不同类型青少年特发性脊柱侧凸患者臀部压力及身体倾斜分析  

Analysis of buttock pressure and trunk tilt in patients with different types of adolescent idiopathic scoliosis

作　　者：袁望舒[1] 陈丽霞[1] 沈建雄[2] 陈铮威 张宇航 石润林 张厚强 YUAN Wangshu;CHEN Lixia;SHEN Jianxiong;CHEN Zhengwei;ZHANG Yuhang;SHI Runlin;ZHANG Houqiang(Department of Rehabilitation Medicine;Department of Orthopaedics,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院康复医学科,北京100730 [2]中国医学科学院北京协和医学院北京协和医院骨科,北京100730

出　　处：《中华骨与关节外科杂志》2022年第7期507-512,共6页Chinese Journal of Bone and Joint Surgery

摘　　要：目的:探讨青少年特发性脊柱侧凸(AIS)的类型与患者臀部压力、身体倾斜(简称体倾)的关系。方法:回顾性分析2021年2—6月收治的179例AIS患者。选择同期就诊的非AIS患者30例作为对照。测量AIS患者和非AIS患者左右臀部压力,并标记其体倾方向。比较不同分型AIS患者臀部压力和体倾情况。结果:单弯(腰弯)的AIS患者,腰弯凸侧的臀部压力峰值为(89.6±38.6)mmHg(1 mmHg=0.133 kPa),高于凹侧的(77.0±26.8)mmHg,且差异有统计学意义(P=0.007)。双弯(胸弯+胸腰弯或腰弯)的AIS患者,腰弯凸侧的臀部压力峰值为(98.0±40.4)mm Hg,臀部压力平均值为(28.3±6.2)mmHg,均高于凹侧的(79.3±40.2)mmHg和(24.8±6.1)mmHg,且差异均有统计学意义(P均<0.001)。三弯(上胸弯+胸弯+胸腰弯或腰弯)的AIS患者,腰弯凸侧的臀部压力平均值为(25.7±4.4)mmHg,高于凹侧的(22.9±3.6)mmHg,且差异有统计学意义(P=0.021)。腰弯、胸弯+胸腰弯或腰弯、上胸弯+胸弯+胸腰弯或腰弯的患者体倾方向与其腰弯凸侧方向相同,分别占84.1%(37/44)、81.0%(51/63)和77.8%(7/9)。结论:AIS患者臀部压力和体倾与腰椎的相关性较大。腰椎凸侧的臀部压力大于凹侧,体倾方向与腰椎凸侧方向相同。本研究结论可用来对比治疗前后AIS患者坐姿改善的效果;亦可指导保守治疗,采取提高腰椎凸侧骨盆从而矫正腰椎侧凸。Objective: To explore the correlation between buttock pressure and trunk tilt in patients with different types of adolescent idiopathic scoliosis(AIS). Methods: A total of 179 AIS patients admitted to our hospital between February and June 2021 were enrolled in this retrospective study. Meanwhile, 30 healthy people were selected as normal control group. The buttock pressure of scoliosis patients and normal controls was measured and their trunk tilt was marked. The buttock pressure and trunk tilt were compared in patients with different types of AIS. Results: In AIS patients with single curve(lumbar curve), the peak buttock pressure on the convex side was higher than that on the concave side([89.6±38.6] mmHg, [77.0±26.8] mmHg, P=0.007). In AIS patients with double curves(thoracic curve plus thoracolumbar or lumbar curve, TTL curve), the peak value and average value of buttock pressure on the convex side of lumbar curve were(98.0±40.4) mmHg and(28.3±6.2) mm Hg, respectively, which were higher than those on the concave side([79.3±40.2] mmHg,[24.8±6.1] mmHg, P<0.001). InAIS patients with three curves(upper thoracic curve plus thoracic curve plus thoracolumbar or lumbar curve,UTTL curve), the average buttock pressure on the convex side of lumbar curve was higher than that on the concave side([25.7±4.4] mmHg,[22.9±3.6] mmHg, P=0.021). Patients with lumbar curve, TTL curve and UTTL curve had the same trunk tilt direction as that of lumbar curve, accounting for 84.1%(37/44), 81.0%(51/63) and 77.8%(7/9), respectively. Conclusions: There is a great correlation between buttock pressure, trunk tilt and lumbar curve. The buttock pressure on the convex side of lumbar spine is higher than that on the concave side. The trunk tilt direction is the same as the direction of lumbar curve. This study can be used to compare the treatment effect and guide conservative treatment in AIS patients, that is, correct lumbar curve by raising the pelvis on the lumbar convex side.

关 键 词：青少年特发性脊柱侧凸 臀部压力 身体倾斜 生物力学 

分 类 号：R682[医药卫生—骨科学]