颈性眩晕与寰枢关节错缝临床相关性研究

发布时间：2018-05-04 02:17

本文选题：颈性眩晕 + 寰枢关节错缝　；参考：《广州中医药大学》2015年硕士论文

【摘要】：目的：利用X线及CT的影像学检查对比分析,结合对有颈性眩晕症状的寰枢关节错缝患者进行影像学观察的关节间隙以及症状评分的相关性分析,探讨颈性眩晕与寰枢关节错缝的临床相关性,借此探讨寰枢关节错缝在颈性眩晕患者中的诊断意义。方法：随机选取符合颈性眩晕诊断标准的20岁到50岁患者80例,经X线颈椎张口正位及侧位摄片,参照寰枢关节错缝的诊断标准进行诊断,复查寰枢关节CT对比其与X线检查测量的寰枢关节关节间隙数据及寰枢关节错缝的阳性率,对比两者的差异。随后剔除CT检查下不符合寰枢关节错缝的病例,采取通用的手段对余下病例进行一周的临床干预,对比治疗前后关节间隙的数据及症状评分数据,并将其差值进行相关性分析。结果：本研究纳入的80例患者,在X线下测量的寰齿侧间隙差值平均值为1.39±0.41mm,CT测量寰齿侧间隙差值平均值为1.05±0.67mm。两者的差异具有统计学意义(P0.05)。X线检查的寰枢关节错缝阳性率为77.5%,CT检查的阳性率为41.3%,两者间差异具有统计学意义(P0.05)。对CT观察符合寰枢关节错缝的33例患者进行症状评分分值为11.76±1.98,并采取同样的手段进行临床干预1周,再次进行症状评分分值为18.91±2.80,两者间差异有统计学意义(P0.05)。治疗后的寰齿侧间隙差值平均值为1.50±0.41mmm,与治疗前对比没有明显差异(P0.05)。治疗前后的寰齿前间隙的差值及前后寰齿侧块间隙差值变化值与症状评分差值没有明显的相关性。(相关系数分别为-0.126,P0.05,相关系数分别为-0.341,P0.05)。结论：单纯依靠X线诊断寰枢关节错缝,可增大诊断的假阳性率,而且寰枢关节关节间隙的变化与颈性眩晕症状也无明显的相关性,因此颈性眩晕与寰枢关节错缝没有明显的临床相关性。由此推断现有寰枢关节错缝的诊断在颈性眩晕患者的病因诊断中可能没有临床意义。
[Abstract]:Objective: to analyze the correlation between the joint space and symptom score of atlantoaxial joint dislocation suture patients with cervical vertigo by means of X-ray and CT. To investigate the clinical correlation between cervical vertigo and atlantoaxial joint dislocation, and to explore the diagnostic significance of atlantoaxial joint dislocation in cervical vertigo. Methods: 80 patients aged from 20 to 50 years old who met the diagnostic criteria of cervical vertigo were randomly selected. X-ray radiographs were performed on the anterior and lateral positions of the open mouth of the cervical vertebrae, and the diagnosis was carried out according to the diagnostic criteria of atlantoaxial joint suture. The CT data of atlantoaxial joint and the positive rate of atlantoaxial joint dislocation were compared between CT and X-ray. Then the patients who did not accord with atlantoaxial joint dislocation under CT examination were eliminated, and the remaining cases were treated with a general method for one week of clinical intervention. The data of articular space and symptom score before and after treatment were compared, and the difference was analyzed. Results: the average value of atlantodentate space difference measured under X-ray was 1.39 卤0.41 mm CT and the average value of atlantodentate space difference was 1.05 卤0.67 mm. The positive rate of atlantoaxial joint dislocation suture was 77.5%. The positive rate of CT examination was 41.3%. The difference between the two groups was statistically significant (P 0.05). The symptom score was 11.76 卤1.98 in 33 patients with atlantoaxial joint suture observed by CT and treated with the same method for one week. The score of symptom score was 18.91 卤2.80 again. The difference between the two groups was statistically significant (P 0.05). The average difference of atlantodentate space after treatment was 1.50 卤0.41 mm m, which was not significantly different from that before treatment (P 0.05). There was no significant correlation between the difference of anterior atlantodentate space and the difference between anterior and posterior atlantodentate lateral mass space and the difference of symptom score before and after treatment. (the correlation coefficients were -0.126, P 0.05, and the correlation coefficients were -0.341 and P 0.05, respectively. Conclusion: the diagnosis of atlantoaxial joint dislocation by X-ray alone can increase the false positive rate of diagnosis, and there is no significant correlation between the change of atlantoaxial joint space and cervical vertigo. There is no obvious correlation between cervical vertigo and atlantoaxial joint suture. It is concluded that the diagnosis of atlantoaxial joint dislocation may not be of clinical significance in the etiological diagnosis of cervical vertigo.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R681.5

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