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[1]朱旻宇,王靖,黃河,等.經(jīng)顱多普勒對(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(10):14-17.
　ZHU Min-yu*,WANG Jing,HUANG He,et al.Safety evaluation on the cervical rotatory manipulation for the arteriosclerosis patients through transcranial doppler[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2011,23(10):14-17.
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經(jīng)顱多普勒對(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)()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第23卷
期數(shù):
2011年10期
頁(yè)碼:
14-17
欄目:
臨床研究
出版日期:
2011-10-31

文章信息/Info

Title:
Safety evaluation on the cervical rotatory manipulation for the arteriosclerosis patients through transcranial doppler
作者:
朱旻宇; 王靖; 黃河; 等
溫州醫(yī)學(xué)院附屬第一醫(yī)院,浙江 溫州 325000
Author(s):
ZHU Min-yu*; WANG Jing; HUANG He; et al.*
The First Affiliated hospital of Wenzhou Medical College,Wenzhou 325000,Zhejiang,China
關(guān)鍵詞:
頸椎病 超聲檢查; 多普勒; 經(jīng)顱 動(dòng)脈硬化 椎動(dòng)脈 基底動(dòng)脈 手法; 骨科
Keywords:
Cervical spondylosis;  Ultrasonography; doppler; transcranial;  Arteriosclerosis;  Vertebral artery;  Basilar artery;  Manipulation; orthopedic
摘要:
目的:采用經(jīng)顱多普勒評(píng)價(jià)動(dòng)脈硬化患者行頸椎旋轉(zhuǎn)手法的安全性。方法:選取208例動(dòng)脈硬化患者納入動(dòng)脈硬化組,同期選取50例經(jīng)檢查無明顯動(dòng)脈狹窄、硬化斑塊及高血壓病史的志愿者納入對(duì)照組。分別采用經(jīng)顱多普勒測(cè)定2組患者頸椎中立位、左右旋轉(zhuǎn)45°時(shí)椎動(dòng)脈、基底動(dòng)脈的收縮期血流速度、舒張末期血流速度、平均流速及搏動(dòng)指數(shù)等參數(shù)。結(jié)果:頸椎中立位時(shí)2組患者雙側(cè)椎動(dòng)脈血流參數(shù)、左旋頸時(shí)右側(cè)椎動(dòng)脈血流參數(shù)、右旋頸時(shí)左側(cè)椎動(dòng)脈血流參數(shù)及頸椎中立位和左右旋頸時(shí)基底動(dòng)脈血流參數(shù)比較,差異無統(tǒng)計(jì)學(xué)意義; 左側(cè)旋頸時(shí)對(duì)照組左側(cè)椎動(dòng)脈的收縮期血流速度、舒張末期血流速度、平均流速大于動(dòng)脈硬化組(t=5.944,P=0.000; t=6.571,P=0.000; t=6.665,P=0.000),搏動(dòng)指數(shù)小于動(dòng)脈硬化組(t=4.802,P=0.001); 右側(cè)旋頸時(shí)對(duì)照組右側(cè)椎動(dòng)脈的收縮期血流速度、舒張末期血流速度、平均流速大于動(dòng)脈硬化組(t=4.122,P=0.001; t=4.221,P=0.000; t=11.320,P=0.000),搏動(dòng)指數(shù)小于動(dòng)脈硬化組(t=2.249,P=0.001)。結(jié)論:頸椎旋轉(zhuǎn)手法能改變動(dòng)脈硬化患者椎動(dòng)脈的血流參數(shù),而經(jīng)顱多普勒能夠準(zhǔn)確反映這些變化,因而可用于頸椎手法前對(duì)伴有動(dòng)脈硬化的患者進(jìn)行篩查,以減少由于椎動(dòng)脈血流改變而引起的臨床不良事件。
Abstract:
Objective:To evaluate the safety of cervical rotatory manipulation for the arteriosclerosis patients through transcranial doppler(TCD).Methods:Two hundred and eight arteriosclerosis patients were selected and enrolled into the arteriosclerosis group,at the same period,50 volunteers without obvious arteriostenosis,atherosclerotic plaque and history of hypertension were selected and enrolled into the control group.The parameters as peak systolic velocity(Vs),end diastolic velocity(Vd),mean velocity(Vm)and pulsatility index(PI)of the vertebral artery(VA)and basilar artery(BA)of the patients in the 2 groups were respectively evaluated through TCD when their cervical vertebras(CV)in the position of neutral and 45-degree rotation.Results:There was no statistical difference between the 2 groups in the following blood flow parameters as that of bilateral VA when CV in the neutral position,that of right VA when left rotation on CV,that of left VA when right rotation on CV,that of BA when CV in the neutral position,and that of BA when left/right rotation on CV for the patients.When left rotation on CV,the following parameters as Vs,Vd and Vm of left VA of the control group were larger than those of the arteriosclerosis group(t=5.944,P=0.000; t=6.571,P=0.000; t=6.665,P=0.000),while PI of left VA in the control group was smaller than that of the arteriosclerosis group(t=4.802,P=0.001).When right rotation on CV,the following parameters as Vs,Vd and Vm of right VA of the control group were larger than those of the arteriosclerosis group(t=4.122,P=0.001; t=4.221,P=0.000; t=11.320,P=0.000),while PI of right VA in the control group was smaller than that of the arteriosclerosis group(t=2.249,P=0.001).Conclusion:Cervical rotatory manipulation can change the blood flow parameters of VA for the arteriosclerosis patients,which can be reflected accurately through TCD,therefore,TCD should be used to screen the patients with arteriosclerosis before cervical manipulation for fear of the clinical adverse events caused by the change of the VA blood flow.

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更新日期/Last Update: 1900-01-01