智能支具个性化管理系统治疗青少年特发性脊柱侧凸的初步临床观察  

The preliminary clinical application of a smart orthosis personalized management system for the treatment of patients with adolescent idiopathic scoliosis

作　　者：朱策 吴强[2] 肖冰 王珏翰 罗超[1] 余权 刘立岷[1] 宋跃明[1] ZHU Ce;WU Qiang;XIAO Bing;WANG Juehan;LUO Chao;YU Quan;LIU Limin;SONG Yueming(Department of Orthopedics,Orthopedics Research Institute,West China Hospital,Sichuan University,Chengdu Sichuan,610041,P.R.China;Department of Rehabilitation Medicine,West China Hospital,Sichuan University,Chengdu Sichuan,610041,P.R.China;Chengdu Spine Medical Technology Co.,Ltd,Chengdu Sichuan,610000,P.R.China;Sichuan NeoSource BioTektronics Limited,Chengdu Sichuan,610000,P.R.China)

机构地区：[1]四川大学华西医院骨科骨科研究所,成都610041 [2]四川大学华西医院康复科,成都610041 [3]成都市思倍恩医疗科技有限公司,成都610000 [4]四川新源生物电子科技有限公司,成都610000

出　　处：《中国修复重建外科杂志》2021年第7期801-806,共6页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：四川省科技计划项目(2017SZ0046、2017SZDZX0021);中央高校基本科研业务费专项资金(2012017yjsy192)。

摘　　要：目的设计一种青少年特发性脊柱侧凸(adolescent idiopathic scoliosis,AIS)智能支具个性化管理系统,通过初步临床应用评估其可行性和有效性。方法用无线压力传感器、患者端微信小程序、云存储系统和医生端网站管理后台共同组成智能支具个性化管理系统,纳入2020年3月—12月行支具治疗且符合选择标准的22例AIS患者临床资料进行分析,随访时间4个月。分析指标(背部和腰部)包括:压力基线值、压力实测值、压力依从性(压力实测值/压力基线值×100%)、实测佩戴时长(压力值>0 N的佩戴时长)、时间依从性(实测佩戴时长/规定佩戴时长×100%),其中规定佩戴时长均为23 h/d。初次佩戴支具时测量患者的压力基线值,随访期间测量各时间点的压力实测值、压力依从性、实测佩戴时长和时间依从性,并比较佩戴后1、2、3、4个月各指标。结果22例患者整体(背部+腰部)实测压力平均值为(0.83±0.34)N,压力依从性平均值为68.5%±17.9%,实测佩戴时长平均值为(15.4±1.7)h,时间依从性平均值为66.9%±7.7%。患者背部压力基线值和实测值均显著大于腰部(P<0.05);背部和腰部压力依从性、实测佩戴时长、时间依从性比较,差异均无统计学意义(P>0.05)。佩戴后1个月背部和腰部压力实测值、压力依从性、实测佩戴时长及时间依从性均显著小于佩戴后2、3、4个月(P<0.05);佩戴后2、3、4个月间差异无统计学意义(P>0.05)。佩戴后各时间点除背部压力实测值均显著大于腰部(P<0.05)外,其余各指标背部和腰部间比较差异均无统计学意义(P>0.05)。结论智能支具个性化管理系统治疗AIS具有较高的可行性,可提高该类患者支具佩戴的依从性。Objective To develop a smart orthosis personalized management system for the treatment of patients with adolescent idiopathic scoliosis(AIS)and to evaluate the feasibility and efficiency through clinical preliminary applications.Methods The smart orthosis personalized management system consists of a wireless force monitor,a WeChat Mini Program,a cloud-based storage system,and a website backstage management system.Twenty-two patients with AIS who underwent orthosis treatment and met the selection criteria between March 2020 and December 2020 were enrolled.The follow-up time was 4 months.The parameters used to evaluate patients’compliance were as follows(back and lumbar):baseline force value,measured force value,force compliance(measured force value/baseline force value×100%),measured wearing time(wearing time of force value was more than 0 N),and time compliance(measured wearing time/prescribed wearing time×100%),in which the prescribed wearing time was 23 hours/day.The baseline force values were measured at initiation,while the measured force value,measured wearing time,force compliance,and time compliance were measured during follow-up.The differences of these parameters between back and lumbar,and the differences among these parameters at 1,2,3,and 4 months after orthosis wearing were analyzed.Results The average measured force value of 22 patients(back and lumbar)was(0.83±0.34)N,the average force compliance was 68.5%±17.9%,the average measured wearing time was(15.4±1.7)hours,and the average time compliance was 66.9%±7.7%.The baseline force value and measured force value of back were significantly higher than those of lumbar(P<0.05);the measured wearing time,force compliance,and time compliance between back and lumbar showed no significant difference(P>0.05).The measured force value,measured wearing time,force compliance,and time compliance at 1 month after wearing were significantly lower than those at 2,3,and 4 months after orthosis wearing(P<0.05),no significant difference was found among 2,3,and 4 m

关 键 词：青少年特发性脊柱侧凸 支具治疗 实时监测管理 依从性 

分 类 号：R726.8[医药卫生—儿科]