赤峰市548名小学生姿势性脊柱侧弯的干预效果  

Effect of intervention on postural scoliosis in 548 pupils in Chifeng City

作　　者：王玉娥 武珊珊[3] 刘佐相 高天奎 徐鑫 徐帅[4] 孙凤[1] WANG Yu-e;WU Shan-shan;LIU Zuo-xiang;GAO Tian-kui;XU Xin;XU Shuai;SUN Feng(Department of Epidemiology and Health Statistics,School of Public Health,Peking University,Beijing,100191,China)

机构地区：[1]北京大学公共卫生学院流行病与卫生统计学系,北京100191 [2]赤峰松山医院,内蒙古赤峰024005 [3]首都医科大学附属北京友谊医院临床流行病学与循证医学研究室,国家消化系统疾病临床医学研究中心,北京100050 [4]北京大学人民医院脊柱外科,北京100044

出　　处：《中国健康教育》2022年第10期888-891,931,共5页Chinese Journal of Health Education

基　　金：赤峰市自然科学研究项目(SZR019)。

摘　　要：目的评价“学生-家庭-学校-医疗”四位一体的综合性干预模式对小学生姿势性脊柱侧弯的预防效果。方法按照知情同意,自愿参加的原则,随机抽取赤峰市两所城区小学的四、五年级学生进行脊柱弯曲异常的筛查,结合学校对干预措施的配合意愿,将筛查无异常者按校区分为干预组和对照组,对干预组进行为期6个月的跟踪干预,干预措施采取“学生-家庭-学校-医疗”四位一体的综合性干预模式进行,对照组采取空白对照,主要结局为姿势性脊柱侧弯的发生率。结果该研究纳入无脊柱弯曲异常者共计548人(干预组266人,对照组282人)。经过6个月干预,干预组和对照组姿势性脊柱侧弯的发生率分别为19.2%和26.6%(χ2=4.26,P=0.039);按性别分层分析,女生中干预组和对照组脊柱侧弯的发生率分别为14.3%和26.8%(χ2=5.56,P=0.018),男生两组间无差异;按年级分层分析,四年级学生中,干预组和对照组脊柱侧弯的发生率分别为12.2%和22.0%(χ2=4.65,P=0.031),五年级学生中两组间无差异。脊柱侧弯部位以胸段为主(52例,41.3%);侧弯方向以右凸异常居多(76例,60.3%),脊柱侧弯Ⅰ度共124例,占98.4%。结论四位一体的综合干预模式,可以有效预防姿势性脊柱侧弯的发生。Objective To evaluate the preventive effect of a comprehensive intervention model of"student⁃home⁃school⁃medical treatment"on postural scoliosis in primary school students.Methods Based on the principle of informed consent and voluntary participation,the students in Grade 4th and 5th from 2 urban primary schools in Chifeng city were screened for abnormal spinal curvature.Then,according to the willingness of the school to cooperate with the intervention measures,the patients with normal spinal curvature were divided into the intervention group and the control group according to the school district,and followed up the intervention for 6 months.The intervention group adopted a comprehensive inter⁃vention mode of"student⁃home⁃school⁃medical treatment",and the control group adopted a blank control.The main outcome was the incidence of postural scoliosis.Results A total of 548 subjects(266 in the intervention group and 282 in the con⁃trol group)were included in this study.After 6 months of intervention,the incidence of postural scoliosis was 19.2%in the intervention group and 26.6%in the control group(χ2=4.26,P=0.039).Stratified by gender,the incidence of abnor⁃mal spinal curvature in the intervention group and the control group was 14.3%and 26.8%,respectively(χ2=5.56,P=0.018).There was no difference between the two groups of boys.Stratified by grade,the incidence of abnormal spinal cur⁃vature was 12.2%in the intervention group and 22.0%in the control group in Grade 4th(χ2=4.65,P=0.031),and there was no difference between the two groups in Grade 5th.In the two groups of abnormal spinal curvature,the thoracic segment was the most abnormal part(52 cases,41.3%).Right convexity was the abnormal direction with the highest pro⁃portion(76 cases,60.3%),and 124 patients had scoliosis degree I,accounting for 98.4%.Conclusion A comprehen⁃sive intervention model combining four aspects can effectively reduce the incidence of postural scoliosis.

关 键 词：姿势性脊柱侧弯 干预 小学生 预防效果 

分 类 号：R193[医药卫生—卫生事业管理]