[1]张法尧△ 赵树森 朱立国.颈部旋转相关极限体位对椎动脉血流的影响[J].中国中医骨伤科杂志,2017,25(03):17-20.
 ZHANG Fayao ZHAO Shusen ZHU Liguo.Effect of Cervical Rotation-related Limit Position on Vertebral Artery Blood Flow[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2017,25(03):17-20.
点击复制

颈部旋转相关极限体位对椎动脉血流的影响()
分享到:

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第25卷
期数:
2017年03期
页码:
17-20
栏目:
临床研究
出版日期:
2017-03-08

文章信息/Info

Title:
Effect of Cervical Rotation-related Limit Position on Vertebral Artery Blood Flow
文章编号:
1005-0205(2017)03-0017-04
作者:
张法尧12△ 赵树森1 朱立国2
1.黑龙江齐齐哈尔市中医医院(黑龙江 齐齐哈尔,161005)
2.中国中医科学院望京医院
△.通信作者 E-mail:jipinningmeng@126.com
Author(s):
ZHANG Fayao12△ ZHAO Shusen1 ZHU Liguo2
1.Qiqihar Hospital of Traditional Chinese Medicine,Qiqihar 161005,Heilongjiang China;
2.Wangjing Hospital of China Academy of Chinese Medical Sciences,Beijing 100102,China.
关键词:
颈部 极限旋转体位 椎动脉血流
Keywords:
neck limit rotation positions vertebral artery blood flow
分类号:
R681.5
文献标志码:
A
摘要:
目的:使用多普勒超声评价颈部旋转相关极限体位对椎动脉血流的影响。方法:对40个健康成人年龄在19~21岁(平均20.2岁),分别在颈部中立位、同侧旋转极限,同侧屈曲旋转极限,同侧后伸旋转极限,对侧旋转极限,对侧屈曲旋转极限,对侧后伸旋转极限,卧位,卧位同侧旋转极限,卧位对侧旋转极限等体位下进行椎动脉的流速,管径多普勒超声测量。测量椎动脉位于颈3~4节段,血流量和总血流量通过计算获得,总血流量为同一体位下双侧椎动脉流量和。对包括椎动脉流速,管径,流量及颈部活动角度等数据进行统计分析。结果:后伸旋转极限体位的总血流量大于立位旋转极限位,屈曲旋转极限位,卧位旋转极限位,差异有统计学意义(P<0.05),而后三者之间差异无统计学意义(P>0.05); 与中立位比较,旋转极限位和屈曲旋转极限位时,对侧椎动脉血流量均减少,差异有统计学意义(P<0.05),后二者差异无统计学意义(P>0.05),而旋转极限位同侧椎动脉流速,管径均增加,屈曲旋转极限位同侧仅管径增加,差异有统计学意义(P<0.05),流量差异无统计学意义(P>0.05)。结论:颈部不同的旋转相关极限体位对椎动脉血流产生不同的影响,后伸旋转极限位可能增加椎基底动脉血流量。
Abstract:
Objective:To evaluate the effect of cervical rotation-related limit position on vertebral artery blood flow by using transcranial Doppler(TCD).Methods:Transcranial Doppler was used to measure blood flow velocity and artery diameter in the vertebral arteries of 40 healthy adults aged 19 to 21 years old(mean 20.2 years old)in the positions as follows:neck neutral position,ipsilateral rotation limit,ipsilateral flexion rotational limit,ipsilateral extension of rotation limit,contralateral rotation limit,contralateral flexion rotation limit,contralateral extension rotation limit,supine,supine ipsilateral rotation limit,supine contralateral rotation limit and so on.The vertebral artery in the cervical 3-4 segment were measured,the blood flow and the total blood flow were obtained by calculation.The total blood flow was the sum of bilateral vertebral artery flow under the same position.The data including the vertebral artery flow rate,diameter,flow and the activity of neck angle were statistically analyzed.Results:The total blood flow in posterior rotation limit position was higher than that in the rotation limit position,flexion rotation limit position and supine rotation limit position(P<0.05),and there was no significant difference between the three positions(P>0.05).Compared with the neutral position,the contralateral vertebral artery blood flow were reduced in the rotational limit position and flexion limit(P<0.05),and there was no significant difference between the two group(P>0.05),while the flow velocity and the diameter of ipsilateral vertebral artery in rotation limit position were both increased,for the ipsilateral vertebral artery in flexion rotation limit position,only its diameter was increased(P<0.05),there was no significant difference in the flow velocity(P>0.05).Conclusion:The different rotation-related limit positions of the neck have different effects on the blood flow of the vertebral arteries,and the posterior rotation limit can increase the vertebrobasilar blood flow.

参考文献/References:

[1] 焦明德.实用经颅多普勒超声学[M].北京:北京医科大学协和医科大学联合出版社,1995:116.
[2] 诸兴明,黄丽娜,万琦,等.经颅多普勒超声转颈试验在颈性眩晕诊断中的应用价值[J].脊柱外科杂志,2014,12(3):173-175.
[3] 郄晓红,王海音.经颅多普勒转颈试验对椎动脉血流的影响[J].空军总医院学报,2010,26(2):82-83.
[4] Machaly SA,Senna MK,Sadek AG.Vertigo is associated with advanced degenerative changes in patients with cervical spondylosis CIl[J].Clin Rheumatol,2011,30(12):1527-1534.
[5] 王辉昊,詹红生,吕桦,等.矫正颈椎“筋出槽骨错缝”手法治疗颈性眩晕的远期疗效观察[J].上海中医药杂志,2014,48(2):51-55.
[6] 席智杰,梁倩倩,施杞.有关颈椎定点旋转手法的几点思考[J].中国中医骨伤科杂志,2015,23(2):65-67.
[7] 孙金水,李云.龙氏正骨手法治疗颈椎小关节病错位型颈椎病的临床疗效观察[J].当代医学,2014,24(359):35-36.
[8] 谢利民,张涛.张氏手法治疗椎动脉型颈椎病疗效观察[J].中医正骨,1999,11(7):411.
[9] 李义凯,钟世镇.旋转手法对椎管内结构和容积影响的研究[J].中国中医骨伤科杂志,1997,5(6):4-6.
[10] 赵美玲.转颈试验对椎动脉型颈椎病患者椎-基底动脉血流速的影响[J].医学影像学杂志,2008,18(7):724-726.
[11] 贾杰,闻春艳,张文杰.转颈试验在彩色多普勒超声检测颅外段椎动脉诊断椎动脉型颈椎病的价值[J].中国实验诊断学,2015,19(9):1544-1545.
[12] 李泽宇,博 林,王智光,等.转颈屈颈及仰头试验与经颅多普勒和核磁共振血管成像评估椎动脉狭窄性眩晕的效应比较[J].中国临床康复,2005,9(18):254-255.
[13] 叶洁,顾小华,许金海,等.颈性眩晕的中医证型与脑血流动力学的相关性研究[J].中国中医骨伤科杂志,2014,22(3):7-11.
[14] 何及,樊东升,孙宇.颈性眩晕[J].中国实用内科杂志,2011,31(6):414-415.
[15] 刘铁军,张西平.TCD转颈试验在诊断椎基底动脉供血不足中的应用价值[J].陕西医学杂志,2011,40(9):1255-1256.
[16] Thomas LC,McLeod LR,Osmotherly PG,et al.The effect of end-range cervical rotation on vertebral and internal carotid arterial blood flow and cerebral inflow:A sub analysis of an MRI study[J].Man Ther,2015,20(3):475-480.

更新日期/Last Update: 2017-03-15