84年鼠女哪年财运最旺,857comvvv色九欧美激情|85PO_87国产精品欲av国产av资源

[1]滕紅林,王靖,張純武,等.椎動(dòng)脈超聲對(duì)動(dòng)脈硬化患者 頸椎旋轉(zhuǎn)手法治療的安全性評(píng)價(jià)[J].中醫(yī)正骨,2011,23(02):20-23.
　Teng Hong-lin*,Wang Jing,Zhang Chun-wu,et al.Safety evaluation during rotational manipulation of the cervical spine in the patients with arteriosclerosis by sonography on the vertebral arteries[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2011,23(02):20-23.
點(diǎn)擊復(fù)制

椎動(dòng)脈超聲對(duì)動(dòng)脈硬化患者 頸椎旋轉(zhuǎn)手法治療的安全性評(píng)價(jià)()
分享到：

《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第23卷
期數(shù):
2011年02期
頁(yè)碼:
20-23
欄目:
臨床研究
出版日期:
2011-02-25

文章信息/Info

Title:
Safety evaluation during rotational manipulation of the cervical spine in the patients with arteriosclerosis by sonography on the vertebral arteries
作者:
滕紅林; 王靖; 張純武; 吳春雷; 朱旻宇; 趙亮; 呂超
溫州醫(yī)學(xué)院附屬第一醫(yī)院,浙江 溫州 325000
Author(s):
Teng Hong-lin*; Wang Jing; Zhang Chun-wu; et al.*
The first affiliated hospital of Wenzhou Medical College,Wenzhou 325000,Zhejiang,China
關(guān)鍵詞:
椎動(dòng)脈 超聲檢查 動(dòng)脈硬化 頸椎旋轉(zhuǎn)手法
Keywords:
Vertebral Artery; ultrasongraphy;  arteriosclerosis; manipulation of the cervical rotation
摘要:
目的:通過(guò)對(duì)伴有動(dòng)脈硬化中老年患者進(jìn)行模擬旋頸狀態(tài)下頸椎椎動(dòng)脈超聲檢查,權(quán)衡手法的好處和潛在的風(fēng)險(xiǎn),為臨床醫(yī)師對(duì)頸椎采取手法治療前提供參考。方法:對(duì)208例動(dòng)脈硬化患者進(jìn)行彩色多普勒超聲檢查,觀察椎動(dòng)脈的狹窄程度以及血流充盈程度,血流頻譜形態(tài)等。測(cè)量血流參數(shù)[收縮期峰值血流速度(VMAX)、舒張末期流速(VMIN)、平均血流速度(VTAMX)]、反映血管舒縮和阻力狀況的阻力指數(shù)(RI)、反映血管順應(yīng)性和血管彈性的搏動(dòng)指數(shù)(PI)。結(jié)果:超聲顯示在旋頸狀態(tài)下VA血流變細(xì),血管迂曲及局部受壓狹窄; 伴有動(dòng)脈粥樣硬化者,可見(jiàn)血管內(nèi)膜粗糙,管壁增厚,回聲增強(qiáng),有動(dòng)脈粥樣硬化小斑塊形成及管腔狹窄,椎骨段VA走形迂曲,VA平均內(nèi)徑<3 mm。在過(guò)屈位旋頸后血流減少甚至部分患者彩色血流中斷而不顯像。在正常仰臥位時(shí)所測(cè)得的血流參數(shù)與對(duì)照組相比差異無(wú)統(tǒng)計(jì)學(xué)意義,經(jīng)左右旋頸45°后,檢測(cè)所得兩組血流動(dòng)力學(xué)參數(shù)與對(duì)照組相比開(kāi)始出現(xiàn)差異,當(dāng)過(guò)屈位旋頸45°后,兩組血流動(dòng)力學(xué)參數(shù)呈現(xiàn)顯著性差異。結(jié)論:彩色多譜勒超聲可以觀察椎動(dòng)脈形態(tài)的變化并對(duì)血流進(jìn)行定量測(cè)定,其檢查操作便捷,敏感性高,可以作為頸椎手法前篩查潛在VA損傷的動(dòng)脈硬化患者的方法之一。
Abstract:
Objective:To weight the pros and cons before rotatory manipulation of the cervical spine in the patients with arteriosclerosis.Methods:208 cases with arteriosclerosis underwent sonography to explore the course and stenosis of the vertebral arteries. The VMAX, VMIN, VTMAX and RI were also measured.Results:The results showed the decreased blood stream and local compression of the VA during the rotatory manipulation of the cervical spine. In cases with arteriosclerosis, coarse inner membrane, thickening of the arterial wall and increased echogenicity were found. The blood stream decreased or even totally blocked during rotation and flexion of the cervical spine. In the prone position, there was no hemodynamics difference between the two groups, while difference was found between the two groups after 45° rotation of the cervical spine. Significant difference was found between the two groups after 45° rotation and flexion of the cervical spine.Conclusion:Sonography could observe the morphological changes of the vertebral arteries and measure the hemodynamics parameters. It could be one of the routines to exclude the potential injuries to the VA in the patients with arteriosclerosis before the rotatory manipulation of the cervical spine.

參考文獻(xiàn)/References:

[1] Haldeman S,Carey P,Townsend M,et al.Arterial dissections following cervical manipulation:the chiropractic experience[J].CMAJ,2001,165(7):905-906.
[2] Haldeman S,Kohlbeck FJ,McGregor M.Risk factors and precipitating neck movements causing vertebrobasilar artery dissection after cervical trauma and spinal manipulation[J].Spine,1999,24(8):785-794.
[3] Miley ML,Wellik KE,Wingerchuk DM,et al.Does cervical manipulative therapy cause vertebral artery dissection and stroke[J].Neurologist,2008,14(1):66-73.
[4] Young YH,Chen CH.Acute vertigo following cervical manipulation[J].Laryngoscope,2003,113(4):659-662.
[5] Heikkila H,Johansson M,Wenngren BI.Effects of acupuncture,cervical manipulation and NSAID therapy on dizziness and impaired head repositioning of suspected cervical origin:a pilot study[J].Man Ther,2000,5(3):151-157.
[6] Di Fabio RP.Manipulation of the cervical spine:risks and benefits[J].Phys Ther,1999,79(1):50-65.
[7] Haldeman S,Kohlbeck FJ,McGregor M.Unpredictability of cerebrovascular ischemia associated with cervical spine manipulation therapy:a review of sixty-four cases after cervical spine manipulation[J].Spine,2002,27(1):49-55.
[8] Haldeman S,Kohlbeck FJ,McGregor M.Stroke,cerebral artery dissection,and cervical spine manipulation therapy[J].J Neurol,2002,249(8):1098-1104.
[9] Cagnie B,Barbaix E,Vinck E,et al.Atherosclerosis in the vertebral artery:an intrinsic risk factor in the use of spinal manipulation[J]? Surg Radiol Anat,2006,28(2):129-134.
[10] 李義凱,鐘世鎮(zhèn).旋轉(zhuǎn)手法對(duì)椎管內(nèi)結(jié)構(gòu)和容積影響的研究[J].中國(guó)中醫(yī)骨傷科,1997,5(6):4-7.

備注/Memo

備注/Memo:
基金項(xiàng)目:浙江省中醫(yī)藥管理局科技項(xiàng)目(2009CA078)
更新日期/Last Update: 2011-02-25