| Halo-头盆环牵引联合Ⅱ期矫形治疗重度僵硬性脊柱侧弯 |
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Received:September 19, 2019
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| 作者 | Author | 单位 | Unit | E-Mail |
| 王增平 |
WANG Zeng-ping |
甘肃省人民医院骨2科, 甘肃 兰州 730000 |
The Second Department of Orthopaedics, Gansu Provincial People's Hospital, Lanzhou 730000, Gansu, China |
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| 薛文 |
XUE Wen |
甘肃省人民医院骨2科, 甘肃 兰州 730000 |
The Second Department of Orthopaedics, Gansu Provincial People's Hospital, Lanzhou 730000, Gansu, China |
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| 王中华 |
WANG Zhong-hua |
甘肃省人民医院骨2科, 甘肃 兰州 730000 |
The Second Department of Orthopaedics, Gansu Provincial People's Hospital, Lanzhou 730000, Gansu, China |
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| 钱耀文 |
QIAN Yao-wen |
甘肃省人民医院骨2科, 甘肃 兰州 730000 |
The Second Department of Orthopaedics, Gansu Provincial People's Hospital, Lanzhou 730000, Gansu, China |
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| 刘林 |
LIU Lin |
甘肃省人民医院骨2科, 甘肃 兰州 730000 |
The Second Department of Orthopaedics, Gansu Provincial People's Hospital, Lanzhou 730000, Gansu, China |
liulin3669@163.com |
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| 期刊信息：《中国骨伤》2020年33卷，第2期，第106-110页 |
| DOI：10.12200/j.issn.1003-0034.2020.02.003 |
| 基金项目:甘肃省人民医院院内研发攻关项目（编号：17GSSY3-3） |
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目的：探讨头盆环牵引联合Ⅱ期矫形在重度僵硬性脊柱侧弯的临床疗效。
方法：2015年1月至2019年5月行头盆环牵引的脊柱侧弯患者共16例，其中男7例，女9例；年龄14~28岁，平均17.6岁；Cobb角90°~140°（108.84±17.93）°；先天性脊柱侧凸10例（分节不良6例，形成障碍3例，混合型1例），特发性脊柱侧凸4例，神经纤维瘤病2例。16例均采用Ⅰ期头盆环牵引联合Ⅱ期手术治疗，其中7例采用自制髂骨穿针导向器进行髂骨穿针，9例采用徒手髂骨穿针。对16例患者手术治疗前后身高、侧凸Cobb角、后凸Cobb角及矫正率进行观察。
结果：患者身高由治疗前（144.88±6.32）cm矫正至（154.56±7.87）cm，侧凸Cobb角由（108.84±17.93）°矫正至（42.12±7.29）°，后凸Cobb角由（64.18±16.39）°矫正至（33.81±6.06）°。Ⅰ期术前牵引后身高增加、侧凸及后凸Cobb角平均矫正率分别为（7.06±5.65）cm、（41.50±9.09）%、（30.52±9.66）%；Ⅱ期牵引矫形内固定后身高增加、侧凸及后凸Cobb角平均矫正率分别为（2.63±1.78）cm、（32.47±10.80）%、（15.55±9.47）%（矫正率参照的基准Cobb角是上一期治疗的Cobb角）；分期牵引联合手术治疗的身高增加、侧凸及后凸Cobb角平均矫正率分别为（9.69±5.42）cm、（61.09±5.03）%、（46.07±8.60）%。各期治疗前后患者侧凸Cobb角、后凸Cobb角及矫正率差异均有统计学意义（P<0.05）。
结论：采用头盆环牵引联合Ⅱ期矫形治疗重度僵硬性脊柱侧弯，能够明显矫正畸形，改善外观，且手术并发症少，具有较强的临床可操作性。 |
| [关键词]:头盆环牵引 重度脊柱侧弯 临床疗效 |
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| Halo-pelvic traction combined with stageⅡsurgical correction for the treatment of severe and rigid scoliosis |
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Abstract:
Objective: To investigate the clinical effects of the Halo-pelvic traction combined with posterior instrumentation correction and internal fixation for the treatment of severe and rigid scoliosis.
Methods: From January 2015 to 2019 May,16 patients with severe and rigid scoliosis were treated by the Halo-pelvic traction combined with posterior instrumentation correction. There were 7 males and 9 females,aged 14 to 28 years with an average of 17.6 years,Cobb angle was 90° to 140° with an average of (108.84±17.93)°. Including congenital scoliosis in 10 cases (6 cases of dyssegmented scoliosis,3 cases of dysplasia,1 case of mixed scoliosis),idiopathic scoliosis in 4 cases and neurofibromatosis in 2 cases. All patients in group had scoliosis corrected by Halo-pelvic distraction combined with posterior instrumentation correction and internal fixation. Among them,7 cases were treated with self-made guide device for iliac bone puncture,and the other cases with traditional bare hands. The height,scoliosis Cobb angle,kyphosis Cobb angle and correction rate of 16 patients before and after surgery were observed.
Results: The body height was corrected from (144.88±6.32) cm to(154.56±7.87) cm;Cobb angle of scoliosis was corrected from(108.84±17.93)° to (42.12±7.29)°,Cobb angle of kyphosis was corrected from(64.18±16.39)° to(33.81±6.06)°. After the Halo pelvic traction,the body height increase,Cobb angle of scoliosis and kyphosis were changed with the mean of(7.06±5.65)cm,(41.50±9.09)%,(30.52±9.66)%,respectively. After the stageⅡsurgical correction,the body height increase,Cobb angle of scoliosis and kyphosis were changed with the mean of(2.63±1.78) cm,(32.47±10.80)%,(15.55±9.47)%(The baseline Cobb angle referenced by the correction rate was the Cobb angle of the previous treatment). The body height increase and correction rate of Cobb angle of scoliosis and kyphosis with staged traction combined with surgery was(9.69±5.42) cm,(61.09 ±5.03)%,(46.07±8.60)%. There was significant difference in body height increase,correction rate of Cobb angle of scoliosis and kyphosis between before and after each period of treatment(P<0.05).
Conclusion: Treatment of severe and rigid scoliosis with Halo-pelvic traction combined with stageⅡsurgical correction can significantly correct deformities and improve appearance,and has fewer surgical complications and strong clinical operability. |
| KEYWORDS:Halo pelvic traction Severe and rigid scoliosis Clinical effects |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 王增平,薛文,王中华,钱耀文,刘林.Halo-头盆环牵引联合Ⅱ期矫形治疗重度僵硬性脊柱侧弯[J].中国骨伤,2020,33(2):106~110 |
| 英文格式: | WANG Zeng-ping,XUE Wen,WANG Zhong-hua,QIAN Yao-wen,LIU Lin.Halo-pelvic traction combined with stageⅡsurgical correction for the treatment of severe and rigid scoliosis[J].zhongguo gu shang / China J Orthop Trauma ,2020,33(2):106~110 |
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