| 摘要: |
| 目的 探讨术前病程对青少年特发性脊柱侧凸(adolescent idiopathic scoliosis,AIS)矫形手术及患者术后生存质量的影响。方法 行单纯后路矫形、全椎弓根内固定的AIS患者，根据术前病程分为2组:S组（术前病程<2年）和L组(术前病程≥2年)。两组患者以性别比相同、Lenke分型相同、主弯Cobb角相似进行匹配，每组均有55例入选。将两组患者术前、术后及随访时的各种放射学参数进行对比，比较两组融合椎体数、术中失血量、SRS-22量表得分等指标。结果 两组患者术前主侧凸Cobb角相似，S组主侧凸柔韧性大于L组(P=0.034)。S组术前次侧凸Cobb角小于L组(P=0.035)。术后两组冠状面及矢状面放射学参数相似，术中失血及输血量无统计学差异。L组融合椎体数多于S组(P=0.027)。随访时两组SRS-22量表中功能/活动度、疼痛、自我形象/外观及精神健康得分无统计学差异，S组治疗满意度维度得分高于L组(P=0.037)。结论 脊柱侧凸的柔韧性会随着病程延长而降低，病程可能是次侧凸进展的危险因素,对AIS患者术后生存质量存在影响。 |
| 关键词: 青少年特发性脊柱侧凸 病程 外科手术 生存质量 |
| DOI：6DOI:10.3724/SP.J.1008.2010.00638 |
| 投稿时间：2010-03-18修订日期：2010-05-25 |
| 基金项目: |
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| Influence of pre-operative disease course on operation and post-operative quality of life in adolescents with idiopathic scoliosis |
| JI Xin-ran1, WANG Chuan-feng1, LI Tao2, ZHAO Ying-chuan1, LI Ming1* |
| (1. Department of Orthopaedics, Changhai Hospital, Second Military Medical University, Shanghai 200433, China;2. Training Center of Medical Staff, General Hospital, PLA Nanjing Military Area Command, Nanjing 210002, Jiangsu, China) |
| Abstract: |
| Objective To study the influence of pre-operative disease course on the operation and post-operation quality of life of adolescents with idiopathic scoliosis (AIS). Methods A total of 110 AIS patients who were treated with classic posterior correction, pedicle internal fixation were divided into two groups according to their disease courses (n=55): short course group with a pre-operation course <2 years(S group), long course group with a pre-operation course ≥2 years(L group). The gender, Lenke type, and major curve Cobb angle were matchable between the two groups. Various radiographic measurements and indices like fusion level, intraoperative blood loss and scores of SRS-22 scale were compared between the two groups before operation, immediately, and 2 years after operation. Results The pre-operative Cobb angles of the major curve were similar between the two groups, but the flexibility of the major curve averaged (55.7±18.77)% in the S group and (48.1±18.24)% in the L group (P=0.034). Pre-operative Cobb angles of the minor curve were larger in L group than those in S group (\[30.1±12.10\]° in the S group and \[34.8±10.85\]° in the L group, P=0.035). The post-operative radiographic measurements and the blood loss/infusion were similar between the two groups. The number of fused vertebrae in the L group was significantly more than that in the S group (P=0.027). The parameters in the SRS-22 scale, including function/activity, pain, self-image/appearance, and mental health were similar between the two groups during follow-up. And the L group had a significantly lower satisfaction rate of treatment compared with the S group (\[4.0±0.70\] vs \[3.7±0.78\], P=0.037). Conclusion The flexibility of the curve in AIS decreases with the increase of disease course, and the disease course might be a risk factor for the scoliosis progression of the minor side. Patients with a disease course ≥2 years have more fused vertebrae than those with a disease course <2 years. The length of pre-operative disease course has influence on the quality of life of AIS patients after operation. |
| Key words: adolescent idiopathic scoliosis course of disease operative surgical procedures quality of life |
