本文選題：多裂肌 + 腰背痛　； 參考：《山東大學(xué)》2014年碩士論文

【摘要】：背景：腰腿痛已成為現(xiàn)代社會(huì)嚴(yán)重影響社會(huì)生產(chǎn)力,大量消耗醫(yī)療資源的社會(huì)性頑疾。關(guān)于腰腿痛的原因也被眾多專家、學(xué)者廣泛研究,發(fā)現(xiàn)腰痛癥影響因素不僅存在腰椎間盤退變、腰椎不穩(wěn)等病理因素,而且還包括遺傳因素、年齡、性別、職業(yè)、及社會(huì)心理等眾多因素,關(guān)于腰痛的治療手段從康復(fù)理療、藥物治療到手術(shù)處理,都涉及到全面評估疾病重要影響因素,才能獲得更佳療效。在大量研究發(fā)現(xiàn)脊柱退變性疾病主要是其穩(wěn)定性紊亂導(dǎo)致,那么除了骨骼、韌帶以外的椎旁肌在脊柱穩(wěn)定中的作用,也就顯得彌足重要,其中多裂肌是椎旁肌群中肌束最大,且位置靠近脊柱最內(nèi)側(cè)的肌肉,肌纖維特點(diǎn)為短而韌,通過力學(xué)原理探索證實(shí)多裂肌在維持腰椎矢狀面和冠狀面平衡穩(wěn)定中起到重要作用。目前許多關(guān)于多裂肌退變與脊柱疾病相關(guān)研究文獻(xiàn)顯示,研究存在樣本量偏小、規(guī)模較小等因素,因此會(huì)影響研究結(jié)果,易產(chǎn)生偏倚。 目的：通過進(jìn)一步研究有腰腿痛癥狀患者多裂肌MRI影像學(xué)改變,發(fā)現(xiàn)其中規(guī)律,并探討臨床價(jià)值。 方法：選取在影像科2011年1月-2013年12月期間所有行腰椎MRI檢查者中年齡18周歲以上并含18周歲,然后按照男女性別不同分兩組,每組分別自18歲始,年齡每遞增10歲分為一亞組,共分：18歲-27歲組、28歲-37歲組、38歲-47歲組、48歲-57歲組、58歲-67歲組、68歲-77歲組、78歲以上組七個(gè)亞組,共14個(gè)亞組,每研究組由隨機(jī)抽取的20人組成,男性140人、女性140人,本研究共含280人。 結(jié)果：1、男性組均比對應(yīng)年齡女性組多裂肌厚度大；2、多裂肌脂肪浸潤程度與年齡增長呈正相關(guān)關(guān)系；3、多裂肌橫斷面面積在男性58歲以前、女性48歲以前無明顯統(tǒng)計(jì)學(xué)差異性改變,但在男性58歲以后、女性48歲以后肌纖維萎縮、多裂肌橫斷面積縮小以及肌組織脂肪浸潤情況改變出現(xiàn)年齡相關(guān)性加劇。4、多裂肌至棘突中線最長距離成正態(tài)分布,相同節(jié)段男女間無顯著性差異,各年齡段之間也無顯著差異。 結(jié)論：腰椎多裂肌退變現(xiàn)象女性比男性出現(xiàn)的早,其退變主要MRI影像特征為：1、肌纖維萎縮,對應(yīng)影像表現(xiàn)為肌束變細(xì)、形態(tài)縮小、輪廓萎縮；2、肌纖維組織脂肪浸潤,表現(xiàn)為肌間隙點(diǎn)狀、線狀、羽狀或網(wǎng)格狀改變。多裂肌至棘突中線的最長距離符合正態(tài)分布,在下腰椎該距離較遠(yuǎn),隨著腰椎節(jié)段的上升間距逐漸縮小,在上腰椎相對靠近棘突中線,此為臨床手術(shù)治療提供解剖學(xué)依據(jù)。
[Abstract]:Background: lumbago and leg pain has become a social obstinate disease which seriously affects social productivity and consumes a large amount of medical resources in modern society. The causes of low back pain have also been extensively studied by many experts and scholars. It has been found that there are not only pathological factors such as lumbar disc degeneration, lumbar instability and so on, but also genetic factors, age, sex, occupation, etc. The treatment of low back pain, from rehabilitation physiotherapy, drug treatment to surgical treatment, all involve comprehensive evaluation of the important factors affecting the disease, in order to obtain a better curative effect. In a large number of studies, it has been found that degenerative diseases of the spine are mainly caused by its disorder of stability. Besides bones and ligaments, the role of the paravertebral muscles in the stability of the spine appears to be important, and the polybifida muscle is the largest muscle bundle in the paravertebral muscle group. The muscle is located near the innermost side of the spine, and the muscle fiber is short and tough. It is proved that the polyfissure muscle plays an important role in maintaining the balance and stability of the sagittal and coronal planes of the lumbar vertebrae. At present, many literatures on the relationship between polybifida degeneration and spinal diseases show that there are some factors in the study, such as small sample size and small scale, which will affect the research results and easily produce bias. Objective: to study the MRI imaging changes of polyfissure muscle in patients with lumbago and leg pain, to find out the regularity and to explore the clinical value. Methods: from January 2011 to December 2013, all the patients who underwent lumbar vertebrae MRI examination were divided into two groups according to the sex of men and women, from the age of 18 years old to the age of 18 years, each group started from the age of 18 years. Each increase in age by 10 years was divided into one subgroup, divided into seven subgroups, including 14 subgroups, aged from 68 to 77 years old and over 78 years old, divided into 7 subgroups, including 14 subgroups, composed of 20 randomly selected persons in the age group of 18 to 27 years of age and the age group of 28 years to 37 years of age and the age group of 48 years to 57 years old, age group between 58 years old to 67 years old group, age group of 58 years to 67 years old group, group of 68 years old to 77 years old group, There were 140 males and 140 females. Results in the male group, the thickness of the polyfissure muscle was 2% larger than that in the corresponding age group. There was a positive correlation between the degree of fat infiltration of the polyfissure muscle and the age increase. The cross-sectional area of the polyfissure muscle was not significantly changed before the male was 58 years old and the female was 48 years old. However, after 58 years of age in men and 48 years in women, muscle fiber atrophy, cross-sectional area of polyfissure muscle and fatty infiltration of muscle tissue were increased in age correlation. The longest distance between the polyfissure muscle and the middle line of spinous process was normal distribution. There was no significant difference between men and women in the same segment, and there was no significant difference between different age groups. Conclusion: the degenerative phenomenon of lumbar polyfissure in women is earlier than that in men. The main MRI imaging features of the degeneration are: 1: 1, muscle fiber atrophy. The corresponding imaging features are muscle bundle thinning, shape shrinking, contour atrophy 2, muscle fiber tissue fat infiltration. The results showed that the muscle space was punctate, linear, pinnately or reticulate. The longest distance from the polyfissure muscle to the middle line of the spinous process accords with the normal distribution, and the distance between the lower lumbar vertebrae and the middle line of the spinous process accords with the normal distribution. With the ascending distance of the lumbar vertebrae gradually reduced, the upper lumbar vertebrae is relatively close to the central line of the spinous process, which provides anatomic basis for clinical surgical treatment.
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R681.5;R445.2

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

1 史進(jìn)軍;卞榮;王新北;林紅軍;;在多種訓(xùn)練姿態(tài)下超聲成像對多裂肌的形態(tài)測量的研究[J];江蘇醫(yī)藥;2012年22期

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本文編號：1905847