孙 旭,邱 勇,王 斌,俞 杨,朱泽章,钱邦平,朱 锋,马薇薇.性别对青少年特发性脊柱侧凸患者支具治疗效果的影响[J].中国脊柱脊髓杂志,2010,20(5):376-379.
性别对青少年特发性脊柱侧凸患者支具治疗效果的影响
中文关键词:  青少年特发性脊柱侧凸  支具治疗  性别  进展  影响因素
中文摘要:
  【摘要】 目的:比较男、女性青少年特发性脊柱侧凸(adolescent idiopathic scoliosis,AIS)患者支具治疗的效果,探讨性别因素对支具治疗效果的影响。方法:2003年7月~2009年7月在我院完成支具治疗的男性AIS患者19例(A组),初诊时平均年龄14.0±2.0岁,平均主弯Cobb角28.8°±5.7°,初始Boston支具治疗6例,Milwaukee支具治疗13例;随机抽取同时期完成支具治疗的女性AIS患者57例(B组),初诊时平均年龄13.0±1.4岁,平均主弯Cobb角29.4°±6.1°,初始Boston支具治疗17例,Milwaukee支具治疗40例。定义末次随访时Cobb角大于初诊6°或治疗期间建议行矫形手术者为侧凸进展。结果:两组初诊时Risser征(P=0.786)、Cobb角(P=0.790)、弯型分布(P=0.350)和应用支具类型分布(P=0.350)等无显著性差异。A组和B组平均支具治疗时长分别为2.1±0.7年和2.5±0.9年,平均依从性分别为84.4%±7.6%和87.1%±5.7%。A组患者中发生侧凸进展8例(42%),其中需手术治疗者6例(32%);B组中侧凸进展12例(21%),其中需手术治疗者10例(18%)。男性患者侧凸进展比例高于女性,但统计学差异不明显(P=0.071)。两组中,生长发育状态低下、侧凸Cobb角大及主胸弯型患者侧凸进展比例高。结论:支具治疗可有效控制多数AIS患者的侧凸进展,女性患者支具治疗效果可能好于男性患者。
Sex-related effect of bracing treatment for adolescent idiopathic scoliosis
英文关键词:Adolescent idiopathic scoliosis  Brace treatment  Sex  Progression  Influence factor
英文摘要:
  【Abstract】 Objective:To compare the sex-related efficiency of bracing treatment for adolescent idiopathic scoliosis.Method:Form July 2003 to July 2009,76 AIS patients experiencing bracing treatment were enrolled in this study.All patients were assigned into male group(n=19,group A) and female group(n=57,group B).Patients in group A averagely aged of 14.0±2.0 years with a initial major curve of 28.8°±5.7°,and those in group B had an average age of 13.0±1.4 years with Cobb angle 29.4°±6.1°.Six patients were treated with Boston brace and 13 with Milwaukee brace in group A,while 17 with Boston brace and 40 with Milwaukee brace in group B respectively.Curve progression was defined as Cobb angle greater than 45° or increment over than 6° compared with before bracing which is indicative for surgery,otherwise was defined as non-progression.Result:The Risser grade,Cobb angle of major curve,distribution of curve pattern and brace type were showed no difference in both groups.The duration of bracing averaged 2.1±0.7 years and 2.5±0.9 years and the treatment compliance averaged 84.4%±7.6% and 87.1%±5.7% for group A and B respectively.Eight patients(42%) in group A were found with curve progression,and six of them(32%) were indicative for surgery. 12 patients(21%) in group B were found with curve progression,and ten of them(18%) were indicative for surgery.Lower growth status,larger Cobb angle and main thoracic curve were noted with higher progression rate in both groups.Conclusion:Bracing treatment is effective to prevent curve progression in most AIS patients,however its efficiency might remain lower for male than for female.
投稿时间:2009-12-21  修订日期:2010-03-08
DOI:10.3969/j.issn.1004-406X.2010.[quarter_id].376.[Nu
基金项目:江苏省创新学者攀登项目(编号:BK2009001)
作者单位
孙 旭 南京大学医学院附属鼓楼医院骨科 210008 南京市 
邱 勇  
王 斌  
俞 杨  
朱泽章  
钱邦平  
朱 锋  
马薇薇  
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