寰枢关节旋转半脱位的保守治疗:手法复位是否必要?

Conservational treatment of atlantoaxial rotatory subluxation: is manipulative reduction necessary

背景资料寰枢关节旋转半脱位(atlantoaxial rotatory subluxation,AARS)是一种相对常见的儿科疾病。对于此病的治疗,目前国内外均首选保守治疗,但对于保守治疗的具体方法不尽相同。目的探讨手法复位在寰枢关节旋转半脱位保守治疗中的意义。方法将84例寰枢关节旋转半脱位患者随机分为治疗组和对照组,每组42例,治疗组采用牵引加手法复位法治疗,对照组采用单纯牵引治疗,观察并比较两组治疗效果。结果治疗组治愈19例,显效18例,有效3例,无效2例;对照组治愈9例,显效9例,有效14例,无效10例,2组比较,差异有统计学意义(P【0.05)。对治疗有效的患者随访1年,治疗组复发1例,对照组复发9例,2组比较,差异有统计学意义(P【0.05)。讨论在寰枢关节旋转半脱位的保守治疗中,手法复位是很必要的,它既可以提高近期疗效,又可以降低1年复发率。

Objective Atlantoaxial rotatory subluxation( AARS) is a relatively common condition in pediatric patients.The first choice of treatment is conservational treatment in the foreign and domestic therapeutic regimen currently. But there are different details of management in different treatment. Objective: To discuss the significance about manipulative reduction of atlantoaxial rotatory subluxation. Methods All 84 patients were divided into two groups. 42 patients were treat with traction and manipulative reduction as treatment group and 42 patients were treat with traction only as control group,we observed the different between treatment group and control group. Results In treatment group,19 patients were cured,and 18 outcoms were good,and 3 were fair,and 2 were useless. In control group,9 patients were cured,and 9 outcoms were good,and 14 were fair,and 10 were useless. There were significance differences between two groups( P < 0. 05) . During the 1 year of follow-up,recur-rence occurred in 1 patient of treatment group and 9 patient of control group. There were significance differences between two groups( P < 0. 05) . Conclusion Manipulative reduction is necessary during conservational treatment of atlantoaxial rotatory subluxation. It can increase the short-term curative effect,and it can decrease the relapse rate during the 1 year of follow-up.