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目的 :分析发育成熟的女性青少年特发性脊柱侧凸(adolescent idiopathic scoliosis,AIS)患儿在停止支具治疗后长期随访中的侧凸进展情况,并探讨其相关因素。方法:回顾性分析于我院门诊就诊符合SRS(scoliosis research society)支具治疗标准的女性AIS患儿130例,初诊年龄11.8±1.4岁(10~14岁)。所有患儿均随访至支具治疗结束后至少2年,且至少具有佩戴支具后初次随访、停止支具治疗时、停止支具治疗后6个月、1年、2年及末次随访时的资料。在每次随访时的全脊柱正位X线片上测量主弯侧凸Cobb角,并评估侧凸进展超过5°的患儿及比例、侧凸进展度数和进展速率。末次随访时侧凸进展超过5°定义为侧凸进展,采用独立样本t检验比较侧凸进展组和非进展组患儿的初诊年龄、月经初潮年龄、初诊Cobb角、初始矫正率、停止支具治疗年龄。结果:与停止支具治疗时相比,停止支具治疗后6个月、1年、2年及末次随访时的侧凸进展超过5°的患儿分别为33例(25.4%)、42例(32.3%)、61例(46.9%)和63例(48.5%);侧凸进展度数分别为2.0°±4.4°、3.2°±5.0°、4.9°±5.5°和5.1°±6.9°;侧凸进展速率分别为0.33°±0.71°/月、0.20°±0.41°/月、0.14°±0.29°/月和0.01°±0.19°/月。停止支具治疗后侧凸非进展组和进展组患儿的初诊年龄、月经初潮年龄、初诊Cobb角、初始矫正率、停止支具治疗时年龄等无显著性差异(P>0.05),而停止支具治疗时的Cobb角有统计学差异(P<0.05)。结论:行支具治疗的AIS患儿停止支具治疗后仍有较高的侧凸进展风险,停止支具治疗后的6个月内为侧凸进展高风险和高速率期;停止支具治疗时的侧凸Cobb角越大发生侧凸进展的风险越高。
OBJECTIVE: To analyze the progress of scoliosis in long-term follow-up of adolescent idiopathic scoliosis (AIS) patients with mature adolescent adolescents and to explore the related factors. Methods: A retrospective analysis of 130 women with AIS who met the criteria of supporting scoliosis research society (SRS) in our outpatient clinic was performed. The initial diagnosis was 11.8 ± 1.4 years old (10-14 years). All children were followed up for at least 2 years after the brace was over, and had at least an initial follow-up after wearing the brace. At the time of stopping the brace, 6 months, 1 year, 2 years and the last follow-up data. Scoliosis Cobb angle was measured on all spine anteroposterior X-ray at each visit, and the rate of progression and progression of scoliosis in children with a progression of more than 5 ° scoliosis was assessed. At the last follow-up, the progress of scoliosis over 5 ° was defined as progression of scoliosis. The age at onset of menarche, the age of menarche, the initial Cobb angle, the initial correction rate and the cessation of braces were compared with independent sample t test Treatment age. Results: 33 (25.4%) children had scoliosis progressed more than 5 ° at 6 months, 1 year, 2 years and the last follow-up after stopping the brace, compared with 42 cases (32.3%), 61 cases (46.9%) and 63 cases (48.5%). The degrees of progression of scoliosis were 2.0 ° ± 4.4 °, 3.2 ° ± 5.0 °, 4.9 ° ± 5.5 ° and 5.1 ° ± 6.9 °, respectively Convex development rates were 0.33 ° ± 0.71 ° / month, 0.20 ° ± 0.41 ° / month, 0.14 ° ± 0.29 ° / month, and 0.01 ° ± 0.19 ° / month, respectively. There was no significant difference (P> 0.05) in the age of onset, the age of menarche, the initial Cobb angle, the initial correction rate and the age at the time of cessation of brachial plexus treatment There was a significant difference in Cobb angle when using the brace (P <0.05). Conclusion: There is still a high risk of scoliosis in children with AIS treated with brace after the brace is stopped, and high risk and high rate of scoliosis progress within 6 months after the brace is stopped. The treatment of brace is stopped The greater the Cobb angle, the higher the risk of scoliosis progression.