中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (12): 2257-2260.doi: 10.3969/j.issn.1673-8225.2010.12.042

• 生物材料临床实践 clinical practice of biomaterials • 上一篇    下一篇

热塑矫形器及其材料在青少年特发性脊柱侧凸治疗中的应用

林志伟，王应球，喻锦成   

  1. 海南省人民医院康复医学部，海南省海口市  570102
  • 出版日期:2010-03-19 发布日期:2010-03-19
  • 作者简介:林志伟，男， 1962年生，海南省海口市人，汉族，1984年海南医学院毕业，副主任医师，主要从事青少年特发性脊柱侧凸研究。 Lzhw8112@163.com

Application of thermosetting plastic brace for treating adolescent idiopathic scoliosis

Lin Zhi-wei, Wang Ying-qiu,Yu jin-cheng   

  1. Department of Rehabilitation Medicine, Hainan Provincial People's Hospital, Haikou 570102, Hainan Province, China
  • Online:2010-03-19 Published:2010-03-19
  • About author:Lin Zhi-wei, Associate chief physician, Department of Rehabilitation Medicine, Hainan Provincial People's Hospital, Haikou 570102, Hainan Province, China Lzhw8112@163.com

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796

被引次数

8

摘要：

背景：矫形器治疗是目前公认的适于未发育成熟轻中度特发性脊柱侧凸患者惟一有效的非手术治疗方法。
目的：回顾性分析热塑矫形器治疗青少年特发性脊柱侧凸临床疗效。
方法：1997-04/2004-03在海南省人民医院康复医学部矫形科收治特发性脊柱侧凸患者113例。佩戴热塑矫形器(brace)从开始2.0~3.0 h/d，逐渐增加22 h/d。复查时cobb’s角减少大于30%，则佩戴时间减至20 h/d，Risser征Ⅳ度或月经初潮1年后佩戴时间减至4 h/d。同时每天完成1 h矫正体操，包括腰背肌锻练：5点式(即头、双肘及双足支撑)和3点式(即头、双足支撑)锻练。随访2年后复测cobb’s角，监测cobb’s角变化。
结果与结论：全部病例随访2年，有效98例(86.7%)；治疗无效15例(13.3%)，出现脊柱侧凸进展加重。脊柱侧凸cobb’s角在20°~30°者68例，有效63例(92.6%)。31°~45°者45例，有效35例(77.8%)。未发现材料方面的特殊不良反应。结果证明，热塑矫形器结合矫正体操综合治疗特发性脊柱侧凸疗效明显，可减少cobb’s角度，改善侧凸，防止或延缓特发性脊柱侧凸进展。

关键词: 矫形器, 特发性脊柱侧凸, 青少年, 脊柱畸形, 医用生物材料

Abstract:

BACKGROUND: Orthosis therapy has been well known as an effective method for treating mild or moderate adolescent idiopathic scoliosis.
OBJECTIVE: To retrospectively analyze the clinical efficacy of thermosetting plastic brace on treating adolescent idiopathic scoliosis.
METHODS: A total of 113 patients with adolescent idiopathic scoliosis were selected from Department of Orthopaedics, Rehabilitation Medicine Services, Hainan Provincial People’s Hospital between April 1997 and March 2004. The thermosetting plastic brace was performed for 2.0-3.0 hours per day and then gradually for 22 hours per day. By rechecking, the cobb’s angle reduced more than 30%, so the thermosetting plastic brace was performed for 20 hours per day. Additionally, the thermosetting plastic brace was perforemd 4 hours per day if the Risser symptoms were classified into grade IV or menarche was finished 1 year. Meanwhile, corrective gymnastics, including 5-point style (head, both elbows, and both feet supporting) and 3-point style (head and both feet supporting) were done for 1 hour everyday. Two years after following up, the cobb’s angle was remeasured.
RESULTS AND CONCLUSION: Two years after following up, 98 cases (86.7%) were treated effectively, and 15 cases (13.3%) were treated ineffectively, showing an aggravation of adolescent idiopathic scoliosis. Cobb's angle was 20-30° in 68 cases, and 63 cases (92.6 %) were treated effectively; cobb’s angle was 31-45° in 45 cases, and 35 cases (77. 8%) were treated effectively. Any adverse reaction was not observed in all cases. The results suggested that thermosetting plastic brace was an effective method to treat adolescent idiopathic scoliosis, reduce cobb’s angle, relieve symptoms of scoliosis, and provent or delay development of adolescent idiopathic scoliosis.

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