平山病患者73例颈托佩戴依从性调查

Investigation of the compliance of cervical collar therapy in 73 patients with Hirayama disease

目的了解平山病患者治疗方式选择及影响颈托佩戴因素。方法回顾性分析2010—2014年北京大学第三医院临床资料完整的73例患者资料。结果（1） 10例首选手术治疗，36例首选保守颈托治疗，其余27例首选采用其他保守治疗。（2）患者颈托佩戴时间为0.3-36.0（7±11）个月，其中28例（77.8%）患者佩戴时间≤6个月，仅有8例（22.2%）患者佩戴时间在1年及以上。（3）影响患者佩戴颈托的因素依次为影响外观（33.3%）、生活工作不便（22.2%）、病情加重改手术（14.3%）、就诊时病情已稳定（9.5%）、选择其他保守治疗（9.5%）、自觉病情轻（8%）及佩戴不适（3.2%）。（4）发病年龄及就诊年龄小的患者更易选择颈托治疗，而发病年龄及就诊年龄大的患者多选择保守治疗（P〈0.05）。结论平山病是一种可致残的疾病，本研究发现平山病患者佩戴颈托的依从性较差，多种因素影响患者佩戴颈托，未来应加强患者的宣教或改变颈托外观，提高患者依从性。

ObjectiveTo summarize the therapeutic approaches of patients with Hirayama disease and investigate the patient′s compliance to cervical collar therapy and its influencing factors. MethodsThis was a retrospectively study.The clinical data of 73 patients was collected from Peking university 3rd hospital between 2010 and 2014. Results（1）Of the 73 patients, 10 patients received surgery, 36 patients received collar therapy , and 27 patients received other conservative therapy at first visit.（2）The mean collar wearing time was from 0.3 to 36 months （means was 7±11 months）. 28 patients （77.8%） wore less than 6 months, only 8 patients （22.2%） wore for more than 1 year. （3）The influencing factors were affecting appearance （33.3%）, inconvenience to work （22.2%）, surgical treatment performed after the exacerbation of symptoms（14.3%）, illness stabilization （9.5%）, choosing other conservative therapy （9.5%）, personally feeling not seriously （8%） and discomfort while wearing （3.2%）. （4）The patients with younger age of onset and treatment were more likely to choose neck care, while patients with older age of onset and treatment tended to choose more conservative treatment（P〈0.05）. ConclusionsAs Hirayama disease can cause disability, application of a cervical collar to minimize neck flexion can prevent progressive muscular weakness in the early stages of the disease. But from our study, the compliance to cervical collar therapy is unsatisfactory.Multiple factors influence the compliance.Education for patients must be enhanced, and other methods to promote the therapeutic compliance should also be developed.