头部旋转和伸展过程中椎动脉血流速度的变化及其意义。

Changes and implications of blood flow velocity of the vertebral artery during rotation and extension of the head.

作者信息

Li Y K, Zhang Y K, Lu C M, Zhong S Z

机构信息

Department of Traditional Chinese Medicine, Institute of Clinical Anatomy and Biomechanics, The First Military Medical University, People's Republic of China.

出版信息

J Manipulative Physiol Ther. 1999 Feb;22(2):91-5. doi: 10.1016/s0161-4754(99)70113-2.

DOI:10.1016/s0161-4754(99)70113-2

PMID:10073624

Abstract

OBJECTIVE

To study the effects of extension and extension-rotation of the head on the blood flow velocity of the vertebral artery experimentally and clinically.

DESIGN

Randomized experimental clinical study.

SETTING

Institute of Clinical Anatomy and Biomechanics and the Department of Ultrasound, NanFang Hospital of the First Military Medical University, Guangzhou, China.

SUBJECTS

The fresh spines from T1-2 to the occipital bone were obtained from persons who died of acute brain death (n = 10). For the transcranial Doppler measurement, 27 asymptomatic subjects with routine physical examination results and 23 students from the above-mentioned university took part in the test.

INTERVENTIONS

The instillation experiment in the cadavers was made. Clinical measurements of blood flow velocity in the vertebral artery in the subjects and students were taken and recorded.

MAIN OUTCOME MEASURES

Changes in the drop of the vertebral artery were measured by the instillation test in the experimental sample. The blood flow velocity was measured with transcranial Doppler sonography during extension and extension-rotation of the head.

RESULTS

During one-sided rotation of the head with extension of the head, measurements in the contralateral vertebral artery and the bilateral vertebral arteries were both reduced in the instillation experiment. The blood flow velocity in the bilateral vertebral arteries decreased during extension and extension-rotation of the head in the subjects and the students. The pulsatility index in the right vertebral arteries increased more than that in the left in extreme extension and that in the bilateral vertebral arteries in neutral position.

CONCLUSIONS

Extreme rotation and extension are dangerous to patients who have abnormal vertebral arteries when extreme rotatory and extension manipulations are applied. Doctors should be very careful when rotating the patient's head to the right side.

摘要