本文選題：頸性眩暈 + 寰樞關(guān)節(jié)錯縫　； 參考：《廣州中醫(yī)藥大學》2015年碩士論文

【摘要】：目的：利用X線及CT的影像學檢查對比分析,結(jié)合對有頸性眩暈癥狀的寰樞關(guān)節(jié)錯縫患者進行影像學觀察的關(guān)節(jié)間隙以及癥狀評分的相關(guān)性分析,探討頸性眩暈與寰樞關(guān)節(jié)錯縫的臨床相關(guān)性,借此探討寰樞關(guān)節(jié)錯縫在頸性眩暈患者中的診斷意義。方法：隨機選取符合頸性眩暈診斷標準的20歲到50歲患者80例,經(jīng)X線頸椎張口正位及側(cè)位攝片,參照寰樞關(guān)節(jié)錯縫的診斷標準進行診斷,復查寰樞關(guān)節(jié)CT對比其與X線檢查測量的寰樞關(guān)節(jié)關(guān)節(jié)間隙數(shù)據(jù)及寰樞關(guān)節(jié)錯縫的陽性率,對比兩者的差異。隨后剔除CT檢查下不符合寰樞關(guān)節(jié)錯縫的病例,采取通用的手段對余下病例進行一周的臨床干預,對比治療前后關(guān)節(jié)間隙的數(shù)據(jù)及癥狀評分數(shù)據(jù),并將其差值進行相關(guān)性分析。結(jié)果：本研究納入的80例患者,在X線下測量的寰齒側(cè)間隙差值平均值為1.39±0.41mm,CT測量寰齒側(cè)間隙差值平均值為1.05±0.67mm。兩者的差異具有統(tǒng)計學意義(P0.05)。X線檢查的寰樞關(guān)節(jié)錯縫陽性率為77.5%,CT檢查的陽性率為41.3%,兩者間差異具有統(tǒng)計學意義(P0.05)。對CT觀察符合寰樞關(guān)節(jié)錯縫的33例患者進行癥狀評分分值為11.76±1.98,并采取同樣的手段進行臨床干預1周,再次進行癥狀評分分值為18.91±2.80,兩者間差異有統(tǒng)計學意義(P0.05)。治療后的寰齒側(cè)間隙差值平均值為1.50±0.41mmm,與治療前對比沒有明顯差異(P0.05)。治療前后的寰齒前間隙的差值及前后寰齒側(cè)塊間隙差值變化值與癥狀評分差值沒有明顯的相關(guān)性。(相關(guān)系數(shù)分別為-0.126,P0.05,相關(guān)系數(shù)分別為-0.341,P0.05)。結(jié)論：單純依靠X線診斷寰樞關(guān)節(jié)錯縫,可增大診斷的假陽性率,而且寰樞關(guān)節(jié)關(guān)節(jié)間隙的變化與頸性眩暈癥狀也無明顯的相關(guān)性,因此頸性眩暈與寰樞關(guān)節(jié)錯縫沒有明顯的臨床相關(guān)性。由此推斷現(xiàn)有寰樞關(guān)節(jié)錯縫的診斷在頸性眩暈患者的病因診斷中可能沒有臨床意義。
[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 鹵0.41 mm CT and the average value of atlantodentate space difference was 1.05 鹵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 鹵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 鹵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 鹵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.
【學位授予單位】：廣州中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R681.5

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