胸12椎体骨质疏松性椎体压缩骨折致心前区牵涉痛误诊为冠心病特征分析  

Characteristic analysis of precordial referred pain caused by osteoporotic vertebral compression fracture in the 12th thoracic vertebrae misdiagnosed as coronary heart disease

作　　者：郭义城 谢志鹏 刘万里 赵阳 车艳生 赵敏 Guo Yicheng;Xie Zhipeng;Liu Wanli;Zhao Yang;Che Yansheng;Zhao Min(Department of Traumatology and Neurosurgery,946th Hospital of PLA,Yining 835000,China;Department of Drug and Equipment,946th Hospital of PLA,Yining 835000,China;Hygienic Unit of PLA Unit 69349,Zhaosu 835600,China)

机构地区：[1]解放军第946医院创伤神经外科,伊犁哈萨克自治州伊宁市835000 [2]解放军69349部队卫生队,伊犁哈萨克自治州昭苏县835600 [3]解放军第946医院药械科,伊犁哈萨克自治州伊宁市835000

出　　处：《中华诊断学电子杂志》2023年第2期136-139,共4页Chinese Journal of Diagnostics(Electronic Edition)

摘　　要：目的探讨胸12椎体骨质疏松性椎体压缩骨折(OVCF)伴心前区牵涉痛的误诊原因及临床特点。方法回顾性分析解放军946医院骨科于2019年5月25日和2021年3月8日收治的误诊为冠心病的胸12椎体OVCF 2例患者的临床资料,总结胸12椎体OVCF引起心前区牵涉痛的临床特征。结果2例均因“胸部、背部疼痛不适”入院,最初均考虑冠心病并进行相关检查和治疗,效果不佳,进一步检查后发现由胸12椎体骨折引起,给予经皮椎体成形术,术后心前区疼痛消失,出院后随访效果较好。结论胸12椎体骨折引起心前区远处牵涉痛临床少见,对老年人OVCF引起的牵涉性痛要加强认识,减少误诊误治。Objective To discuss the causes of misdiagnosis and clinical characteristics of osteoporotic vertebral compression fractures(OVCF)in the 12th thoracic vertebrae with precordial referred pain.Methods The clinical data of 2 cases of OVCF in the 12th thoracic vertebrae misdiagnosed as coronary heart disease admitted to the Department of Orthopedics of the 946th Hospital of PLA on May 25,2019,and March 8,2021,were retrospectively analyzed,and the clinical characteristics of referred pain in the precordial area caused by OVCF of the 12th thoracic vertebrae were summarized.Results Both cases were all admitted due to"chest and back pain and discomfort".Coronary heart disease was initially considered and relevant examination and treatment were performed,but the results were not good.Further examination revealed that it was caused by the 12th thoracic vertebral fracture,and percutaneous vertebroplasty was performed.The pain in the precordial area disappeared after the surgery,and the follow-up results were good after discharge.Conclusions The 12th thoracic vertebral fracture causes far precordial referred pain,which is rare in clinical practice.We should strengthen the understanding of the referred pain caused by OVCF in the elderly to reduce misdiagnosis and mistreatment.

关 键 词：脊柱骨折 骨质疏松 心前区 牵涉痛 冠心病 

分 类 号：R687.3[医药卫生—骨科学]