“点式挤压”支具治疗青少年特发性脊柱侧凸
发布时间：2018-12-14 06:05
【摘要】：目的 通过观察“点式挤压”型支具治疗青少年特发性脊柱侧凸患者，探讨其临床效果。 方法 本研究通过规范化的“点式挤压”型支具治疗，并要求患者在佩戴支具期间加强腰背肌锻炼及肺功能锻炼；观察青少年特发性脊柱侧凸佩戴支具治疗前、佩戴支具时及末次随访时的冠状面主弯Cobb角、躯干平衡、生活质量（心理健康、背部疼痛、功能活动以及自我形象/外观、治疗满意度等）、肺功能等各项指标的变化情况；本研究对2008年1月-2011年3月在我院收治的96例青少年特发性脊柱侧凸并取得完整资料的进行研究;其中男性30例，女性66例；初诊时年龄10-15岁，平均13.6±2.4岁；治疗前主弯冠状面Cobb角18°-36°，平均28.09°±3.43°，所有患者均接受“点式挤压”型支具治疗并坚持肺功能锻炼，观察支具治疗前、佩戴支具时、末次随访时主弯冠状面Cobb角度、VC（肺活量）、FEV1(第1秒时间肺活量)、MVV（最大通气量）实测值及占预计值百分率等肺功能指标的变化，分析并观察“点式挤压”型支具的临床效果。 结果 所有患者均得到随访，平均时间为13-38个月，平均25.8个月： 1.主弯Cobb角变化：“点式挤压”型支具治疗末次随访时主弯Cobb角16.43±10.12°，平均矫正率为44.86%,较治疗前有显著差异（P＜0.05）； 2.佩戴支具后，随访期间患者的躯干平衡有明显改善，患者的生活质量（心理健康、背部疼痛、功能活动以及自我形象/外观、治疗满意度等）未受到明显影响； 3.佩戴支具期间对患者的肺功能变化比较，佩戴支具时肺功能指标较佩戴支具前均有不同程度下降，有显著性差异（P＜0.05）；患者佩戴支具期间，患者进行肺功能锻炼，末次随访时肺功能指标基本恢复支具治疗前的水平，与支具治疗前比较，无显明显差异（P＞0.05）。 4.随访患者脊柱侧凸畸形均得到改善，无严重皮肤溃破、活动功能障碍、肺功能障碍并发症发生。 结论 “点式挤压”型支具治疗青少年特发性脊柱侧凸治疗可取得满意临床效果，对于脊柱侧弯凸患者的冠状面主弯Cobb角、躯干平衡等有明显的改善作用；同时对患者的生活质量、肺功能等方面无明显消极影响；由于支具治疗的时间周期较长，，远期效果仍需进一步随访；
[Abstract]:Objective to observe the treatment of adolescent idiopathic scoliosis with "point compression" brace and to explore its clinical effect. Methods in this study, the patients were required to strengthen the exercise of the lumbar dorsal muscle and pulmonary function during the wearing of the support through the standardized "point extrusion" type of brace. To observe the coronal Cobb angle, trunk balance, quality of life (mental health, back pain, functional activity, and self-image / appearance) of adolescent idiopathic scoliosis before, during and at the last follow-up. Treatment satisfaction), pulmonary function and other indicators of the changes; In this study, 96 adolescent idiopathic scoliosis patients admitted in our hospital from January 2008 to March 2011 were studied, including 30 males and 66 females, with an average age of 13.6 卤2.4 years old at the time of initial diagnosis. Before treatment, the Cobb angle of the main curved coronal plane was 18 掳-36 掳(mean 28.09 掳卤3.43 掳). All the patients were treated with "point compression" brace and continued to exercise their lung function. The angle of Cobb on the main curved coronal plane was observed before and after the treatment, and the angle of Cobb on the main curved coronal plane was observed at the last follow-up. The changes of lung function indexes such as VC (vital capacity), FEV1 (maximum ventilation volume of), MVV (at 1 second) and the percentage of predicted value were analyzed and observed. The clinical effects of "point extrusion" brace were analyzed and observed. Results all patients were followed up, the average time was 13-38 months, average 25.8 months: 1. The change of Cobb angle of main bend: the Cobb angle of main bend was 16.43 卤10.12 掳at the last follow-up, and the average correction rate was 44.86 掳, which was significantly different from that before treatment (P < 0. 05); 2. After wearing the brace, the trunk balance of the patients improved significantly during the follow-up period, and the quality of life (mental health, back pain, functional activity, self-image / appearance, treatment satisfaction, etc.) was not significantly affected. 3. The changes of pulmonary function during the period of wearing the brace were significantly lower than those before wearing the brace (P < 0. 05), and the indexes of pulmonary function of the patients with the abutment were lower than those before wearing the abutment (P < 0. 05). During the period of wearing the abutment, the patients underwent pulmonary function exercise, and at the last follow-up, the pulmonary function indexes basically recovered the level before the treatment of the brace, and there was no significant difference between the patients before and after the treatment (P > 0.05). 4. The scoliosis deformities were improved and no severe dermatorrhagia, motor dysfunction and pulmonary dysfunction complications occurred. Conclusion the treatment of adolescent idiopathic scoliosis with "dot compression" brace can obtain satisfactory clinical results, and can obviously improve the Cobb angle and trunk balance of the patients with scoliosis. At the same time, there was no significant negative effect on the quality of life and lung function of the patients.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R682.3
