發(fā)布時間：2018-05-17 19:26

  本文選題：高位腰椎間盤突出癥 + 性別��； 參考：《河北醫(yī)科大學(xué)》2015年碩士論文

【摘要】：目的:高位腰椎間盤突出癥是導(dǎo)致腰腿痛最為常見的原因之一,是指腰椎間盤退變、纖維環(huán)破裂后髓核向后方突出或突出至椎板內(nèi)壓迫和刺激相鄰組織導(dǎo)致的綜合性臨床癥狀。在高位腰椎間盤突出癥患者中男女比例約為3.7:1,且隨著年齡的增加,腰椎退變程度的加重,高位腰椎間盤突出癥臨床特征明顯加重。通過對高位腰椎間盤突出癥患者的病例調(diào)查分析,探討了性別、年齡差異對高位腰椎間盤突出癥的影響,以期為臨床治療提供參考。方法:1回顧性分析2013年至2015年河北醫(yī)科大學(xué)第三醫(yī)院骨科住院的高位腰椎間盤突出癥患者96例,其中男性60例,女性36例,年齡33~63歲,平均年齡(47.68±9.51)歲。2全部患者均采用SIEMENS Verio SQ3.0T超導(dǎo)MR掃描儀器行磁共振成像(magnetic resonance imaging,MRI)檢查,參照T2WI矢位、軸位掃描,設(shè)置MRI掃描參數(shù)為體部線圈,T2WI矢位,仰臥位,TE:101,TR:3000,掃描層厚:4 mm,間距:1.1mm,距陣384×288,FOV:300×300。T2WI軸位TE:112,TR:3500,掃描層厚:4 mm,間距:0.2mm,距陣320×240,FOV:220×220。3按照性別分為男性組(n=60)與女性組(n=36)。按照年齡將患者分為高齡組(年齡≥48歲,50例)與低齡組(年齡48歲,46例)。比較兩組間腰椎間盤突出癥病變分級、MRI信號強度、Oswestry功能障礙指數(shù)(Oswestry disability index,ODI)評分和日本矯形協(xié)會(Japanese Orthopedic Association,JOA)評分。4采用SPSS19.0統(tǒng)計軟件處理數(shù)據(jù)。結(jié)果:1在96例高位腰椎間盤突出癥患者中,參照Pfirrmann腰椎間盤突出癥MRI分級標(biāo)準(zhǔn)進(jìn)行分級,男女兩組在不同MRI等級的分布存在明顯差異(P0.05),提示男性組比女性組病變程度嚴(yán)重。女性組椎間隙髓核信號強度和椎間隙髓核信號強度/腦脊液信號強度比值高于男性組,兩組間差異具有統(tǒng)計學(xué)意義(P0.05)。女性組高位腰椎間盤突出癥患者ODI評分低于男性組(P0.05),兩組間差異具有統(tǒng)計學(xué)意義(P0.05);女性組高位腰椎間盤突出癥患者JOA評分高于男性組,兩組間差異具有統(tǒng)計學(xué)意義(P0.05)。2在96例高位腰椎間盤突出癥患者中,參照Pfirrmann腰椎間盤突出癥MRI分級標(biāo)準(zhǔn)進(jìn)行分級,高齡組與低齡組在不同MRI等級的分布存在明顯差異(P0.05),提示高齡組比低齡組病變程度嚴(yán)重。低齡組椎間隙髓核信號強度、椎間隙髓核信號強度與腦脊液信號強度比值高于高齡組,兩組間差異具有統(tǒng)計學(xué)意義(P0.05),低齡組ODI評分低于高齡組,兩組間差異具有統(tǒng)計學(xué)意義(P0.05),低齡組JOA評分高于高齡組,兩組間差異具有統(tǒng)計學(xué)意義(P0.05)。結(jié)論:1參照Pfirrmann腰椎間盤突出癥MRI分級標(biāo)準(zhǔn),男女兩組在不同等級比較存在差異,提示男性組比女性組病變程度更嚴(yán)重。2高位椎間盤突出癥女性患者椎間隙髓核信號強度、椎間隙髓核信號強度與腦脊液信號強度比值顯著高于男性患者,提示相同年齡段同一椎間盤男性比女性退變嚴(yán)重。3高位椎間盤突出癥女性患者ODI評分低于男性患者,JOA評分高于男性患者,提示高位椎間盤突出癥女性患者病變程度較輕,男性高位椎間盤突出癥患者病變程度較為嚴(yán)重。4參照Pfirrmann腰椎間盤突出癥MRI分級標(biāo)準(zhǔn),高齡組與低齡組在不同等級比較存在差異,提示高齡組比低齡組病變程度更嚴(yán)重。5高位椎間盤突出癥低齡患者椎間隙髓核信號強度、椎間隙髓核信號強度與腦脊液信號強度比值顯著高于高齡患者,揭示了低齡高位椎間盤突出癥患者病變程度較輕,高齡高位椎間盤突出癥患者病變程度較重。6高位椎間盤突出癥低齡患者ODI評分低于高齡患者,JOA評分高于高齡患者,提示高位椎間盤突出癥低齡患者病變程度較輕,高齡高位椎間盤突出癥患者病變程度較為嚴(yán)重。
[Abstract]:Objective: high lumbar intervertebral disc herniation is one of the most common causes of lumbago and leg pain, which refers to the comprehensive clinical symptoms of lumbar disc degeneration, the nucleus pulposus protruding back to the rear after the rupture of the fibrous ring or the compression of the intervertebral lamina and stimulation of adjacent tissues. The proportion of men and women in the patients with high lumbar intervertebral disc protrusion is about 3.7:1 and with the year. The increase of age, the aggravation of lumbar degeneration, the clinical features of high lumbar intervertebral disc herniation are obviously aggravated. Through the investigation and analysis of patients with high lumbar intervertebral disc herniation, the influence of sex and age on high lumbar intervertebral disc herniation is discussed in order to provide reference for clinical treatment. Method: 1 retrospective analysis from 2013 to 2015 96 cases of high lumbar intervertebral disc herniation in the Department of orthopedics, Third Hospital of Hebei Medical University, including 60 males and 36 females, age 33~63 years, the average age of (47.68 + 9.51) years old.2 all were examined by SIEMENS Verio SQ3.0T superconducting MR scanner (magnetic resonance imaging, MRI), with reference to T2WI sagittal, axis Bit scan, set MRI scanning parameters for body coil, T2WI vector position, supine position, TE:101, TR:3000, scanning layer thickness: 4 mm, spacing: 1.1mm, distance matrix 384 x 288, FOV:300 x 300.T2WI axis TE:112, TR:3500, scanning layer thickness: 4 mm, spacing: 0.2mm, 320 x 240, 220 * 220.3 according to sex. The patients were divided into older age group (age 48 years old, 50 cases) and low age group (age 48 years, 46 cases). Compared with two groups of lumbar intervertebral disc herniation classification, MRI signal intensity, Oswestry dysfunction index (Oswestry disability index, ODI) score and Japanese Orthopedic Association (Japanese Orthopedic Association, JOA) score.4 by SPSS19.0 statistical software treatment