青少年特发性脊柱侧弯患者仅在夜间使用普罗维登斯支具的门诊和住院患者方案比较——依从性和满意度
Comparison of in-and outpatients protocols for providence night time only bracing in AIS patients - compliance and satisfaction.
作者信息
Al-Aubaidi Zaid Tj, Tropp Hans, Pedersen Niels W, Jespersen Stig M
机构信息
Odense university hospital, Odense, Denmark ; Department of Orthopedics, Odense University Hospital, Soender Boulevard 29, Odense C, DK-5000, Denmark.
Linkoping hospital, Linkoping, Sweden.
出版信息
Scoliosis. 2013 Apr 12;8:6. doi: 10.1186/1748-7161-8-6. eCollection 2013.
BACKGROUND
Skeletally immature patients diagnosed with adolescent idiopathic scoliosis (AIS) and a Cobb angle above 25degrees is usually treated with a brace. Standard protocols in many centers include hospitalisation for a few days for the purpose of brace adaptation and fitting. The aim of this study is to compare compliance and satisfaction in hospitalization and out patient clinic protocols, at the initiation phase of brace treatment.
MATERIALS AND METHODS
Twenty-four consecutive patients with AIS were initiated with the Providence night time only brace at our department between October 2008 and September 2009. The first twelve patients were admitted for a maximum of 3 days during the initiation phase of brace treatment. The following twelve patients were initiated in an outpatient clinic set-up. In this later group, patients and parents were informed about the possibility to be admitted to the hospital, at the initiation phase but all patients chose to be treated as out patient's protocol. All patients were evaluated by means of conventional x-ray and patients reported outcome measurements. The mean follow up was 6 months for the outpatient group (3-8) and 12 months for the hospitalisation group (9-14). Scoliosis Quality of Life Index (SQLI) was used together with the Odense Scoliosis questionnaire, which was developed for this study. Compliance was measured using the patients' own statements and the Landauer compliance scoring system.
FINDINGS/RESULTS: The two groups' matches regarding the age, Risser grad, Cobb angle and primary correction. There were no statistically significant differences between the two groups regarding the SQLI and the Odense Scoliosis questionnaire. The compliance was higher in the ambulatory group.
CONCLUSION
Outpatient initiation of bracing in scoliosis seems to give the same correction but better compliance compared to initiation during hospitalization.
背景
骨骼未成熟且被诊断为青少年特发性脊柱侧凸（AIS）且Cobb角大于25度的患者通常采用支具治疗。许多中心的标准方案包括住院几天以适应和佩戴支具。本研究的目的是比较支具治疗起始阶段住院方案和门诊方案的依从性及满意度。
材料与方法
2008年10月至2009年9月期间，在我们科室连续有24例AIS患者开始使用仅在夜间佩戴的普罗维登斯支具。前12例患者在支具治疗起始阶段住院最多3天。接下来的12例患者在门诊开始治疗。在后面这组患者中，患者及其家长在起始阶段被告知有可能住院，但所有患者都选择按门诊方案治疗。所有患者均通过传统X线检查进行评估，并进行患者报告的结局测量。门诊组的平均随访时间为6个月（3 - 8个月），住院组为12个月（9 - 14个月）。使用脊柱侧凸生活质量指数（SQLI）以及为本研究开发的奥登塞脊柱侧凸问卷。依从性通过患者自己的陈述和兰道尔依从性评分系统进行测量。
研究结果
两组在年龄、里塞尔分级、Cobb角和初始矫正方面匹配。两组在SQLI和奥登塞脊柱侧凸问卷方面无统计学显著差异。门诊组的依从性更高。
结论
与住院起始治疗相比，脊柱侧凸门诊起始支具治疗似乎能达到相同的矫正效果，但依从性更好。
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