小儿特发性寰枢椎半脱位

Atlantoaxial Subluxation in Children

目的 :探讨小儿特发性寰枢关节半脱位的发病机理及其治疗 ,评价X线平片、CT、MRI等检查在诊疗及康复过程的意义。方法 :1991年 2月～ 2 0 0 0年 3月间本院收治的 2 86例小儿自发性寰枢椎半脱位病儿 ,仅作X线平片检查者 2 12例 ,另 74例因为各种原因还作CT或MRI检查确诊。全部患儿均给予颈托牵引治疗 ,其中 16例加用地塞米松和甘露醇治疗。结果 :平均住院 12d ,大部分治愈出院 ,出院后继续牵引 1周巩固疗效。随访 2～ 3年 ,11例有 1～ 2次反复发生 ,及早牵引自愈。结论 :分析发现 195例患儿在颈托牵引治疗前后咽后壁软组织厚度的变化 ,与临床好转关系密切 ,因而对该病病因的深入认识提供了客观新线索。及早治疗见效快 ,颈托牵引治疗是最恰当的治疗方法。颈椎CT检查尤其是三维CT成像在该病的诊断中有重要意义 ,但由于价格原因使其在康复评价中受到限制。

Objective:To explore the pathogenesis and treatment of the atlantoaxial subluxation in children,and to evaluate the significance of X-rays,CT and MRI in this disease.Methods:Two hundred and eighty-six children with atlantoaxial subluxation were treated and followed-up from Feb.1991 to Mar.2000 in the hospital.There were 176 boys and 110 girls from 1 to 14 years old,with the treatment of neck support traction (Glission traction).Result:Most of them were cured by admission from 7 to 21 days (averaged 12 days).All were followed-up for 2 to 3 years.Conclusion:There were 195 cases had changes in the thickness of the soft tissues in posterior wall of pharyngo which was related closely to clinical curing,and it means that may be the pathogenesis of the atlantoaxial subluxation in children.Traction is the best appropriate treatment method,CT scan is of significance in the diagnosis of the disease.