中山市青少年脊柱侧凸防治网的建立及临床意义

The Establishment and Clinical Significance of Prevention and Treatment Network for Adolescent Scoliosis in Zhongshan City

目的探讨青少年脊柱侧凸防治网对脊柱侧凸综合防治的成效及临床意义。方法我单位于1997年6月至1998年6月采用"三检筛选"普查方法对广东省中山市城乡26所中、小学18 329名7~15岁中、小学生进行了脊柱侧凸普查,并建立了由医院、学校、家庭组成的脊柱侧凸防治网络。对三检阳性者建立档案,纳入脊柱侧凸患儿动态数据库,对确诊的患儿根据Cobb角大小有选择性地进行了宣教、体操、牵引、支具、手术等治疗方法,指导、督促并定期复查追踪,对发现的新病例及时反馈到中心并进行跟踪治疗。结果 1997年至今入库患者共计594例,剔除各种原因失访患者61例,共随访脊柱侧凸患者533例。将患者按5°<Cobb角<10°、10°≤Cobb角<20°、20°≤Cobb角<40°、Cobb角≥40°分组并采取阶梯治疗的方式,前三组病情进展率分别为2.60%、6.55%、5.43%,最后一组实施手术治疗,亦取得了满意的矫形效果。结论青少年脊柱侧凸防治网能够有效控制患者的侧凸进展。

Objective To explore the results and clinical significance of prevention and treatment network had exerted to integrated control for adolescent scoliosis.Methods From June 1997 to June 1998,18 329 students between 7 to 15 years old in 26 primary and junior middle schools were checked for scoliosis with three steps,and we established prevention and treatment network for adolescent scoliosis which consists of hospital,school and family.We establish archives for those with positive results,and then add them to adolescent scoliosis dynamic database.According to Cobb angle,underwent scoliosis knowledge learning,gymnastics,traction,braces,surgery and other treatment methods,and strictly followed-up.Results A total of 594 cases were investigated since 1997,and 533 cases were followed up,with 61 cases missed.The children whose Cobb＇s angle ≥5° were separated into four groups：5°≤Cobb＇s angle〈10°,10°≤Cobb＇s angle〈20°,20°≤Cobb＇s angle〈40°,Cobb＇s angle≥40°,and then were treated with scoliosis knowledge learning,gymnastics,traction,braces or surgery respectively.This management strategy was named to step treatments.The rates of the worse of disease were 2.60%,6.55% and 5.43% in former three groups respectively.The last group underwent operations and achieved satisfactory results.Conclusion Prevention and treatment network for adolescent scoliosis can control the progression of scoliosis effectively.