动态关节松动术结合冲击波对颈椎病患者血液流变学、颈椎生理曲度及功能改善的影响

Effect of dynamic arthrodesis combined with shockwave on the improvement of blood rheology, cervical physiological curvature and function in patients with cervical spondylosis

目的 探讨动态关节松动术结合冲击波在颈椎病患者的应用及对血液流变学、颈椎生理曲度及功能改善的影响。方法 选取颈椎病患者100例,随机分为2组,各50例。对照组予以动态关节松动术治疗,观察组予以动态关节松动术结合冲击波。观察2组临床疗效、治疗前后颈椎病症状20分量表评分及颈椎病临床评价量表(cervical vertebra disease clinical evaluation scale, CASCS)评分、疼痛分级指数(paing rading index, PRI)评分、颈椎生理曲度、颈部失能指数(neck disability index, NDI)评分、血液流变学[全血高切黏度、全血低切黏度、血细胞比容]、日本骨科协会评估治疗(Japanese Orthopaedic Associationscores, JOA)分数及日常生活能力量表(Activity of Daily Living Scale, ADL)评分。结果 观察组临床总有效率92.00%明显高于对照组78.00%(P<0.05);观察组疗程结束后、随访3个月颈椎病症状20分量表评分及CASCS评分高于对照组(P<0.05);观察组疗程结束后、随访3个月PRI指数(感觉评分、情感评分及总分)低于对照组(P<0.05);观察组疗程结束后、随访3个月颈椎生理曲度明显优于对照组,NDI评分低于对照组(P<0.05);观察组疗程结束后、随访3个月全血高切、低切黏度及血细胞比容均低于对照组(P<0.05);观察组疗程结束后、随访3个月JOA、ADL评分高于对照组(P<0.05)。结论 动态关节松动术结合冲击波治疗颈椎病疗效确切,能有效调节患者血液流变学,减轻颈椎病症状,改善颈椎和腰椎功能,增强日常生活能力。

Objective To investigate the application of dynamic arthrodesis combined with shock waves in patients with cervical spondylosis and their effects on the improvement of blood rheology,cervical physiological curvature and function.Methods A total of 100 patients with cervical spondylosis were selected and randomly divided into two groups,with 50 patients in each group.The control group was treated with dynamic arthrodesis and the observation group was treated with dynamic arthrodesis combined with shock wave.The clinical efficacy,the 20-point scale of cervical spondylosis symptoms and the clinical assessment scale for cervical spondylosis(CASCS),the pain rating index(PRI) score,the cervical physiological curvature,and neck disability index(NDI) score,blood rheology(whole blood high-cut viscosity,whole blood low-cut viscosity,erythrocyte volume),Japanese Orthopaedic Association(JOA) scores and Activity of Daily Living(ADL) scale before and after treatment were observed in the two groups.Results The total clinical efficacy of the observation group was 92.00%,significantly higher than that(78.00%) of the control group(P<0.05);The 20-point scale score of cervical spine symptoms and CASCS score were higher in the observation group than in the control group at the end of the treatment course and at 3 months of follow-up(P<0.05).The PRI index(sensory score,emotional score and total score) was lower in the observation group than in the control group at the end of the treatment course and at 3 months of follow-up(P<0.05).The cervical physiological curvature was significantly better in the observation group than in the control group at the end of the treatment course and at 3 months of follow-up,and the NDI score was lower than that of the control group(P<0.05).The whole blood high-cut and low-cut viscosity and erythrocyte volume were lower in the observation group than in the control group at the end of the treatment course and at 3 months of follow-up(P<0.05);The JOA and ADL scores were higher in the observation group than in the control group at the end of the treatment course and at 3 months of follow-up(P<0.05).Conclusion Dynamic arthrodesis combined with shock wave therapy for cervical spondylosis is effective in regulating patients′ blood rheology,reducing cervical spondylosis symptoms,improving cervical and lumbar spine functions,and enhancing ADL.