發(fā)布時間：2018-04-03 04:31

  本文選題：生長棒　切入點：脊柱側凸　出處：《北京協(xié)和醫(yī)學院》2015年碩士論文

【摘要】：目的 探討生長棒治療脊柱側凸的臨床效果,并研究治療過程中不同撐開間隔對患者脊柱生長、畸形矯正及并發(fā)癥發(fā)生率的影響。方法 回顧性統(tǒng)計我院2002年7月～2014年2月收治的應用生長棒治療早發(fā)性脊柱側凸患者的臨床信息及影像學資料,選取其中間隔12個月的一次撐開或連續(xù)間隔6個月的兩次撐開,分別定義為一個研究事件,并歸入A、B兩組。比較兩組事件末在cobb角變化值、T1-S1、坐高、身高增加值及并發(fā)癥發(fā)生率方面的不同。通過多元線性回歸分析患者性別、年齡、Risser征、不同治療階段的cobb角及事件內不同撐開次數等不同因素對上述指標的影響,并進一步通過協(xié)方差分析及獨立樣本T檢驗驗證陽性發(fā)現(xiàn),明確對生長棒治療效果的影響因素。結果 經過一年的生長棒撐開治療,患者一年內的cobb變化值平均為17.35°±8.675°,T1-S1長度由起點的30.95cm±4.29cm增長至32.46cm±4.52cm。通過多元線性回歸分析可能影響療效的因素,結果顯示事件內不同撐開次數是唯一影響事件末T1-S1和坐高增加值的因素(P0.001),事件內不同撐開次數、事件發(fā)生時(起點)的cobb角(P=0.043)及性別對事件末cobb角變化值及身高增長分別有影響。進一步的協(xié)方差分析及獨立樣本T檢驗表明A組的cobb角變化值為12.04°±1.08°,T1-S1增加值為1.05±0.72cm,坐高增加值為2.52±1.40cm,身高增加值為5.64±1.84cm；B組的cobb角變化值為23.49°±1.16°,T1-S1增加值為1.97±0.88cm,坐高增加值為3.84±1.82cm,身高增加值為7.72±2.99cm。兩組差異有統(tǒng)計學意義(P0.05)。A組有10個研究事件發(fā)生內固定并發(fā)癥,內固定并發(fā)癥發(fā)生率為27%。B組發(fā)生傷口愈合不良1例,無內固定并發(fā)癥。結論 相比于一年撐開1次,每6個月?lián)伍_1次可以更好的改善脊柱側凸畸形、促進脊柱生長發(fā)育并可能降低內固定并發(fā)癥的發(fā)生率。
[Abstract]:Objective to investigate the clinical effect of the treatment of scoliosis with growth rod, and to study the effect of different distraction intervals on spinal growth, correction of deformity and the incidence of complications in patients with scoliosis.Methods the clinical information and imaging data of patients with early scoliosis treated with growth rod from July 2002 to February 2014 were analyzed retrospectively.Each is defined as a research event and falls into two groups, Agna B.The changes of cobb angle T1-S1, sitting height, height increment and incidence of complications were compared between the two groups at the end of the event.Multiple linear regression analysis was used to analyze the influence of different factors such as sex, age and Risser sign, cobb angle in different stages of treatment and the number of distraction in events on the above indexes.The positive results were confirmed by covariance analysis and independent T test.Results after one year's treatment, the mean cobb of the patients increased from 30.95cm 鹵4.29cm to 32.46cm 鹵4.52cm. the mean length of T1-S1 was 17.35 擄鹵8.675 擄T1-S1.Multiple linear regression analysis was used to analyze the possible factors influencing the efficacy. The results showed that the only factors affecting T1-S1 and the added value of sitting height were the different times of distraction in the event, and different times of distraction in the event.At the time of the event (starting point), the cobb angle (P0. 043) and gender had influence on the cobb angle change and height growth at the end of the event, respectively.榪涗竴姝ョ殑鍗忔柟宸�鍒嗘瀽鍙婄嫭绔嬫犱h湰T媯，

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