【摘要】 目的:观察青年颈型颈椎病危险因素、症状、体征特点及对生活的影响,并提出诊治策略。方法:通过调查问卷的形式,收集患者的基本信息,并通过列表分析患者危险因素、症状、体征特点,运用颈椎功能障碍指数量表(NDI)评价对其生活的影响,疼痛视觉模拟评分法(VAS)评价疼痛,测量颈椎活动度等方式,总结得出青年颈型颈椎病患者危险因素、症状、体征特点及对生活的影响,提出颈型颈椎病的诊治策略。结果:在青年颈椎病发病人群中,低头工作(92%)、枕头因素(66%)、久居寒湿之地(54%)为致病最常见的危险因素;颈部疼痛、颈部活动受限(100%)为主要主诉症状,而颈项部乏力(43.7%)、头痛(25.2%)、头晕头沉(12.6%)为次要主诉症状。VAS评分1~3分占5.88%(7例),4~6分占93.28%(111例),7~10分占0.84%(1例),其中位数为5。NDI评分区间13~17分,平均为15.41分,提示对于生活质量的影响,以轻度到中度影响为主。常见的压痛点位于颈部肌群的起止点、颈椎棘突旁、横突旁、肩胛骨内上角、棘突上、枕骨下缘、肩颈部等。应用头盔式颈椎活动仪进行颈椎活动度的测量评分,平均(12.24±1.05)分,提示为中度的活动受限,在三维六个方向上,以屈伸功能受限为最重,侧旋次之。结论:低头工作、枕头因素、久居寒湿之地为青年颈型颈椎病致病最常见的危险因素;其症状特点为中度疼痛、以屈伸、旋转受限为主,对生活质量产生轻到中度影响。针对青年颈型颈椎病提出"筋骨并重、医患合作"的诊治策略,以手法治疗为核心,能够很好地改善患者的症状,维持治疗疗效,可达到治愈的目的。更多还原

【Abstract】 Objective:To observe the risk factors and characteristics of symptoms and signs of cervical spondylopathy in young people as well as the impact of cervical spondylopathy on life,and to put forward the treatment strategy. Methods:Gathered basic information of patients by means of questionnaires,and analyzed risk factors,characteristics of symptoms and signs of patients through the lists. Through the evaluation of impact on life using neck disability index(NDI), the assessment of pain using pain visual analogue scale(VAS) and the measurement of cervical range of motion,summed up the risk factors,symptoms,signs and the impact on life,and provided the treatment strategy of cervical spondylopathy in young people. Results:Among the young people with cervical spondylopathy,lowering heads when working(92%),pillow factors(66%) and long-time staying in cold and damp places(54%) were the most common risk factors; neck pain and cervical motion limitation(100%) were the chief complaints, and cervical hypodynamia(43.7%), headache(25.2%) and dizziness(12.6%) were the secondary complaints. VAS scores between 1 and 3 took up 5.88%(7 cases),between 4 and 6 took up93.28%,(111 cases),and between 7 and 10 accounted for 0.84%(1 case),median being 5. NDI scores ranged from 13 to17,with an average of 15.41,suggesting the effect on quality of life was from mild to moderate. The common tender points were located in the starting and ending points of neck muscles, the border of spinous process, transverse process, the superior angle of scapula,the upper edge of spinous process,the lower edge of the occipital and the shoulder and neck,etc. The cervical range of motion was scored by a head-mounted cervical activity recorder,with an average score of(12.24±1.05), indicating that the moderate activity was limited. In six directions of the three-dimensional space, flexion andextension function was most heavily limited, followed by lateral rotation. Conclusion: The most common risk factors of cervical spondylosis among young patients were lowering heads when working,pillow factors and long-time staying in cold and damp places. The symptoms were featured by moderate pain, mainly presenting by flexion and extension function limitation and lateral rotation limitation,the quality of life being influenced from mildly to moderately. According to the cervical spondylopathy in young people,we bring forward the treatment strategy——"Equal emphasis on muscles and bones and Cooperation between doctors and patients". Viewing manipulation treatment as the key element can greatly improve the symptoms of patients,maintain the curative effect and cure the disease.更多还原