颈根部扳机点按压法在神经根型颈椎病诊断与治疗中的应用(1)
摘要目的：提出针对颈肩上肢疼痛的颈根部扳机点检查来快速鉴别诊断神经根型颈椎病与椎管外疾病的特殊体征检查方法，并探讨其临床阳性率及其检查方法与在治疗中的意义。方法：回顾性分析海军总医院疼痛诊疗中心收治的200例神经根型颈椎病患者的临床查体资料。比较治疗前与治疗后扳机点按压试验检查方法与椎间孔挤压试验、臂丛牵拉试验检查方法的阳性率并与肌电图检查结果相对照。结果：术前3种特殊体征检查阳性率以颈根部扳机点按压试验阳性率最高达965%，臂丛牵拉试验阳性率为3398%，扳机点按压试验并且与肌电图检查结果吻合率较高。结论：颈根部扳机点按压试验临床应用中检出阳性率高，操作简单快速，能更好的反应神经根型颈椎病病情，在门诊工作中可以快速筛查患者，指导后续检查并且在治疗中有关键性的作用，值得推广。
关键词颈根部扳机点按压试验；椎管内外病变；体征检查；治疗作用
Application of Cervical Roots Trigger Point Pressing Method in the Diagnosis and Treatment of Cervical Spondylotic Radiculopathy
, 百拇医药
Fu Bensheng， Ding Yu， Qiao Jinlin， Du Wei， Zhang Jing， Cui Hongpeng， Zhong Yuxian， Tian Suhuai
(Department of Rehabilitation Medicine and Pain Treatment Center， Navy General Hospital， Beijing 100048， China)
AbstractObjective：To put forward an examination method of special signs to rapidly identify and diagnose cervical spondylotic radiculopathy and extraspinal diseases by cervical roots trigger point pressing for neck shoulder and limb pain， and to explore its clinical positive rate and the significance of examination method in clinical practice.Methods：The clinical physical examination data of 200 patients with cervical spondylotic radiculopathy who were received and treated in Pain Treatment Center of Navy General Hospital from June 2013 to May 2016 were retrospectively studied.The positive rates of trigger point pressure test method， intervertebral foramen extrusion test， and brachial plexus pull test method before and after treatment were compared， and they were also compared with the results of electromyography.Results：Among the three special signs examination methods before treatment， the positive rate of cervical roots trigger point pressing method was highest of 965%， and brachial plexus pull test method of 3398%.The trigger point pressure test method had a relatively higher agreement rate with the results of electromyography.Conclusion：Cervical roots trigger point pressing method has a high positive rate in clinical application with easy and quick operation， and can better reflect the conditions of patients with cervical spondylotic radiculopathy.This method can quickly screen patients in outpatient work， and guide the followup check， as well as plays a key role in the treatment， which is worthy of promotion.
Key WordsCervical roots trigger point pressure test； Pathological changes in the intravertebral canal and extravertebral canal； Physical examination； Curative effect
中圖分类号：R274文献标识码：Adoi：10.3969/j.issn.1673-7202.2017.09.013, http://www.100md.com(付本升丁宇乔晋琳杜薇张静崔洪鹏钟毓贤田苏淮)
关键词颈根部扳机点按压试验；椎管内外病变；体征检查；治疗作用
Application of Cervical Roots Trigger Point Pressing Method in the Diagnosis and Treatment of Cervical Spondylotic Radiculopathy
, 百拇医药
Fu Bensheng， Ding Yu， Qiao Jinlin， Du Wei， Zhang Jing， Cui Hongpeng， Zhong Yuxian， Tian Suhuai
(Department of Rehabilitation Medicine and Pain Treatment Center， Navy General Hospital， Beijing 100048， China)
AbstractObjective：To put forward an examination method of special signs to rapidly identify and diagnose cervical spondylotic radiculopathy and extraspinal diseases by cervical roots trigger point pressing for neck shoulder and limb pain， and to explore its clinical positive rate and the significance of examination method in clinical practice.Methods：The clinical physical examination data of 200 patients with cervical spondylotic radiculopathy who were received and treated in Pain Treatment Center of Navy General Hospital from June 2013 to May 2016 were retrospectively studied.The positive rates of trigger point pressure test method， intervertebral foramen extrusion test， and brachial plexus pull test method before and after treatment were compared， and they were also compared with the results of electromyography.Results：Among the three special signs examination methods before treatment， the positive rate of cervical roots trigger point pressing method was highest of 965%， and brachial plexus pull test method of 3398%.The trigger point pressure test method had a relatively higher agreement rate with the results of electromyography.Conclusion：Cervical roots trigger point pressing method has a high positive rate in clinical application with easy and quick operation， and can better reflect the conditions of patients with cervical spondylotic radiculopathy.This method can quickly screen patients in outpatient work， and guide the followup check， as well as plays a key role in the treatment， which is worthy of promotion.
Key WordsCervical roots trigger point pressure test； Pathological changes in the intravertebral canal and extravertebral canal； Physical examination； Curative effect
中圖分类号：R274文献标识码：Adoi：10.3969/j.issn.1673-7202.2017.09.013, http://www.100md.com(付本升丁宇乔晋琳杜薇张静崔洪鹏钟毓贤田苏淮)
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