國小學生脊柱側彎之篩檢

Screening For Scoliosis In Primary School

鍾佩珍(Pei-Chen Chung) ； 林銘川(Ming-Chuan Lin) ； 賴金鑫(Jin-Shin Lai)

《中華民國復健醫學會雜誌》 26卷2期 (1998/06) Pp. 47-52

摘要

原發性脊柱側彎 （idiopathic scoliosis） 好發於成長中的青少年，「早期發現早期治療」是避免它惡化之不二法門，因此歐美日等國家已相當普遍地施行學校學生之脊柱側彎篩檢。而吾人有興趣的是：（一）究竟從什麼年齡開始篩檢最恰當？（二）那一種篩檢方法最方便且可靠呢？針對台北市敦化國小之５１８５名學生，由同一位復健專科醫師用向前彎腰的方式來測試學生之背部，被懷疑有問題之學生再接受x光檢查，結果判定１９５名學生有脊柱側彎，盛行率為３.７６％，而男女比例則為１：２.２。如從各年級的盛行率來看，則三年級學生就有５.７９％之盛行率，故吾人認為在台灣脊柱側彎之篩檢年齡約從九到十歲開始較合適，略早於西方國家的十一到十二歲。至於篩檢的方法，只要是由非常有經驗的專科醫師來執行，即使是「非定量」的「向前彎腰測試」亦可獲得十分準確的判斷，故「向前彎腰測試」仍是一種簡易且可靠的篩檢方法。

關鍵字

原發性 ； 脊柱側彎 ； 學校篩檢

並列摘要

Idiopathic scoliosis is more frequently found in early adolescence. To prevent possible deterioration and thus, inevitable surgery, early diagnosis and treatment are strongly considered. Screening school children for scoliosis has been very popular in developed countries. The purpose of this study is to find (1) the best age to start screening and (2) the best way to screen. Using the forward bending test, one experienced physiatrist observed the backs of 5185 students from Taipei
Municipal Dun-Hwa Primary School, which included 2618 boys and 2567 girls. Among them, 195 students had scoliosis. The prevalence rate was 3.76% which is similar to other reports around the world. The male/female ratio was 1:2.2 which is similar to other surveys as well. Among the scoliotic students, the highest incidence rate occurred in the students between nine and ten years old. We conclude that screening school children for scoliosis might start as early as nine years old in Taiwan. Because there was no difference between the referral rate and the diagnostic rate, a physiatrist is the best screening personnel. In addition, the forward bending test is a simple and reliable qualitative screening method if it is performed by a specialist.

並列關鍵字

scoliosis ； idiopathic ； school screening