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目的探讨选择适当的支具佩戴对特发性脊柱侧凸青少年患者的临床效果及预后。方法选取温州医科大学附属黄岩医院骨科2013年1月—2016年1月期间的18例青少年特发性脊柱侧凸患者,根据治疗方法分为2组,每组9人,研究组佩戴适当的支具进行治疗,对照组使用电刺激疗法,9个月后进行随访,分析整理Risser征级别和Cobb角对矫正结果的影响,通过对比2组的治疗总有效和生活质量满意度评分,对2组患者的临床疗效和预后生活质量差异进行评价。结果研究组的治疗总有效率为88.89%,对照组为66.67%(P>0.05);研究组和对照组各有1例(11.11%)和3例(33.33%)并发症发生,并发症发病率差异无统计学意义(P>0.05);Risser征级越低,初诊矫正率、侧凸进展率越高,顶锥旋转矫正率并未表现出规律,不同Risser征级下初诊矫正率差异有统计学意义(P<0.05),而侧凸进展率和顶锥旋转矫正率无显著差异(P>0.05);研究组在功能/活动度、疼痛、精神健康和治疗满意度上的评分均高于对照组,差异具有统计学意义(P<0.05)。结论佩戴合适的支具可有效地降低青少年特发性脊柱侧凸患者侧凸进展,提高生活质量,值得在轻中度青少年特发性脊柱侧凸患者中推广使用。
Objective To investigate the clinical effect and prognosis of adolescents with idiopathic scoliosis by selecting appropriate braces. Methods 18 cases of adolescent idiopathic scoliosis patients from January 2013 to January 2016 in Huangyan Hospital Affiliated to Wenzhou Medical University were divided into two groups according to the treatment method, with 9 in each group. The study group wore the appropriate branches The patients in control group were treated with electro-stimulation therapy and followed up for 9 months. The grade of Risser and the effect of Cobb angle on the correction were analyzed. By comparing the total effective rate of treatment and quality of life satisfaction scores of two groups, The patient’s clinical efficacy and prognosis of quality of life differences were evaluated. Results The total effective rate was 88.89% in the study group and 66.67% in the control group (P> 0.05). One case (11.11%) and three cases (33.33%) in the study group and the control group each had complications and the incidence of complications (P> 0.05). The lower the Risser grade, the higher the rate of initial diagnosis and scoliosis, the correction rate of top cone did not show the regularity. The difference of initial diagnosis rate under different Risser classifications was (P <0.05), but there was no significant difference between the rate of scoliosis and the correction of cone rotation (P> 0.05). The scores of function / activity, pain, mental health and treatment satisfaction were all high in the study group In the control group, the difference was statistically significant (P <0.05). Conclusion Wearing appropriate braces can effectively reduce the scoliosis progression and improve the quality of life in adolescent idiopathic scoliosis patients. It is worth to promote the use of adolescent idiopathic scoliosis patients.