本文编号：2378061
[Abstract]:Objective to observe the treatment of adolescent idiopathic scoliosis with "point compression" brace and to explore its clinical effect. Methods in this study, the patients were required to strengthen the exercise of the lumbar dorsal muscle and pulmonary function during the wearing of the support through the standardized "point extrusion" type of brace. To observe the coronal Cobb angle, trunk balance, quality of life (mental health, back pain, functional activity, and self-image / appearance) of adolescent idiopathic scoliosis before, during and at the last follow-up. Treatment satisfaction), pulmonary function and other indicators of the changes; In this study, 96 adolescent idiopathic scoliosis patients admitted in our hospital from January 2008 to March 2011 were studied, including 30 males and 66 females, with an average age of 13.6 卤2.4 years old at the time of initial diagnosis. Before treatment, the Cobb angle of the main curved coronal plane was 18 掳-36 掳(mean 28.09 掳卤3.43 掳). All the patients were treated with "point compression" brace and continued to exercise their lung function. The angle of Cobb on the main curved coronal plane was observed before and after the treatment, and the angle of Cobb on the main curved coronal plane was observed at the last follow-up. The changes of lung function indexes such as VC (vital capacity), FEV1 (maximum ventilation volume of), MVV (at 1 second) and the percentage of predicted value were analyzed and observed. The clinical effects of "point extrusion" brace were analyzed and observed. Results all patients were followed up, the average time was 13-38 months, average 25.8 months: 1. The change of Cobb angle of main bend: the Cobb angle of main bend was 16.43 卤10.12 掳at the last follow-up, and the average correction rate was 44.86 掳, which was significantly different from that before treatment (P < 0. 05); 2. After wearing the brace, the trunk balance of the patients improved significantly during the follow-up period, and the quality of life (mental health, back pain, functional activity, self-image / appearance, treatment satisfaction, etc.) was not significantly affected. 3. The changes of pulmonary function during the period of wearing the brace were significantly lower than those before wearing the brace (P < 0. 05), and the indexes of pulmonary function of the patients with the abutment were lower than those before wearing the abutment (P < 0. 05). During the period of wearing the abutment, the patients underwent pulmonary function exercise, and at the last follow-up, the pulmonary function indexes basically recovered the level before the treatment of the brace, and there was no significant difference between the patients before and after the treatment (P > 0.05). 4. The scoliosis deformities were improved and no severe dermatorrhagia, motor dysfunction and pulmonary dysfunction complications occurred. Conclusion the treatment of adolescent idiopathic scoliosis with "dot compression" brace can obtain satisfactory clinical results, and can obviously improve the Cobb angle and trunk balance of the patients with scoliosis. At the same time, there was no significant negative effect on the quality of life and lung function of the patients.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R682.3
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