156例颈性眩晕患者病因分析及治疗探讨  

作　　者：张健[1] 吕守正[1] 刘英春[1] 李志勇[1] 赵日光[2] 

机构地区：[1]天津市宝坻区人民医院骨科,301800 [2]天津市宝坻区人民医院神经内科,301800

出　　处：《当代医学》2012年第15期83-84,共2页Contemporary Medicine

摘　　要：目的 回顾156例颈性眩晕患者临床资料,分析病因并探讨合理的治疗方法。方法 回顾2007～2010年收治的156例颈性眩晕患者,全部病人均行磁共振血管造影(MRA)和/或椎动脉造影检查(DSA),其中非手术治疗96例,颈椎前路融合手术57例,椎动脉支架成形术3例,术后按照Nagashima标准评价其疗效。结果 随访8～42个月,平均25个月,93例(59.6%)患者效果为优或良,手术组优于非手术组;椎动脉受累部位:起始段4例,椎体段118例,颅内段8例,发育性椎动脉狭窄6例,无影像学异常者20例;本组无死亡病例,手术组无神经系统并发症病例,椎动脉造影后脑梗塞2例,髂骨取骨伤口感染2例,颈椎螺钉松动1例。结论 钩椎关节增生、椎间隙塌陷导致的椎动脉扭曲是颈性眩晕的主要原因,前路颈椎融合术是治疗椎动脉型颈椎病的有效方法。Objective To analyze the pathogenetic factors and explore rational treatment by reviewing 156 cervical vertigo patients. Methods Reviewing 156 cervical vertigo patients from 2007-2010, all patients had MRA and/or DSA, 96 patients had conservative therapy, 57 had cervical anterior fusion, 3 had interventional therapy, clinical result was evaluated by Nagashima Scoring. Results After 8-42 months following（average 25）, 93 patients had excellent or good result, the patients having cervical anterior fusion had more benefit when compared with who had conservative therapy. The involving segment of vertebral artery： 4 at V1, 118 at V2, 8 at V4, 6 had congenital stenosis, 20 had no imaging abnormality. 2patients had cerebral infarction after DSA. Conclusion Cervical degeneration, collapse of intervertebral disc, distortion of vertebral artery are main pathogenetic factors, and cervical anterior fusion Can benefit most patients.

关 键 词：颈性眩晕 颈椎前路融合术 椎动脉造影检查 CTA 磁共振血管造影 

分 类 号：R687.3[医药卫生—骨科学]