溫州市中小學生脊柱側彎患病率調查

溫州市中小學生脊柱側彎患病率調查

王誼,吳奮茸,林野

(溫州醫學院附屬第二醫院,浙江溫州325027)

摘要目的:調查溫州市中小學生脊柱側彎患病情況。方法:20109月至201112月在溫州市706所小學和474所中學中 隨機整群抽取8所小學和8所中學進行脊柱側彎患病率調查。依次對16所中小學的所有學生進行體格檢查、云紋照相及X線檢 查。結果:此次調查共涉及18 154名學生,男9 319名,女8 835;7 10歲者6018,11 ~ 14歲者5 983,15 ~ 18歲者6 153 名;市區學生9 231名,縣區學生8 923名。體格檢查陽性者418名,云紋照相檢查陽性者191名,X線檢查陽性者112名,患病率 為0.62%。112名患者中男49名,女63名,不同性別患病率比較,差異無統計學意義(V =2. 594,P =0. 107)。市區學生44名, 縣區學生68名,縣區學生患病率高于市區學生(P =6.028,P =0.014)。7-1024,11 -1456,15 ~ 1832,3個年 齡組脊柱側彎的患病率比較,差異有統計學意義=15.545,P=0.000);ll ~14歲年齡組脊柱側彎患病率高于其余2個年齡組 頒=13. 075,P =0.000;/ =7. 289,F =0.007);其余2個年齡組的患病率比較,差異無統計學意義(/ =0. 977,P = 0. 323)。11 14歲年齡組女性患病率高于男性(男21名,女35名必=3.947,P =0.047),其余2個年齡組男女患病率比較,差異無統計學意義 (男14名,女10,V =0.203,P=0.652;14名,女18名,/ =0. 436,P =0. 509)。結論:溫州市中小學生的脊柱側彎患病率為 0. 62% ;其中11 ~14歲學生的脊柱側彎患病率較高,在這一年齡段女性的患病率高于男性;市區學生患病率低于周邊縣區學生。 關鍵詞脊柱側凸患病率青少年學生橫斷面研究

A scoliosis-prevalence survey of students in primary and secondary schools in Wenzhou city WANG Yi* , WU Bei-rong, LIN Ye. * The Second Affiliated Hospital of Wenzhou Medical College, Wenzhou 325027, Zhejiang, China ABSTRACT ObjectiveTo investigate e scoliosis prevalence in primary and secondary school students in Wenzhou city. MethodsEight primary schools and 8 secondary schools were randomly selected from 706 primary schools and 474 secondary schools in Wenzhou city from September 2010 to December 2011,using the cluster sampling method. Physical examination, moire photography and X-ray examination were performed in turn for scoliosis prevalence survey in all the students in the 16 schools. ResultsEighteen thousand one hundred and fifty-four students(9 319 males and 8 835 females) were involved in this investigation ; age ranged from 7 tolO years in 6 018 students,ranged from 11 to 14 years in 5 983 cases and ranged from 15 to 18 years in 6 153 cases;9 231 students from city,while 8 923 students from counties. Positive results of physical examination, moire photography and X-ray examination were found in 418,191 and 112 students, respectively. The scoliosis prevalence was 0. 62% . There were 112 patients(49 males and 63 females) , and there was no statistical difference in scoliosis prevalence between different genders (^2 =2. 594, P =0. 107 ). Forty-four patients were from city, while 68 cases were from counties, and the scoliosis prevalence was higher in students from counties compared with students from city(^2 = 6. 028,P = 0. 014). Twenty-four patients aged from 7 to 10 years, 56 patients aged from 11 to 14 years, 32 patients aged from 15 to 18 years, and there was statistical difference in scoliosis prevalence among the 3 age groups = 15. 545, P = 0. 000) ; the scoliosis prevalence was higher in the 11-14 years group compared with the rest 2 age groups respectively(^2二 13. 075,P =0. 000;/ =7. 289,P =0. 007) ;and there was no statistical difference in scoliosis prevalence between the rest 2 age groups^2 =0. 977 ,P = 0.323 ). The scoliosis prevalence in females was higher than that in males in the 11 -14 years group(21 males versus 35 females,/ = 3. 947,P =0. 047) ,while there was no statistical difference in scoliosis prevalence between males and females in the rest 2 age groups respectively( 14 males versus 10 femals,^2 =0. 203=0. 652; 14 males

versus 18 femals,/ =0. 436,P =0. 509). Conclusion:The scoliosis prevalence is 0. 62% in the primary and secondary school students in Wenzhou city, The scoliosis prevalence is higher in the students between the age of 11 and 14 years, among which, females have the higher prevalence compared with males and the urban students have lower prevalence compared with those from surrounding counties.

