不同撑开间隔对生长棒治疗脊柱侧凸疗效的影响

发布时间：2018-04-03 04:31

  本文选题：生长棒　切入点：脊柱侧凸　出处：《北京协和医学院》2015年硕士论文

【摘要】：目的 探讨生长棒治疗脊柱侧凸的临床效果,并研究治疗过程中不同撑开间隔对患者脊柱生长、畸形矫正及并发症发生率的影响。方法 回顾性统计我院2002年7月～2014年2月收治的应用生长棒治疗早发性脊柱侧凸患者的临床信息及影像学资料,选取其中间隔12个月的一次撑开或连续间隔6个月的两次撑开,分别定义为一个研究事件,并归入A、B两组。比较两组事件末在cobb角变化值、T1-S1、坐高、身高增加值及并发症发生率方面的不同。通过多元线性回归分析患者性别、年龄、Risser征、不同治疗阶段的cobb角及事件内不同撑开次数等不同因素对上述指标的影响,并进一步通过协方差分析及独立样本T检验验证阳性发现,明确对生长棒治疗效果的影响因素。结果 经过一年的生长棒撑开治疗,患者一年内的cobb变化值平均为17.35°±8.675°,T1-S1长度由起点的30.95cm±4.29cm增长至32.46cm±4.52cm。通过多元线性回归分析可能影响疗效的因素,结果显示事件内不同撑开次数是唯一影响事件末T1-S1和坐高增加值的因素(P0.001),事件内不同撑开次数、事件发生时(起点)的cobb角(P=0.043)及性别对事件末cobb角变化值及身高增长分别有影响。进一步的协方差分析及独立样本T检验表明A组的cobb角变化值为12.04°±1.08°,T1-S1增加值为1.05±0.72cm,坐高增加值为2.52±1.40cm,身高增加值为5.64±1.84cm；B组的cobb角变化值为23.49°±1.16°,T1-S1增加值为1.97±0.88cm,坐高增加值为3.84±1.82cm,身高增加值为7.72±2.99cm。两组差异有统计学意义(P0.05)。A组有10个研究事件发生内固定并发症,内固定并发症发生率为27%。B组发生伤口愈合不良1例,无内固定并发症。结论 相比于一年撑开1次,每6个月撑开1次可以更好的改善脊柱侧凸畸形、促进脊柱生长发育并可能降低内固定并发症的发生率。
[Abstract]:Objective to investigate the clinical effect of the treatment of scoliosis with growth rod, and to study the effect of different distraction intervals on spinal growth, correction of deformity and the incidence of complications in patients with scoliosis.Methods the clinical information and imaging data of patients with early scoliosis treated with growth rod from July 2002 to February 2014 were analyzed retrospectively.Each is defined as a research event and falls into two groups, Agna B.The changes of cobb angle T1-S1, sitting height, height increment and incidence of complications were compared between the two groups at the end of the event.Multiple linear regression analysis was used to analyze the influence of different factors such as sex, age and Risser sign, cobb angle in different stages of treatment and the number of distraction in events on the above indexes.The positive results were confirmed by covariance analysis and independent T test.Results after one year's treatment, the mean cobb of the patients increased from 30.95cm 卤4.29cm to 32.46cm 卤4.52cm. the mean length of T1-S1 was 17.35 掳卤8.675 掳T1-S1.Multiple linear regression analysis was used to analyze the possible factors influencing the efficacy. The results showed that the only factors affecting T1-S1 and the added value of sitting height were the different times of distraction in the event, and different times of distraction in the event.At the time of the event (starting point), the cobb angle (P0. 043) and gender had influence on the cobb angle change and height growth at the end of the event, respectively.杩涗竴姝ョ殑鍗忔柟宸�鍒嗘瀽鍙婄嫭绔嬫牱鏈琓妫，

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