仰卧位与坐位牵引治疗颈椎不稳症的疗效比较

Curative Effect of Supine Traction vs Seat Traction for Unstable Cervical Disease

目的:比较仰卧位与坐位牵引治疗颈椎不稳症的疗效。方法:60例颈椎不稳症患者随机分为2组各30例,A组采取仰卧位牵引治疗;B组取坐位牵引治疗。治疗前后彩色多普勒超声检测颈椎前屈、中立、后伸动态体位下的椎动脉形态、内径、走行、管壁厚度、回声、血流等变化,并评定其疗效。结果:治疗前患者双侧椎动脉异常率为83.7%,其中A组54例血管中血流异常46条(85.2%),B组50条血管中血流异常41条(82.0%),2组异常率比较差异无显著性意义;椎动脉内径、收缩期最高血流速度、舒张期末血流速度、阻力指数、搏动指数亦均差异无显著性意义。治疗4周后,A组椎动脉血流异常率明显低于B组(14.8%与62.0%,P<0.05),2组显效率、总有效率比较,A组明显高于B组(40.7%、78%与6.0%、36%,P<0.05)。结论:治疗颈椎不稳症取仰卧位牵引可明显提高临床疗效和椎动脉的血流速度。

Objective： To compare the curative effectiveness of supine traction vs seat traction in the treatment of unstable cervical disease. Methods： Sixty cases of unstable cervical disease were randomly divided into two groups （n=30 in each group）, receiving supine traction and seat traction separately. The change of vertebral artery shape, diameter, course, wall thickness, echo, and changes in blood flow in the direction of anteflection, erection and extension were compared by using TCD before and after the treatment. Results： Before treatment, there existed 83.7 % of the vertebral artery anomaly （bilateral） ： 46/54 （85.2 %） in supine traction group, and 41/50 （92.0 %） in seat traction group （P〈0.05）. There was no significant difference between the two groups in vertebral artery diameter （mm）, PSV （m/s）, EDV （m/s）, RI, PI （P〉0.05）. Four weeks after treatment, the total efficiency in supine traction group was 78%, and that in seat traction group was 36% （P〈0.05） ; the rate of abnormal vertebral artery was 14.8% （8/54） and 62.0% （31/50） in the supine traction group and seat traction group respectively （P〈0.05）. Conclusion： The supine traction is much better than the seat traction in treating unstable cervical disease.