寰椎椎动脉沟环综合征的防治研究  

Study for diagnosis and treatment of Foramen Arcual

作　　者：孙静宜[1] 王爱莲[2] 李世和 

机构地区：[1]昆明医学院第一附属医院骨科,650032 [2]昆明医学院解剖教研室,云南昆明650031

出　　处：《颈腰痛杂志》2002年第1期15-17,共3页The Journal of Cervicodynia and Lumbodynia

基　　金：国家自然科学基金资助 (391 70 730 )

摘　　要：目的　研究寰椎椎动脉沟环激压椎动脉引起供血障碍导致以眩晕为主的供血区组织器官功能障碍 ,称之为沟环综合征及其防治办法。方法　通过 2 0 0具成年尸骨形态学的观察 ,沟环出现率为 2 8.5 % ,临床 170 0 0例颈性眩患者沟环发病率为 7.4 % ,进一步从临床症状研究 ,12 5 8例沟环患者都有枕颈失稳 ,而 5 0 0例无症状者 2 .4 %有沟环皆无枕颈失稳 ,证明枕颈失稳是沟环发病的主要原因。用 D.S.A.MRA.CT,脉冲多普勒检测成年活弥猴 8条椎动脉 ,成年患者 18条椎动脉和手术治疗患者所见得知沟环激压椎动脉外膜上的椎神经使椎动脉痉摩血流梗阻导致的眩晕 ,结果　发病机制为 :沟环 +枕颈失稳 +头颈转动至某种特定姿位→椎动脉外膜上的椎神经受刺激→椎动脉痉挛→供血障碍→眩晕”。结论　根据发病机制制定的治疗原则疗效优良率 98%以上。沟环综合征不是久治不愈的疾患。Objective The Foramen Arcual of atlas,a kind of congenital abnormality,and it could cause vertigo and sudden fall of body.Yet,little attantion has been paid to those symptoms.We are now studing the approaches of prevention of this disease.Methods 57 foramen arcuals were found on 200 adult skeletons being 28.5% of the total and 12 foramen arcuals were found on 500 normal persons without any signs of symptoms being 2.4% of the total.After study it shown that instabilities of cervical with occipital were found on those with foramen arcuals.It explains that symptoms caused by foramen arculas are associated with instabilities of cervical with occipital.The results of the experimants on 8 Monkies vertebral arteries of 9 adults V.A.treated by D.S.A,MRA and Doppler show that vertigo resulting from vertebral artery spasm and disturbances of arterial flow is due to stimulation of foramen arcural on the Framcois Franck adventitia of vertebral artery.Rasults Foramen arcual+instability of cervical with occipital+head turning to specific position+stimulation on Francois Franck plexus blood supply obstruction due to vertebral artery spasm→Vertigo.Conclussion With the pathogenesis of this disease,effective diagnosis,treatment,and prevention method have been established,thus,unnecessary losses of lives and properties have been successfully avoided.

关 键 词：寰椎 眩晕 骨小桥 寰椎椎动脉沟环综合征 防治 

分 类 号：R682.120.1[医药卫生—骨科学]