Key words Scoliosis ; Prevalence ; Adolescent ; Students ; Cross-sectional studies

 
 

脊柱側彎是一種嚴重威脅青少年身心健康的脊

基金項目:浙江省溫州市科技局項目(Y2OO8O1O8柱畸形,不僅影響體形,嚴重者還可能造成心肺功能 衰竭。青少年脊柱側彎是一種漸進性加重的疾病,早 期發現和干預可有效阻止病情的進一步發展,降低手 術治療率。目前,北京、天津、廣東等地已先后開展了 青少年脊柱側彎的普查工作[,_3]20109月至 201112月,我們對溫州市的中小學生進行了脊柱 側彎的患病率調查,現報告如下。

1調查對象

溫州市共有小學706所,中學474所,隨機從中 整群抽取中學和小學各8所進行調查。共調查 18 154名學生,男9 319名,女8 835名;7 ~ 10歲者 6 018,11 ~14 歲者5 983 ,15-18 歲者6 153 名; 市區學生9 231名,縣區學生8 923名。

2方法

2.1調查方法 在我院脊柱科中選取5位護士,培 訓后與骨科醫師組成調查小組,借鑒國內學者采用的 “三檢篩選法”[3-51依次進行體格檢查、云紋照相及線檢查。

2.1.1體格檢查 令受檢者裸露背部,自然站立,雙 足與肩等寬,雙目平視,調查者對其依次進行以下檢 查:①雙肩是否等高;②雙肩胛下角是否在同一水平; ③雙側腰凹是否等高;④雙側骼嶠是否等高;⑤棘突 連線是否偏離;⑥前彎試驗:受檢者背對檢查者,兩手 合掌置于兩膝間慢慢向前彎腰,檢查者從背部中線切 線位觀察其雙側上胸段、胸段、胸腰段、腰段是否等 高、對稱,不等高、不對稱者為前彎試驗陽性。以上檢 查有1項異常者即由骨科醫師進行復檢,確認有異常 后進行云紋照相檢查。

2.1.2云紋照相 采用日產FM40光柵投影型云紋 攝影裝置對體格檢查陽性患者進行復查。云紋圖像 雙側對比,若有1個以上的云紋間距差為陽性,即表 示脊柱雙側有mm以上的高度差。對于云紋照相檢 查陽性者進行登記,并通知學校組織其到醫院放射科 進行X線檢查。

2.1.3 X線檢查 采用Philips數字放射成像系統為 受檢者拍攝站立位脊柱正、側位X線片。在所拍攝的 X線片上測定受檢者的Cobb亳角,Cobb,S角> 10。者 確定為脊柱側彎。

2.2統計學方法 采用SPSS17. 0軟件對所得數據 進行統計分析,不同性別、市區與縣區及各年齡組不 同性別學生脊柱側彎患病率的組間比較采用四格表 /檢驗,不同年齡組學生脊柱側彎患病率的比較采用 行x列表y檢驗,檢驗水準=0.05。

3結果

3.1總體情況 體格檢查陽性者418名,云紋照相 檢查陽性者191名,X線檢查陽性者112名,患病率 為0. 62% ;其中男49名,女63名,不同性別患病率比 較,差異無統計學意義"2 2. 594, 0. 107);市區 學生44名,縣區學生68名,縣區學生患病率高于市 區學生(/ =6. 028,2=0.014)。

3.2各年齡組學生脊柱側彎患病率7 ~10歲、11~ 14歲、15 ~ 183個年齡組脊柱側彎的患病率比較, 差異有統計學意義(/ = 15. 545 ,P 0. 000);進一步 兩兩比較,a' =0.017,11 ~ 14歲年齡組脊柱側彎的 患病率高于7 ~ 10歲和15 18歲年齡組(/ = 13. 075,P=0.000;V =7. 289,P =0. 007),7 ~ 1。歲 和15-18歲年齡組的患病率比較,差異無統計學意 義(V =0.977,F =0.323)。(表 1)

1各年齡組學生脊柱側彎患病率比較名

年齡組

患病

未患病

合計

7~10 

24

5 994

6 018

11 ~14 

56

5 927

5 983

15-18 

32

6 121

6 153

合計

112

18 042

18 154

3.3各年齡組不同性別學生脊柱側彎患病率11 14歲年齡組女性患病率高于男性,其余2個年齡組男 女患病率比較,差異無統計學意義(表2)。

2各年齡組不同性別學生脊柱側彎患病率比較名

性別

7 ~10 

11 ~14 

15-18 

患病未患病

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