支具治疗指导表指导治疗青少年特发性脊柱侧凸的临床疗效  

Clinical outcomes of brace treatment of adolescent idiopathic scoliosis using the form of guiding bracing treatment

作　　者：王肖虎[1] 夏磊[1] 孟志强[1] 丁勇[1] 王凯[1] 

机构地区：[1]郑州大学第一附属医院骨科,450052

出　　处：《中华骨科杂志》2011年第3期207-212,共6页Chinese Journal of Orthopaedics

摘　　要：目的 建立支具治疗指导表并评价其是否能够正确而有效地指导青少年特发性脊柱侧凸（adolescent idiopathic scoliosis,AIS）患者的支具治疗.方法 2008年3月至2010年6月,采用改良Cheneau支具治疗68例顶椎（apex vertebrae,AV）均在T6以下的AIS患者.根据是否使用支具治疗指导表分组：干预组51例,男16例,女35例;年龄10.6～17.2岁,平均13.6岁;Cobb角20°～38°,平均29.5°;Risser征2～4级;椎体旋转度0～2.对照组17例,男6例,女11例;年龄10.8～16.8岁,平均13.2岁;Cobb角20°～37°,平均28.7°;Risser征2～4级;椎体旋转度0～2.对照组患者在初诊或复查时,被告知规范化的治疗方案;而干预组患者将获得支具治疗指导表2份,嘱其必须按照表格的要求治疗.分析治疗前、治疗后6、12、18个月的Cobb角,评价两组患者的支具治疗效果.结果 对照组中1例和干预组中2例女性患者失访,余65例随访时间为18～27个月.支具治疗指导表的α系数及内部相关系数值均＞0.60,内容效度良好,表格接受率为97.54%（199/204）,合格率为100.00%（199/199）.对照组Cobb角从28.71°降至25.76°,干预组从29.47°降至21.59°.在治疗18个月时,对照组有4例、干预组有34例患者的Cobb角减小值≥5°,两组Cobb角变化比较,差异有统计学意义.结论 支具治疗指导表具有良好的信度和效度,能够正确有效地指导AIS患者的支具治疗.Objective To guide bracing treatment for adolescent idiopathic scoliosis （AIS）. Methods A total of 68 AIS patients with apex vertebrae （AV） under T6 had received the improved Cheneau bracing treatment between March 2008 and June 2010. All patients were divided into two groups. There were 16males and 35 females, with a mean age of 13.6 years （range, 10.6-17.2） in the intervention group. The mean Cobb angle was 29.5° （range, 20°-38°）; Risser sign was 2-4; Vertebralrotation degree was 0-2 in the group;while there were 6 males and 11 females, with a mean of 13.2 years （range, 10.8-16.8） in the control group.The mean Cobb angle was 28.7° （range, 20°-37°）; Risser sign was 2-4; Vertebralrotation degree was 0-2 in the control group. All patients in control group were informed standardized bracing treatment method. But we gave patients in intervention group two copies of ＂The Form of Guiding Bracing Treatment＂ treatment of patients with AIS, and informed that they carried out the bracing treatment according requirement of the form.Cobb angle was measured before the treatment and at 6th, 12th, 18th month after treatment. Results Sixtyfive cases were followed up for 18-27 months. However, one female in control group and two females in intervention group were lost during follow-up. Coefficient and intraclass correlation coefficient of form were both over 0.60. The acceptance rate of the table was 97.54%（199/204）, qualified rate was 100.00%（ 199/199）, and with good content validity. The mean Cobb angle decreased gradually from 28.71° to 25.76° in control group and from 29.47° to 21.59° in intervention group. Four cases in control group and 34 cases in intervention group had reduced more than 5° at 18 months after treatment. There was significant difference regarding Cobb angle between two group. Conclusion The form of guiding bracing treatment has good reliability and validity and can guide bracing treatment of AIS correctly and effectively.

关 键 词：青少年 脊柱侧凸 矫形外科器材 

分 类 号：R682.3[医药卫生—骨科学]