《中国康复理论与实践》

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无锡市北塘区小学生特发性脊柱侧凸患病率调查①

郑瑜1,2,3,吴晓珺3,孙宁3,杨艳3,王涛3,Jan D. Reinhardt2,党英杰3   

  1. 1.四川大学华西医院康复医学中心,四川省康复医学重点实验室,四川成都市610041;2.四川大学灾后重建与管理学院,四川成都市610041;3.无锡市康复医院,江苏无锡市214043。
  • 出版日期:2016-03-25 发布日期:2016-06-01

revalence of Idiopathic Scoliosis in Primary School Children in Beitang District,Wuxi, Jiangsu, China

ZHENG Yu1,2,3, WU Xiao-jun3, SUN Ning3, YANG Yan3, WANG Tao3, Jan D. REINHARDT2, DANG Ying-jie3   

  1. 1. Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; 2. Institute for Disaster Manangement and Reconstruction, Sichuan University-Hong Kong Polytechnic University, Chengdu, Sichuan 610041, China; 3. Department of Rehabilitation Medicine, Wuxi Rehabilitation Hospital, Wuxi, Jiangsu 214043, China
  • Published:2016-03-25 Online:2016-06-01

摘要: 目的调查无锡市北塘区小学生特发性脊柱侧凸患病率。方法2014 年3~6 月对江苏省无锡市北塘区全部11 所小学11,024 名6~13 岁小学生进行特发性脊柱侧凸调查。调查工作分为学校筛查和医院确诊两个部分。学校筛查包括躯干对称性检查、脊柱前屈试验和脊背倾斜角测量;脊背倾斜角>4°者接受全脊柱X片,Cobb角>10°者排除其他原因后确诊。采用基于逆概率权重的倾向指数模型进行患病率校正。结果学校筛查阶段,脊柱倾斜角>4°小学生282 名(2.6%),其中128 名接受免费全面体格检查和全脊柱摄片,共11 名被确诊为特发性脊柱侧凸。小学生特发性脊柱侧凸的校正前总患病率为0.22%,校正后总患病率为0.21%;12~13 岁女生患病率最高,6~9 岁儿童未发现特发性脊柱侧凸者。结论无锡市北塘区小学生特发性脊柱侧凸患病率稍低于国内平均患病率。10 岁前儿童可推迟特发性脊柱侧凸的随访和调查。

关键词: 特发性脊柱侧凸, 筛查, 儿童, 患病率

Abstract: Objective To investigate the epidemiology of idiopathic scoliosis in China based on a representative sample of primary school children from Beitang district, Wuxi, Jiangsu, China. Methods All 11,024 primary school pupils from 11 schools aged 6-13 years were enrolled. A scoliometer was applied to initially screen for idiopathic scoliosis. Those angle of trunk rotation above 4° was invited to a clinical visit. Definite diagnosis was made based on a Cobb angle of 10° or above by X-ray. Inverse probability weights were used to adjust for non-attendance of the physical examination. Results 282 children (2.6%) were screened positive and 128 of them accepted clinical program. 11 children were diagnosed as idiopathic scoliosis, suggesting a prevalence rate of around 0.22% in primary school children in Wuxi. Adjusted for non-response estimated prevalence was slightly lower at 0.21%. Prevalence was higher in girls than in boys. The highest prevalence was found in girls aged 12-13 years. None confirmed case was found in children younger than 10 years old. Conclusion A relatively low overall prevalence of idiopathic scoliosis was found in primary school children of Beitang district, Wuxi. It is suggested to focus on children aged 10-13 years, while the screening for the 6-9 years olds could be slightly postponed.

Key words: idiopathic scoliosis, screening, children, prevalence