Data. Results: 1 in 96 cases of high lumbar intervertebral disc herniation, according to the Pfirrmann lumbar disc herniation MRI grading standard, the distribution of two groups of men and women in different MRI levels was significantly different (P0.05), suggesting that the male group was more serious than the female group. The intensity of intervertebral nucleus pulposus signal intensity and intervertebral nucleus pulposus signal intensity in the female group were strong. The ratio of the intensity / cerebrospinal fluid signal intensity was higher than that of the male group. The difference between the two groups was statistically significant (P0.05). The ODI score of the high lumbar disc herniation patients in the female group was lower than that of the male group (P0.05), and the difference between the two groups was statistically significant (P0.05); the JOA score of the high lumbar disc herniation in the female group was higher than that in the male group, and the difference between the two groups was significant. Statistical significance (P0.05).2 was graded in 96 cases of high lumbar intervertebral disc herniation with reference to the MRI grading standard of Pfirrmann lumbar intervertebral disc herniation. The distribution of the elderly group and the lower age group was significantly different in the different MRI grades (P0.05), suggesting that the age group was more serious than the lower age group. The signal intensity of intervertebral nucleus pulposus and the intervertebral space in the lower age group were more than the lower age group. The ratio of signal intensity of nucleus pulposus and signal intensity of cerebrospinal fluid was higher than that of the elderly group (P0.05), and the ODI score of the low age group was lower than that of the elderly group, and the difference between the two groups was statistically significant (P0.05), the JOA score of the low age group was higher than the older group, and the difference between the two groups was statistically significant (P0.05). Conclusion: 1 reference to the Pfirrmann lumbar intervertebral disc. The two groups of men and women were different in different grades, suggesting that the male group was more serious than the female group, and the intensity of intervertebral nucleus signal intensity was more serious in the female patients with.2 high disc herniation. The ratio of the intervertebral nucleus signal intensity to the signal intensity of the cerebrospinal fluid was significantly higher than that of the male patients, suggesting the same age segment of the same vertebra. The ODI score of the male patients with severe.3 high disc herniation was lower than that of the male patients, and the JOA score was higher than that of the male patients. It suggested that the degree of pathological changes in the female patients with high disc herniation was lighter, and the severity of the male high disc herniated patients was more serious.4 refer to the MRI grading standard of the Pfirrmann lumbar disc herniation. The age group and the lower age group were different in different grades, suggesting that the age group was more serious than the lower age group, and the intensity of intervertebral nucleus pulposus signal of.5 high disc herniated lower age patients, the ratio of intervertebral nucleus signal intensity to the signal intensity of cerebrospinal fluid was significantly higher than those of the elderly, and revealed the low age high disc herniation disease. The degree of pathological changes of the patients with high age intervertebral disc herniation is lower than that of the elderly patients with high.6 high disc herniation, and the JOA score is higher than that of the older patients. It suggests that the degree of pathological changes in the lower age patients with high disc herniation is lighter, and the patients with high vertebral disc herniation are more serious.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R687.3

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本文編號：1902561