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旋转复位手法对颈性眩晕患者椎 |
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王楚怀 卓大宏 赖在文 毛玉蓉 陈颖贤
摘要 目的：为旋转复位手法的安全操作及治疗作用机制提供科学依据。方法：采用经颅多普勒(TCD)检测50例颈性眩晕患者（眩晕组）及健康者(对照组，25例）在实施旋转复位手法使头颈受极度旋转时，以及接受旋转复位手法治疗后椎-基底动脉的血流速度。结果：眩晕组转颈后双侧椎动脉流速明显下降(P＜0.05)，基底动脉流速有所下降；对照组转颈后双侧椎动脉及基底动脉流速下降均不明显。眩晕组双侧椎动脉及基底动脉流速均较对照组明显加快(P＜0.05)，TCD提示椎动脉痉挛或狭窄；经旋转复位手法治疗后颈性眩晕患者症状明显改善或消失，双侧椎动脉及基底动脉流速均明显降低(P＜0.05)，TCD提示椎动脉痉挛或狭窄减轻或消失。结论：旋转复位手法潜伏着导致椎-基底动脉急剧供血不足或损伤椎动脉的危险。但如果选用得当，手法正确娴熟，不但能避免损伤和意外，而且能改善椎-基底动脉供血。
关键词 手法；颈性眩晕；椎-基底动脉
Changes of vertebrobasilar artery blood flow velocity in patients with cervical vertigo during and after rotatory reduction manipulation
WANG Chuhuai, ZHUO Dahong, LAI Zaiwen,et al
Department of Rehabilitation Medicine, The Affiliated First Hospital, Sun Yat-sen University of Medical Sciences,Guangzhou,510080
Abstract Objective:To provide scientific bases of safe operation and mechanism of rotatory reduction manipulation(RRM) on cervical vertigo. Method:Changes of blood flow velocity of vertebral basilar artery in 50 cases of cervical vertigo were examined with Doppler during and after the manipulation. Twenty-five health subjects were chosen as the control group.Result:During rotation of head with RRM the BFV of bilateral vertebral artery (VA) decreased(P<0.05)，but the BFV of basilar artery (BA) did not decreased significantly in the VG, and neither of them decreased significantly in the CG, while neither the VG nor the CG showed vertigo or other discomforts during the manipulation. The BFV of bilateral VA and BA were obviously faster in the VG than in the CG (P<0.05). After treating with RRM for a period of 6 weeks the syndrome improved significantly or disappeared and the BFV of bilateral VA and BA were lowered (P<0.05)in the VG. This suggested that the spasm or stenosis of VA and BA in VG improved as a result of the treatment with RRM. Conclusion:RRM might potentially induce the risk of sudden vertebrobasilar insufficiency or damages of VA. If this method is u[1] [2] 下一页
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