特发性脊柱侧弯青少年上肢功能评估及与曲线模式的关系  

Assessment of upper limb function in adolescents with idiopathic scoliosis and its relationship with curve pattern

作　　者：韩雪 李旭[2] 刘佳琪 郭丞 邵玮 HAN Xue;LI Xu;LIU Jiaqi(Outpatient Department,Shijiazhuang Sport Science Research Center,Hebei,Shijiazhuang 050011,China;不详)

机构地区：[1]河北省石家庄市体育科学研究所门诊部,050011 [2]河北医科大学第三医院骨科 [3]石家庄市体育运动学校

出　　处：《河北医药》2023年第2期202-206,共5页Hebei Medical Journal

基　　金：河北省医学科学研究重点课题计划项目(编号:20211583)。

摘　　要：目的 探讨青少年特发性脊柱侧弯(AIS)的上肢功能评估及其与曲线模式的关系。方法 选择2018年2月至2022年3月收治的102例AIS患者,根据Lenke分型将患者分为胸椎组(Lenke 1型+2型+3型+4型,82例)、胸腰/腰椎组(5型+6型,20例),另招募32例无AIS的青少年为对照组。检测受试者握力、捏压强度、手灵巧度、上肢协调性、上肢稳定性、投掷功能、前臂-肩-手功能障碍评分(Quick DASH)评分。结果 胸椎组、胸腰/腰椎组凸侧握力、凹侧握力、上肢稳定性试验触摸手次数、投掷成功率均低于对照组(P<0.05),凹侧放置试验、凹侧转向试验、Quick DASH评分均高于对照组(P<0.05)。胸椎组凸侧指鼻试验,凹侧指鼻试验结果低于对照组(P<0.05)胸椎组凸侧和凹侧握力、凹侧捏压强度以及凸侧和凹侧指鼻试验低于胸腰/腰椎组(P<0.05),凹侧放置试验、凹侧转向试验、投掷成功率、Quick DASH评分高于胸腰/腰椎组(P<0.05)。胸椎组凸侧的捏压强度、放置和转向试验得分优于凹侧(P<0.05),而胸腰/腰椎组凸侧放置试验、转向试验得分优于凹侧(P<0.05)。结论 AIS患者上肢功能受影响明显,累及胸椎主要影响双侧握力、凹侧捏压强度、凹侧手灵巧度、上肢协调性和主观感受,累及胸腰/腰椎则主要影响投掷成功率,临床对于AIS的治疗应注重评估上肢功能的改变。Objective To investigate the relationship between upper limb function assessment and curve pattern in adolescents with idiopathic scoliosis(AIS).Methods A total of 102 AIS patients admitted from February 2018 to March 2021 were selected.According to Lenke classification,the patients were divided into thoracic vertebra group(Lenke1 +2 +3 +4,82 cases) and thoracolunar/lumbar spine group(5+6,20 cases).Another 32 adolescents without AIS were recruited as the control group.Grip strength,pinch and pressure strength,hand dexterity,upper limb coordination,upper limb stability,throwing function,and forearm-shoulder-hand dysfunction score(Quick DASH) were included as comparisons.Results In thoracic and thoracolumbar/lumbar groups,the convex grip strength,concave grip strength,convex finger and nose test,concave finger and nose test,number of hands touched in upper limb stability test and throwing success rate were all significantly lower than those in control group(P<0.05).The concave placement test,concave steering test,and Quick DASH scores were significantly higher than those in the control group(P<0.05).Compared with those of thoracolumbar/lumbar spine group,the thoracic vertebra group had lower bilateral grip strength,concave pinch strength,bilateral finger and nose test(P<0.05),and significantly higher success rate of concave placement test,concave turning test and throwing test,and Quick DASH scores(P<0.05).The scores of the convex compression strength,placement and steering test in the thoracic spine group were significantly better than those in the concave side(P<0.05),while the placement and steering test in the thoracolumbar/lumbar spine group were better than those in the concave side(P<0.05).Conclusion The upper limb function of AIS patients is significantly affected.The involvement of thoracic vertebra mainly affects the bilateral hand grip strength,concave pinch strength,concave hand dexterity,upper limb coordination and subjective sensation,while the involvement of thoracolumbar/lumbar vertebra mainly affec

关 键 词：青少年 特发性脊柱侧弯 上肢功能 曲线模式 

分 类 号：R682.3[医药卫生—骨科学]