【摘要】：目的 通過觀察“點式擠壓”型支具治療青少年特發(fā)性脊柱側(cè)凸患者，探討其臨床效果。 方法 本研究通過規(guī)范化的“點式擠壓”型支具治療，并要求患者在佩戴支具期間加強(qiáng)腰背肌鍛煉及肺功能鍛煉；觀察青少年特發(fā)性脊柱側(cè)凸佩戴支具治療前、佩戴支具時及末次隨訪時的冠狀面主彎Cobb角、軀干平衡、生活質(zhì)量（心理健康、背部疼痛、功能活動以及自我形象/外觀、治療滿意度等）、肺功能等各項指標(biāo)的變化情況；本研究對2008年1月-2011年3月在我院收治的96例青少年特發(fā)性脊柱側(cè)凸并取得完整資料的進(jìn)行研究;其中男性30例，女性66例；初診時年齡10-15歲，平均13.6±2.4歲；治療前主彎冠狀面Cobb角18°-36°，平均28.09°±3.43°，所有患者均接受“點式擠壓”型支具治療并堅持肺功能鍛煉，觀察支具治療前、佩戴支具時、末次隨訪時主彎冠狀面Cobb角度、VC（肺活量）、FEV1(第1秒時間肺活量)、MVV（最大通氣量）實測值及占預(yù)計值百分率等肺功能指標(biāo)的變化，分析并觀察“點式擠壓”型支具的臨床效果。 結(jié)果 所有患者均得到隨訪，平均時間為13-38個月，平均25.8個月： 1.主彎Cobb角變化：“點式擠壓”型支具治療末次隨訪時主彎Cobb角16.43±10.12°，平均矯正率為44.86%,較治療前有顯著差異（P＜0.05）； 2.佩戴支具后，隨訪期間患者的軀干平衡有明顯改善，患者的生活質(zhì)量（心理健康、背部疼痛、功能活動以及自我形象/外觀、治療滿意度等）未受到明顯影響； 3.佩戴支具期間對患者的肺功能變化比較，佩戴支具時肺功能指標(biāo)較佩戴支具前均有不同程度下降，有顯著性差異（P＜0.05）；患者佩戴支具期間，患者進(jìn)行肺功能鍛煉，末次隨訪時肺功能指標(biāo)基本恢復(fù)支具治療前的水平，與支具治療前比較，無顯明顯差異（P＞0.05）。 4.隨訪患者脊柱側(cè)凸畸形均得到改善，無嚴(yán)重皮膚潰破、活動功能障礙、肺功能障礙并發(fā)癥發(fā)生。 結(jié)論 “點式擠壓”型支具治療青少年特發(fā)性脊柱側(cè)凸治療可取得滿意臨床效果，對于脊柱側(cè)彎凸患者的冠狀面主彎Cobb角、軀干平衡等有明顯的改善作用；同時對患者的生活質(zhì)量、肺功能等方面無明顯消極影響；由于支具治療的時間周期較長，，遠(yuǎn)期效果仍需進(jìn)一步隨訪；
[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 鹵2.4 years old at the time of initial diagnosis. Before treatment, the Cobb angle of the main curved coronal plane was 18 擄-36 擄(mean 28.09 擄鹵3.43 擄). 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 鹵10.12 擄at the last follow-up, and the average correction rate was 44.86 擄, 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.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R682.3

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