青少年特发性脊柱侧凸症网络筛查及早期干预  

Network screening and early intervention of adolescent idiopathic scoliosis

作　　者：聂燕[1] 金掌[1] 张立岩[1] 张凌[1] 金伟燕[1] 应秀华[1] 金丽红[1] 

机构地区：[1]浙江省丽水市人民医院骨科,浙江丽水323000

出　　处：《中国现代医生》2017年第16期16-19,22,共5页China Modern Doctor

基　　金：浙江省丽水市公益性研究计划(2014JYZB39)

摘　　要：目的随访监测青少年脊柱侧凸症患儿非手术治疗效果及侧凸进展程度。方法 2013年5月~2016年2月筛查全市中小学3100名,培训脊柱侧凸检查专业人员,制作脊柱侧凸调查表。制作有关脊柱侧凸科普知识材料、视频,进行脊柱侧凸健康教育、网络随访。然后通过全面体检、X线片检查、第二性征发育情况、骨骼发育情况及脊柱平衡度检查对我市学龄期儿童及青少年实行规模性筛查工作。筛查出的脊柱侧凸病例,分成对照组和实验组。对照组中Cobb角10°~25°患儿,给予观察,做好心理护理+健康生活方式指导;Cobb角26°~45°患儿,同时予佩戴支具。实验组中Cobb角10°~25°患儿,在心理护理、健康生活方式指导的基础上,给予运动疗法+网络教育、随访;Cobb角26°~45°者,同时予规范佩戴支具治疗。每天佩戴时间为23 h,另外1 h用于皮肤护理、运动疗法等。比较两组患儿治疗前、治疗后3、6、12个月的Cobb角,治疗前、治疗后3、6、12个月的生活质量满意度评分。结果两组患儿治疗前与治疗后3、6、12个月的Cobb角变化比较,差异有统计学意义(P<0.05),且实验组优于对照组;两组治疗前与治疗后3、6、12个月的生活质量满意度评分有显著差异,且实验组优于对照组。结论网络筛查可提高青少年特发性脊柱侧凸症患儿的检出率,并可明确脊柱侧凸病例的病理类型与可能的进展情况,并进行早期非手术干预治疗,可减轻患儿脊柱侧凸的严重程度,有效地防止残障的发生或减轻残障的程度,避免或减少手术治疗,减轻社会和家庭经济负担。Objective To follow up and monitor the effect of non-surgical treatment and the degree of scoliosis progression in adolescent patients with scoliosis, and to investigate the results of scoliosis angle, type and classification.Methods 3100 cases of primary and secondary schools from May 2013 to February 2016 were screened. The scoliosis examination professionals were trained, and scoliosis survey tables were made. The materials and videos of scoliosis-related science knowledge were made to carry out scoliosis health education and network follow-up. And then the large-scale screening work on the school children and young people in the city was implemented through a comprehensive physical examination, X-ray filming, secondary sexual development, bone development and spine balance check.The scoliosis cases screened were divided into control group and experimental group. In the control group, observation,good psychological care and healthy lifestyle guidance were given to Cobb angle 10°-25°children, and brace was also given to Cobb angle 26°-45°children. In the experimental group, the exercise therapy＋network education and follow-up were given based on the psychological care and healthy lifestyle guidance to Cobb angle 10° -25° children;meanwhile the standard brace treatment was given to the 26° -45° children. The wearing time was for 23 h, with another 1 h for skin care, exercise therapy and so on. The Cobb angle and the quality of life satisfaction score were compared between the two groups before treatment and after treatment 3, 6, and 12 months. Results There were significant differences in the Cobb angle and quality of life satisfaction scores before treatment and after treatment 3, 6, 12 months between the two groups. Conclusion Network screening can improve the detection rate of adolescent idiopathic scoliosis, and can clarify the pathological type and possible progress of scoliosis cases. And early non-surgical intervention can be carried out to reduce the severity of the scoliosis. This can effectiv

关 键 词：青少年 特发性脊柱侧凸 网络筛查 早期干预 

分 类 号：R744[医药卫生—神经病学与精神病学]