支具治疗中度特发性脊柱侧凸患儿59例8年随访  

Orthosis for adolescent midrange idiopathic scoliosis in 59 cases:Eight years follow-up

作　　者：李卫平[1] 王志勇[1] 宋斌[1] 黄建荣[1] 沈慧勇[1] 宋富强[1] 宋洋[1] 

机构地区：[1]中山大学附属第二医院骨科,广东省广州市510120

出　　处：《中国组织工程研究与临床康复》2008年第30期5853-5856,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：背景:对于中度脊柱侧弯畸形患者的治疗干预方法的选择至关重要。目的:观察规律佩戴支具治疗中度特发性脊柱侧凸的疗效,并与间断佩戴和未佩戴矫形支具比较。设计、时间及地点:回顾性病例对比分析,1996-01/2004-12中山大学附属第二医院。对象:中度脊柱侧凸患儿59例,男21例,女38例,年龄12～16岁。34例患儿进行支具治疗,其中部分患儿遵医嘱规律佩戴,每天20～22h;另有部分患儿没有坚持规律佩戴,每天8～10h。另25例因各种原因未遵医嘱佩戴支具而行体操疗法。方法:观察时间为3～7年,平均时间为4.5年。支具的佩戴终止时间以Risser征5度为主要参考指标。通过摄X-ray的脊柱全长片,对比患者观察前后的侧弯角度,原Cobb角>20°现Cobb<10°为消退,Cobb角减少5°以上为减轻,Cobb角相差在5°内为未变,Cobb角增加5°以上为进展,Cobb角大于40°,最终选择手术治疗为失败。主要观察指标:各组治疗结束后临床疗效。结果:规律佩戴支具组有效率达90.9%,间断佩戴支具组有效率达50.0%,未佩戴支具组有效率为48.0%。经比较支具规律组优于支具间断组和无支具组(P<0.05)。结论:坚持正确规律佩戴支具(佩戴时间不应少于20h)治疗中度特发性脊柱侧凸疗效确切。BACKGROUND： Selection of treatment for midrange idiopathic scoliosis is very important. OBJECTIVE： To observe therapeutic effect of orthosis on （midrange） idiopathic scoliosis, and compare with patients interruptively or not wearing orthosis. DESIGN, TIME AND SETTING： Retrospective case control analysis was performed at the Second Hospital of Sun Yat-sen University from January 1996 to December 2004. PARTICIPANTS： Fifty-nine patients with midrange scoliolosis, 21 males and 38 females aged 12-16 years, were included. Thirty-four patients wore orthosis, of which some wore for 20-22 hours daily, while some worn discontinuously, 8 10 hours daily. The other 25 patients did not wear orthosis. METHODS： All patients were observed for 1-7 years （average 4.5 years）. The major reference index of time wearing orthosis was Risser sign. Through total length of X-ray, the patients＇ angle of lateral curvature was compared： Cobb angle 〉 20° was reduced to 〈 10° , and subside （original Cobb angle 〉 20° , current Cobb 〈 10° , relief （Cobb angle decrease at least 5）, unchanged （Cobb angle less than 5）, and failure （Cobb angle 〉 40, at last choose operation）. MAIN OUTCOME MEASURE： Effect of treatment. RESULTS： Efficacy of regular orthosis was 90.9%. interruptive orthosis was 50%, and without orthosis was 48%. Wearing orthosis regularly was significantly better than the other two groups （P 〉 0.05）. CONCLUSION： Regularly wearing orthosis （at least 20 hours） has precise curative effect in treating midrange idiopathic scoliosis.

关 键 词：青少年 脊柱侧凸 支具 

分 类 号：R318[医药卫生—生物医学工程]