剪切波弹性成像评价鼻咽癌放疗后胸锁乳突肌纤维化康复疗效  

Effect of Exercise on Sternoceleidomastoid Muscular Fibrosis after Radiotherapy for Nasopharyngeal Carcinoma Patients Analyzed by Shear-Wave Elastography

作　　者：何萃[1] 易文鸿 罗宝龙 温圆圆 曹君妍[2] 郭立兵[1] HE Cui;YI Wenhong;LUO Baolong;WEN Yuanyuan;CAO Junyan;GUO Libing(Guangdong Second Provincial General Hospital,Guangzhou,Guangdong 510317,China;The Third Affiliated Hospital,Sun Yat-Sen University,Guangzhou,Guangdong 510630,China;Huizhou No.1 Maternal and Child Care Service Center,Huizhou,Guangdong 516000,China)

机构地区：[1]广东省第二人民医院,广东广州510317 [2]中山大学附属第三医院,广东广州510630 [3]惠州市第一妇幼保健院,广东惠州516000

出　　处：《康复学报》2022年第1期68-74,共7页Rehabilitation Medicine

基　　金：广东省医学科学技术研究基金项目(B2018015);广东省第二人民医院青年科研项目(YQ2016-015)。

摘　　要：目的:运用剪切波弹性成像评价鼻咽癌放疗后胸锁乳突肌纤维化的康复疗效,为放疗肌纤维化提供临床诊疗新思路和方法。方法:选取20例鼻咽癌放疗患者为受试者,放疗年限1.5~5年,接受3个月康复训练,于治疗前后采集患者的颈椎关节活动度数据,运用剪切波弹性成像采集胸锁乳突肌厚度、宽度和杨氏模量值进行自身治疗前后比较。结果:治疗前后双侧胸锁乳突肌厚度比较,差异有统计学意义(P<0.05);治疗前后双侧胸锁乳突肌宽度比较,差异有统计学意义(P<0.05);治疗前后双侧胸锁乳突肌杨氏模量值比较,差异有统计学意义(P<0.05)。对颈椎关节活动度的比较,受试者治疗前后颈椎向左旋转、向右旋转和向右侧屈关节活动度比较,差异有统计学意义(P<0.05),但向左侧屈、颈前屈和颈后伸关节活动度差异无统计学意义(P>0.05)。结论:治疗后胸锁乳突肌的杨氏模量值较治疗前降低,胸锁乳突肌的宽度和厚度较治疗前增加,颈椎向左旋转、向右旋转以及向右侧屈关节活动度较治疗前提高。剪切波弹性成像技术可用于评估和量化放疗后肌纤维化的康复治疗效果。Objective:To evaluate the therapeutic effect of rehabilitation on sternoceleidomastoid muscular fibrosis after radiotherapy(RT)for nasopharyngeal carcinoma(NPC)patients by shear-wave elastography,and to provide a new clinical approach to solve radiation-induced muscular fibrosis.Methods:A total of twenty NPC patients who had received radiotherapy for 1.5-5 years and rehabilitation therapy for three months were enrolled.Cervical spine range of movement(ROM),the thicknesses,widths and Young’s module values of sternoceleidomastoid muscles were assessed before and after treatment.Results:The thickness of right and left sternoceleidomastoid muscles was significant different before and after treatment(P<0.05).The widths of right and left sternoceleidomastoid muscles were significant different before and after treatment(P<0.05).Compared with those before treatment,the Young’s module values of right and left sternoceleidomastoid muscles were significant different after treatment(P<0.05).The left and right rotations and right flexion ROM of cervical spine were significant different before and after treatment(P<0.05),while the left flexion,anteflexion and extension ROM of cervical spine were not significant different(P>0.05).Conclusion:The Young’s module values of sternoceleidomastoid muscles for NPC patients decreased after rehabilitation,while the cervical spine ROM of left and right rotations and right flexion,as well as widths and thickness of sternoceleidomastoid muscles increased after rehabilitation.The shear-wave elastography is a feasible way to evaluate the effectiveness of radiation-induced muscular fibrosis rehabilitation for NPC patients.

关 键 词：鼻咽癌 放射性损伤 肌纤维化 剪切波弹性成像 

分 类 号：R739.63[医药卫生—肿瘤]