颅脑外伤患者颈性眩晕的发生情况及其机制探讨  

Occurrence and mechanism of cervical vertigo in head injury patients

作　　者：鲍洪[1] 丁轩[1] 吴开华[1] 招建华[1] 兰蒙[1] 

机构地区：[1]暨南大学医学院第三附属医院、广东省珠海市人民医院神经外科,珠海519000

出　　处：《中华神经医学杂志》2008年第7期725-727,730,共4页Chinese Journal of Neuromedicine

基　　金：珠海市科技局立项课题（PC20052015）

摘　　要：目的探讨轻、中型颅脑外伤患者颈性眩晕的发生情况及其机制。方法全部患者早期分别行颈椎X线和TCD检查．部分患者行计算机断层螺旋扫描（SCT）检查．结果先行单因素分析，然后对单因素分析有意义的自变量进行多因素非条件Logistic回归分析，了解检查异常的自变量与发生颈性眩晕的关系。结果312例轻、中型颅脑外伤患者中并发颈性眩晕84例。单因素分析颈椎X线异常、SCT异常、TCD中度以上异常组颈性眩晕发生率差异有统计学意义。通过回归分析发现，SCT表现异常及TCD中度以上异常是颈性眩晕发生的独立危险因素，发现单项异常者有可能并发颈性眩晕，若二者以上同时异常，就应高度重视可能并发颈性眩晕。结论颈椎SCT异常和TCD巾度以上异常的轻、中型颅脑外伤患者极有可能并发颈性眩晕，颈椎SCT和TCD检查可预测是否发生颈性眩晕。Objective To investigate the occurrence of cervical vertigo in patients with mild or moderate head injury and the related mechanism. Methods 312 cases suffering from mild or moderate head injury were examined by cervical spine X-ray and transcranial Doppler （TCD）, or spinal computed tomography （SCT） in some. The examination results were analyzed by single factor analysis first, then the independent variables which had statistical meaning were analyzed by unconditional multivariate Logistic regression analysis to find out the relationship between abnormity of their results and cervical vertigo. Results By single factor analysis, the abnormity of cervical spine X-ray, SCT and over moderate abnormity of TCD had statistical significance with cervical vertigo. Logistic regression analysis indicated that the abnormity of SCT and over moderate abnormity of TCD had statistical significance with cervical vertigo. Cervical vertigo may be occurred when one of the two examination results were abnormal, and it must be attached importance to when both examination results were abnormal. Conclusion The patients suffering from mild and moderate head injury accompanied with cervical spine SCT abnormity, or over moderate abnormity of TCD indicating insufficient blood in the vertebrae-base arteries may greatly have cervical vertigo. SCT and TCD may forecast whether cervical vertigo occurs in the patients with mild or moderate head injury.

关 键 词：颅脑外伤 颈性眩晕 颈椎X线 计算机断层螺旋扫描 经颅多普勒 

分 类 号：R651.15[医药卫生—外科学]