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[目的]研究色努支具对青少年特发性脊柱侧凸的治疗效果及不良影响。[方法]回顾性研究本院2013~2015年接诊的使用色努支具的青少年特发性脊柱侧凸(adolescent idiopathic scoliosis,AIS)患者68例,其中女64例,男4例;平均年龄(12.9±1.4)岁,平均治疗327 d。根据支具治疗前、穿戴支具时及随访时所拍摄的脊柱全长X线片,测量患者胸廓横径(thoracic transverse diameter,TTD)、胸廓前后径(thoracic antero-posterior diameter,APD)、两侧肩关节高度(radiographic shoulder height,RSH)和冠状位骨盆倾斜角(pelvic obliquity angle,PO)。对收集数据进行分析整理,探讨色努支具的治疗效果以及使用支具对患者胸廓发育、双肩平衡及骨盆倾斜的影响。[结果]支具治疗前平均Cobb角(29.4±5.2)°,治疗后减少为(23.4±6.3)°(P<0.05)。治疗前胸廓横径(TTD)为(229.4±14.4)mm,支具穿戴时下降至(219.9±16.6)mm(P<0.05)。治疗后TTD为(228.6±15.7)mm,明显低于TTD预测值(234.2±14.7)mm(P<0.05)。治疗前胸廓前后径(APD)为(81.4±14)mm,支具穿戴时为(79.1±13.5)mm(P<0.05)。支具治疗后为(80.7±13.3)mm,同样明显小于预测值(82.4±13.9)mm(P<0.05)。支具治疗前双侧肩关节高度差(RSH)为(7±7.4)mm,治疗后RSH为(8.4±7.7)mm(P>0.05)。支具治疗前冠状位骨盆倾斜角(PO)为(1.5±2)°,治疗后为(1.4±1.8)°(P>0.05)。[结论]色努支具能够有效控制轻度AIS患者的侧凸进展,但会限制胸廓的发育,并影响双肩平衡的风险,尚未发现色努支具加重骨盆倾斜的证据。
[Objective] To study the treatment effect and adverse effect of color nude on adolescent idiopathic scoliosis. [Methods] A retrospective study of 68 adolescent idiopathic scoliosis (ADS) patients admitted from 2013 to 2015 in our hospital with adolescent idiopathic scoliosis (AIS), including 64 males and 4 females, with an average age of (12.9 ± 1.4) years old, with an average of 327 days. The thoracic transverse diameter (TTD), thoracic antero-posterior diameter (APD) were measured according to the total spine length of the spine taken before and at the time of wearing the brace. Radiographic shoulder height (RSH) and pelvic obliquity angle (PO). The collected data were analyzed and analyzed to explore the treatment effect of the color nu-ure and the use of the brace on the patient’s thoracic development, balance of shoulders and pelvic tilt. [Results] The mean Cobb angle before treatment was (29.4 ± 5.2) ° and decreased to (23.4 ± 6.3) ° after treatment (P <0.05). Before treatment, the thoracic diameter (TTD) was (229.4 ± 14.4) mm, while the brace was worn down to (219.9 ± 16.6) mm (P <0.05). The TTD was (228.6 ± 15.7) mm after treatment, which was significantly lower than the TTD (234.2 ± 14.7) mm (P <0.05). The anteroposterior diameter (APD) before treatment was (81.4 ± 14) mm, while the brace was (79.1 ± 13.5) mm when worn (P <0.05). Bracing was (80.7 ± 13.3) mm after treatment, also significantly less than the predicted value (82.4 ± 13.9) mm (P <0.05). Bilateral shoulder joint height (RSH) was (7 ± 7.4) mm before treatment, and (8.4 ± 7.7) mm after treatment (P> 0.05). The pelvic tilt angle (PO) was (1.5 ± 2) ° before treatment and (1.4 ± 1.8) ° after treatment (P> 0.05). [Conclusions] Color nucutics can effectively control the scoliosis progression in patients with mild AIS, but it will limit the development of the thorax and affect the risk of shoulder balance. No evidence of increase of pelvis inclination has been found.