河南漯河地区儿童先天性脊柱侧弯患病率调查

Epidemiology of congenital scoliosis in Luohe

目的了解河南省漯河地区儿童先天性脊柱侧弯患病率及治疗现状。方法采用分层抽样的方法从漯河地区36所公立幼儿园及小学3～10岁84325儿童中随机选出15000名，在其父母签署知情同意书后进行体检，初步筛选出疑似病例。再对疑似病例进行影像学检查确诊为先天性脊柱侧弯。结果最终有14326名儿童参与调查，应答率为95．51％。其中，236例儿童被物理体检出脊柱侧弯，233例进行了全脊柱X线正、侧位片检查，38例进行了MRI和CT检查，确诊先天性脊柱侧弯患儿29例（女21例、男8例）。先天性脊柱侧弯患病率为2‰（29／14326），其中女童患病率为2．9‰（21／7095），男童患病率为1．1‰（8／7231），两者比较，差异有统计学意义（P〈0．05）。筛查出先天性脊柱侧弯的年龄主要集中在3～4岁（58．62％）。畸形类型：半椎体畸形15例、单侧骨桥畸形9例、一侧骨桥合并对侧多节段半椎体畸形4例、L1-4椎体分节不全1例，以半椎体畸形最为多见（51．72％）。畸形部位：中上胸椎（T1-8）5例、胸腰段（T9～L2）21例、腰段（L3-5）3例，畸形主要位于胸腰结合部72．41％（21／29）。侧凸Cobb角：10～19度16例，20-39度8例，≥40度5例，脊柱侧弯Cobb角以10-19度最多（55．17％）。该人群先天性脊柱侧弯知晓率31．03％（9／29），有效治疗率6．90％（2／29）。结论漯河地区儿童先天性脊柱侧弯发病率为0．2％，高于目前报道的全国平均水平（0．1％），女童发病显著高于男童，畸形类型以半椎体多见，部位以胸腰段最多。知晓率、治疗率偏低，先天性脊柱侧弯得到正确治疗的情况不容乐观。

Objective To investigate the prevalence of congenital scoliosis in school children from 3 to 10 years in 36 schools in Luohe. Methods In a cross-sectional study, 15000 students were randomly selected from a total of 84325 students distributed in 36 schools. These subjects received the informed consent prior, which was returned after being signed by parents on physical examination day. We evaluated the symmetry of the shoulders, the scapulae, the triangle-cut, the hip evenness. In suspected cases; Students were referred to panoramic radiographs of the spine. Results 14326 students participated in the study. Of this total, the response rate is 95. 51%. 236 students were suspected of scoliosis. 233 student underwent full-spine radiographs examinations, and 38 patients underwent MRI and CT examination, of which 29 were diagnosed with congenital scoliosis （21 female and 8 male）, The prevalence of congenital scoliosis was 2, female prevalence rate was 2. 9‰, the prevalence rate of male was 1. 1‰ （P〈0. 05）. Congenital scoliosis is mainly concentrated in the age of 3-4（581 62%）. Types of malformations., hemivertebra malformation in 15 cases, unilateral bridge bone deformity in 9 cases, one side of bone bridge with side multi segmental hemivertebra deformity in 4 cases, lumbar 1-4 vertebral segment not complete in 1 case, malformation type mainly is hemivertebra （51.72%）. Malformation position; 5 cases were located in the thoracic 1-8, 21 cases located in the thoracic 9 to lumbar 2, 3 cases located in the lumbar 3-5, malformations mainly located in the Thoracolumbar border area （72. 41%）. Scoliosis Cobb angle. 10-19 in 16 cases, 20-39 in 8 cases, 5 cases of Cobb angle is greater than 40. Awareness rate of congenital scoliosis is 31.03%. The treatment rate is 6. 90%. Conclusions The prevalence of congenital scoliosis in the public schools of Luohe is 2% which is higher than the national average level （0. 1%） reported, female is significantly higher than that of male, malformation type mainly is hemivertebra, malformations Mainly locate in the thoracolumbar border area. the awareness rate and treatment rate of congenital scoliosis are low, and the correct treatment of the congenital scoliosis is not optimistic.