婴儿期先天性脊柱侧凸患病情况调查：基于急诊胸腹X线平片的单中心研究

Prevalence of congenital scoliosis in infants: a single center study based on Chest-abdomen X-ray films detected in the emergency department

中文关键词:  先天性脊柱侧凸  婴儿期  胸腹部X线平片  患病率

英文关键词:Congenital scoliosis  Infant  Chest-abdomen X-ray film  Prevalence

中文摘要:

  【摘要】 目的：调查婴儿期急诊患儿先天性脊柱侧凸（congenital scoliosis，CS）的流行病学规律和特点。方法：收集2008年1月~2018年6月在我院急诊科就诊的患儿资料，1岁以内就诊并拍摄胸腹部X线平片的患者纳入本研究。对其影像学资料进行分析，筛选出CS患者。统计其人口统计学特征、椎体及肋骨畸形位置和类型、椎管内畸形以及合并其他系统畸形情况。结果：共有46318例婴儿期急诊患者纳入本研究，男29643例，女16675例，就诊时年龄124±127d（1~365d）。其中83例确认有CS，患病率为1.8‰。83例CS患者中男52例，女31例，男女患病率无统计学差异（P＞0.05）；患者就诊年龄为1～365d（72±95d），就诊原因：呼吸系统相关主诉34例（41%），消化系统相关主诉45例（54%），哭闹4例（5%）。畸形部位：主胸段（T6~T11）62例，上胸段（T1~T5）37例，胸腰段（T12~L1）23例，腰段（L2~L4）11例，腰骶段（L5~S1）1例。单节段畸形患者34例（41%），随着畸形累及节段数增加患者呈递减趋势。23例（27.7%）患者合并肋骨畸形，其中19例存在主胸段肋骨畸形，13例患者连续3根及以上肋骨畸形。3例患者存在椎管内异常。37例（44.6%）患者合并其他系统畸形，其中7例合并两种系统畸形。最多见的合并畸形包括先天性心脏病（16例，19.3%）和先天性肛门闭锁（20例，24.1%）。结论：婴儿期急诊患者中CS患病率为1.8‰，椎体畸形及肋骨畸形最好发的区域为主胸段。合并严重肋骨畸形、先天性心脏病或消化系统畸形的CS患儿因相关症状出现较早、就诊及时，其脊柱畸形容易被早期发现。

英文摘要:

  【Abstract】 Objectives: To investigate the prevalence of congenital scoliosis in infants based on chest-abdomen X-ray films. Methods: A retrospective review was conducted on infant patients from the emergency clinic in our institution between February 2008 and June 2018. The patients who had taken the chest-abdomen X-ray films were included. The congenital scoliosis patients were screened out. The demographic characteristics of the patients, the type and the location of the vertebral malformation and the rib deformity, intraspinal anomaly, and the combined defect of other systems were analyzed. Results: A total of 46318 infant patients of the emergency clinic were enrolled, including 29643 males and 16675 females. The average visiting age was 124±127d(1-365d). 83 patients were diagnosed with congenital scoliosis with an average age of 72±95d(1-365d), and the prevalence was 1.8‰. Of the CS patients, there were 52 males and 31 females, and there was no statistical gender difference of the scoliosis prevalence(P>0.05). The visiting reasons included chief complains related to respiratory system in 34 cases(41%) and digestive system in 45 cases(54%), and cry in 4 cases(5%). Number of patients with deformity in different regions: main thoracic(T6-T11) in 62 cases, proximal thoracic(T1-T5) in 37 cases, thoracolumbar(T12-L1) in 23 cases, lumbar(L2-L4) in 11 cases, and lumbosacral(L5-S1) in 1 case. 34 patients(41%) had single level deformity. The number of patients decreased with the levels of deformities increasing from 1 to 12. Rib anomalies were documented in 23(27.7%) patients, of which 19(22.79%) had rib anomalies in the main thoracic region. 13(15.7%) patients had at least 3 continuous levels of rib anomalies. 3 patients were found with intraspinal anomalies. A total of 37 patients(44.6%) were found combined with other organic defects, of which 7 patients had 2 other system abnormalities. The most common extraspinal defects were the congenital heart disease(16 cases, 19.3%) and congenital imperforate anus(20 cases, 24.1%). Conclusions: The prevalence of congenital scoliosis in infants is 1.8‰ based on chest-abdomen X-ray films. The malformations of the vertebrae and ribs were most frequently seen in the main thoracic region. The congenital scoliosis patients combined with complicated rib deformities, congenital cardiac defects or digestive system abnormalities were more easily diagnosed at early stage because of their early onsets of symptoms.