低剂量、常规剂量CT与DR评价整脊推拿治疗颈椎病椎间孔棘突变化及疗效的应用研究(1)
【摘要】 目的：研究低剂量、常规剂量多层螺旋CT(MSCT)与DR评价整脊推拿治疗神经根型颈椎病(CSR)椎间孔棘突变化及疗效的应用价值。方法：选取2017年3月-2019年3月笔者所在医院确诊的30例CSR患者，均行低剂量多层螺旋CT(MSCT)、常规MSCT和DR检查，根据影像学检查给予整脊推拿治疗，并于治疗后3个月复查，比较三种检查评价疗效。结果：30例患者治疗3个月后痊愈17例，痊愈率56.67%，显效11例，显效率36.67%，有效2例，有效率6.67%，总有效率100%。患者治疗后左C5～6椎间孔前后径，左C2～3、C4～5、C6～7椎间孔上下径，右C4～5、C5～6椎间孔前后径，右C5～6椎间孔上下径明显大于治疗前，差异有统计学意义(P<0.05)。三种检查方法测量治疗前后名椎间孔前后径、上下径差异均无统计学意义(P>0.05)。结论：低剂量MSCT与常规MSCT和DR一样，均可准确诊断神经根型颈椎病棘突移位方向、椎间孔大小，并给予针对性的治疗，但可减小辐射剂量，更安全。
【关键词】 低剂量多层螺旋CT DR 整脊推拿 颈椎病 效果 评价
doi：10.14033/j.cnki.cfmr.2019.30.027 文献标识码 B 文章编号 1674-6805(2019)30-00-03
[Abstract] Objective： To study the application value of low-dose， routine multi-slice spiral CT (MSCT) and DR in the evaluation of chiropractic massage in the treatment of cervical spondylotic radiculopathy (CSR). Method： 30 CSR patients diagnosed in our hospital from March 2017 to March 2019 were selected. All of them received low-dose multi-slice spiral CT (MSCT)， routine MSCT and DR examinations. According to the imaging examination， chiropractic massage was given， and the results were reviewed 3 months after the treatment. Result： After 3 months of treatment， 17 of the 30 patients were cured， the recovery rate was 56.67%， the significant effect case was 11， the significant efficiency rate was 36.67%， the effective case was 2， the effective rate was 6.67%， and the total effective rate was 100%. After treatment， the anterior and posterior diameters of left C5-6 intervertebral foramen， left C2-3， C4-5， C6-7 intervertebral foramen， right C4-5， C5-6 intervertebral foramen， and upper and lower diameters of right C5-6 intervertebral foramen were significantly larger than before treatment with statistically significant differences (P<0.05). There was no significant difference in anterior and posterior diameters and upper and lower diameters among the three methods (P>0.05). Conclusion： Low dose MSCT， like conventional MSCT and DR can accurately diagnose the direction of spinous process displacement and the size of intervertebral foramen in cervical spondylotic radiculopathy， and give targeted treatment， can reduce the dose of small radiation， which is safer.
[Key words] Low-dose multi-slice spiral CT DR Chiropractic massage Cervical spondylosis Effect Evaluation
First-author’s address： The Second Hospital of Traditional Chinese Medicine of Zhanjiang City， Zhanjiang 524013， China
颈椎病根据发病类型可分为神经根型、椎动脉型、脊髓型、颈型、交感神經型和混合型颈椎病，其中发病率最高的类型是神经根型颈椎病(Cervical spondylotic radiculopathy，CSR)，占CS的60%～70%[1]。目前90%～95%的颈椎病患者经保守治疗可痊愈或缓解，整脊推拿就是保守治疗方法之一[2]，疗效肯定。但治疗前需要检查确定棘突移位方向、椎间孔大小方能对症施术，并定期检查评价效果。目前诊断颈椎病椎间孔棘突变化的影像学方法很多，包括DR、CT等[3-5]，但上述检查均会给患者带来高辐射剂量，因此低剂量MSCT扫描技术受到各方面关注。本研究通过低剂量多层螺旋CT(MSCT)、常规MSCT和DR检查治疗前后椎间孔变化的比较，探讨低剂量MSCT的价值，现报道如下。, http://www.100md.com(庞伟明 招仕富 曾玉儒 招春堂 李健 苏卫平 卢永耀 覃孟怡 黎姣 李广裕)
【关键词】 低剂量多层螺旋CT DR 整脊推拿 颈椎病 效果 评价
doi：10.14033/j.cnki.cfmr.2019.30.027 文献标识码 B 文章编号 1674-6805(2019)30-00-03
[Abstract] Objective： To study the application value of low-dose， routine multi-slice spiral CT (MSCT) and DR in the evaluation of chiropractic massage in the treatment of cervical spondylotic radiculopathy (CSR). Method： 30 CSR patients diagnosed in our hospital from March 2017 to March 2019 were selected. All of them received low-dose multi-slice spiral CT (MSCT)， routine MSCT and DR examinations. According to the imaging examination， chiropractic massage was given， and the results were reviewed 3 months after the treatment. Result： After 3 months of treatment， 17 of the 30 patients were cured， the recovery rate was 56.67%， the significant effect case was 11， the significant efficiency rate was 36.67%， the effective case was 2， the effective rate was 6.67%， and the total effective rate was 100%. After treatment， the anterior and posterior diameters of left C5-6 intervertebral foramen， left C2-3， C4-5， C6-7 intervertebral foramen， right C4-5， C5-6 intervertebral foramen， and upper and lower diameters of right C5-6 intervertebral foramen were significantly larger than before treatment with statistically significant differences (P<0.05). There was no significant difference in anterior and posterior diameters and upper and lower diameters among the three methods (P>0.05). Conclusion： Low dose MSCT， like conventional MSCT and DR can accurately diagnose the direction of spinous process displacement and the size of intervertebral foramen in cervical spondylotic radiculopathy， and give targeted treatment， can reduce the dose of small radiation， which is safer.
[Key words] Low-dose multi-slice spiral CT DR Chiropractic massage Cervical spondylosis Effect Evaluation
First-author’s address： The Second Hospital of Traditional Chinese Medicine of Zhanjiang City， Zhanjiang 524013， China
颈椎病根据发病类型可分为神经根型、椎动脉型、脊髓型、颈型、交感神經型和混合型颈椎病，其中发病率最高的类型是神经根型颈椎病(Cervical spondylotic radiculopathy，CSR)，占CS的60%～70%[1]。目前90%～95%的颈椎病患者经保守治疗可痊愈或缓解，整脊推拿就是保守治疗方法之一[2]，疗效肯定。但治疗前需要检查确定棘突移位方向、椎间孔大小方能对症施术，并定期检查评价效果。目前诊断颈椎病椎间孔棘突变化的影像学方法很多，包括DR、CT等[3-5]，但上述检查均会给患者带来高辐射剂量，因此低剂量MSCT扫描技术受到各方面关注。本研究通过低剂量多层螺旋CT(MSCT)、常规MSCT和DR检查治疗前后椎间孔变化的比较，探讨低剂量MSCT的价值，现报道如下。, http://www.100md.com(庞伟明 招仕富 曾玉儒 招春堂 李健 苏卫平 卢永耀 覃孟怡 黎姣 李广裕)
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