脑外伤后综合征中颈椎损伤致病作用的临床研究

A clinical study of the pathogenic effect of cervical spine injuries on post-traumatic syndrome

目的:探讨脑外伤后综合征中颈椎损伤的致病作用。方法:68例脑外伤后综合征患者接受颈部体查及X线检查并被随机分为治疗组(n=34)和对照组(n=34)。治疗组同时接受脑损伤治疗及颈椎损伤治疗2个疗程(每疗程4周),对照组第一疗程仅接受脑损伤治疗,第二疗程接受与治疗组相同的治疗。所有患者在治疗前及每个疗程后均接受颈性眩晕症状与功能量表(ESCV)及症状自评量表(SCL-90)评估。结果:68例患者均发现有颈椎损伤。第一疗程后治疗组ESCV评分明显提高,SCL-90评分明显降低,与对照组比较差异有显著性(P<0.01);第二疗程后两组ESCV及SCL-90评分接近,差异无显著性(P>0.05)。结论:颈椎损伤是脑外伤后综合征的重要致病因素之一,应颅颈兼治,才能提高脑外伤后综合征的疗效。

Objective:To investigate the pathogenic effect of cervical spine injuries on post-traumatic syndrome(PTS).Method:68cases with PTS were randomly divided into two groups,treatment group(n=34)and control group(n=34)after received physical and X-ray examination of the neck.The patients in the treatment group were received both brain injuries and cervical injuries treatment for8weeks.The patients in the control group were received only brain injuries treatment in the first4weeks then received both in the second4weeks.Evaluation Scale for Cervical Vertigo(ESCV)and SCL-90evaluation were applied to all of the patients before the treatment in the fourth and eighth week during the treatment.Result:Cervical injuries were found in68patients.The study showed the ESCV scores increased and SCL-90decreased significantly(P<0.01)in the treatment group than those in the control group after the treatment in the first4weeks.The final scores of ESCV and SCL-90in the treatment group were near to the control group level(P>0.05).Conclusion:Cervical injuries played important roles in producing the symptoms in the patients with PTS.Author's address First Affiliated Hospital,Sun Yat-Sun University,Guangzhou,510080