanımlanarak, akciğer volümleri, hava yolu akım ve direnç oranları; göğüs duvarı hareketleri, ventilasyon ve perfüzyon çalışmaları sunulmaktadır. Ameliyat öncesi pulmoner fonksiyon testleri ve çeşitli cerrahi yaklaşımların solunum fonksiyonları üzerindeki etkileri de tartışılmıştır

PULMONARY FUNCTIONS IN PATIENTS WITH IDOPATHIC SCOLIOSIS

Idiopathic scoliosis is most common during periods of rapid somativ growth. It is caused by the lateral displacement and rotation of vertebral bodies and has many effects on respiratory function. Scoliosis results in a restrictive lung disease with a multifactorial decrease in lung volumes, displaces the intrathoracic organs, impedes on the movement of ribs and affects the mechanics of the respiratory muscles. Scoliosis decreases the chest wall as well as the lung compliance and results in increased work of breathing at rest, during exercise and sleep. Pulmonary hypertension and respiratory failure may develop in severe disease. In this review the epidemiological and anatomical aspects of idiopathic scoliosis are noted, the pathophysiology and effects of idiopathic scoliosis on respiratory function are described, the pulmonary function testing including lung volumes, respiratory flow rates and airway resistance, chest wall movements, regional ventilation and perfusion studies are presented. Preoperative pulmonary function testing required, as well as the effects of various surgical approaches on respiratory function are also discussed

Kaynakça

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