颈性眩晕的保守治疗效果

发布时间：2019-02-09 14:59

【摘要】：背景:颈性眩晕在临床上常见,目前关于颈性眩晕的病因、发病机制、诊断及治疗仍存在争议,许多问题尚需深入研究。目的目的:分析颈性眩晕保守治疗的效果。方法:分析31例门诊颈性眩晕患者保守治疗3个月后眩晕改善效果,男7例,女24例,年龄20~60岁,平均46.6岁。以Ishihara法测定颈椎曲度指数(cervical curvature index,CCI),测量相邻椎体后缘滑移距离及椎间角,以Cobb法测量颈椎前凸角。采用美国耳鼻咽喉头颈外科学会听力及平衡委员会(Committee on Hearing and Equilibrium,CHE)标准,记录患者治疗前及治疗后眩晕评分,分析不同影像学特点眩晕症状缓解情况及其机制。结果:影像学上,26例患者单个节段不稳,5例患者双个节段不稳;治疗前眩晕评分平均3.5分,治疗后眩晕评分平均1.3分。26例患者症状改善满意,满意率83.9%。眩晕缓解程度与患者CCI、颈椎前凸角及颈椎不稳节段位置、个数无明显相关性(P0.05)。结论:颈部肌肉力量在稳定颈椎中具有重要作用,保守治疗能有效缓解颈性眩晕。
[Abstract]:Background: cervical vertigo is common in clinic. At present, the etiology, pathogenesis, diagnosis and treatment of cervical vertigo are still controversial. Objective: to analyze the effect of conservative treatment of cervical vertigo. Methods: 31 outpatients with cervical vertigo were treated with conservative treatment for 3 months. The improvement of vertigo was observed in 7 males and 24 females, aged 20 to 60 years (mean 46.6 years). The cervical curvature index (cervical curvature index,CCI) was measured by Ishihara method. The slip distance and intervertebral angle of adjacent vertebral body were measured. The cervical kyphosis angle was measured by Cobb method. According to the hearing and balance Committee (Committee on Hearing and Equilibrium,CHE) standard of the American Society of Otolaryngology and head and neck surgery, the vertigo scores were recorded before and after treatment, and the relief of vertigo symptoms and the mechanism of different imaging features were analyzed. Results: radiographically, 26 patients had single segmental instability, 5 patients had double segmental instability, the average score of vertigo was 3.5 before treatment, the average score of vertigo after treatment was 1.3. 26 patients were satisfied with the improvement of symptoms and the satisfaction rate was 83.9. There was no significant correlation between the degree of relief of vertigo and the position and number of CCI, anterior kyphosis angle and unstable segment of cervical spine (P0.05). Conclusion: cervical muscle strength plays an important role in stabilizing cervical spine. Conservative treatment can effectively relieve cervical vertigo.
【作者单位】：浙江大学医学院附属第四医院;中国医学科学院北京协和医学院北京协和医院骨科;
【分类号】：R687.3

【参考文献】