彩超动态检测颈椎不稳症患者椎动脉血流的临床意义

目的探讨彩色多普勒超声动态检测颈椎不稳症患者椎动脉(VA)血流的临床意义。方法收集我院颈椎不稳症患者100例,按年龄、性别分为5组,进行不同的保守治疗,于治疗前、治疗后即刻和治疗后2周运用彩色多普勒超声检测VA血流,观察在颈椎前屈、中立、后伸动态体位下的椎动脉形态、内径、走行、血流等变化。并选择同期30例颈椎病(无颈椎不稳症)患者做对照。结果治疗前治疗组88.0%的患者发现椎动脉形态或各检测指标异常,与对照组比较差异有统计学意义(P<0.05);两组治疗前左右两侧收缩期最高血流速度(PSV)、舒张末期流速(EDV)、阻力指数(RI)比较差异均有统计学意义(P<0.05),同组治疗前后PSV、EDV及RI比较差异均有统计学意义(P<0.05)。治疗结束后即刻和治疗后2周,不稳组中E组(综合治疗组)PSV、EDV、RI检测结果与其他4组比较差异均有统计学意义(P<0.01)。结论彩色多普勒超声检测颈椎不稳症患者的VA血流可进一步了解病情,并为临床治疗提供有价值的参考。颈椎不稳症患者采用综合治疗效果较好。

Clinical Significance of Vertebral Artery Blood Flow Detected by Color Doppler Ultrasonography in Patients with Cervical Instability

Objective To investigate the clinical significance of continuous measurement of vertebral artery blood flow by color Doppler ultrasonography in patients with cervical instability and the treatment effect.Methods Totally 100 patients with cervical instability were divided into five groups according to the age and sex.Each group received different conservative treatments.The vertebral artery blood flow was detected by color Doppler ultrasonography before treatment,at the end of treatment and two weeks after treatment to observe the changes of shape,the internal diameter,route,blood flow at the positions of anteflexion,neutral and retroversion respectively.Another 30 patients with cervical spondylopathy (no instability) were enrolled as concurrent controls.Results Before treatment,88.0% of the patients in the trial group were found to have abnormal vertebral artery in morphology or various indexes,the difference was significant as compared with the control group (P<0.05).There were significant differences before treatment in peak systolic velocity,(PSV),end diastolic velocity (EDV) and resistive index (RI) of both left and right sides between the two groups (P<0.05).And there were also significant differences in.PSV,EDV and RI in the same group before and after treatment (P<0.05).In the comprehensive treatment subgroup in the trial group significantly higher rate of improvement of abnormal vertebral artery was achieved at the end of treatment and two weeks after treatment as compared with others(P<0.01).Conclusion Measurement of vertebral artery blood flow by color Doppler ultrasonography is helpful to about the condition for patients with cervical instability,it can offer valuable references to clinical treatment.The result of comprehensive therapy for patients with cervical instability is good.