本文選題：退行性腰滑脫 + 椎旁肌�。� 參考：《新疆醫(yī)科大學(xué)》2016年碩士論文

【摘要】：目的:探討退行性腰椎滑脫(Degenerative Lumbar spondylolisthesis DLS)患者椎旁肌橫截面積(cross-sectional area CSA)是否發(fā)生改變及其臨床意義。方法:采用回顧性研究方法,選取2013年9月份至2015年2月份的102例退行性腰椎滑脫患者為DLS組,45名男性和57名女性;年齡40-69歲,平均:54.3±8.11歲。選取在我院體檢的資料齊全的健康人102例為對(duì)照組,47名男性,55名女性,年齡45-67歲,平均53.48±6.45,兩組間性別、年齡相匹配(p0.05)。選取MRI圖像T2加權(quán)像L3、L4、L5椎體下緣作為選取測(cè)量平面,應(yīng)用Image J2x軟件分別測(cè)量?jī)山ML3、L4和L5椎體下緣水平線兩側(cè)椎旁肌,包括腰大肌、多裂肌和豎脊肌的CSA,所得數(shù)據(jù)使用t檢驗(yàn)分析兩組椎旁肌CSA的差異,對(duì)比同一組雙側(cè)椎旁肌是否存在差異,并將豎脊肌CSA與多裂肌CSA的比值進(jìn)行兩組之間對(duì)比。結(jié)果:DLS組與對(duì)照組對(duì)比在L5層面,雙側(cè)多裂肌CSA及雙側(cè)腰背伸肌CSA均減小,在L4層面右側(cè)腰大肌CSA及左側(cè)腰背伸肌CSA均減小,在L3層面雙側(cè)腰大肌CSA均減小、雙側(cè)多裂肌CSA及雙側(cè)腰背伸肌CSA均增大。DLS組雙側(cè)椎旁肌對(duì)比,在L3、L4層面多裂肌右側(cè)CSA減小,在L4層面豎脊肌雙側(cè)對(duì)比右側(cè)CSA減小,在L4層面腰背伸肌雙側(cè)對(duì)比右側(cè)CSA減小。對(duì)照組雙側(cè)椎旁肌對(duì)比,在L3層面豎脊肌右側(cè)CSA減小。DLS組與對(duì)照組在同一節(jié)段對(duì)比豎脊肌CSA與多裂肌CSA的比值,發(fā)現(xiàn)在L3層面DLS組豎脊肌CSA與多裂肌CSA的比值在雙側(cè)均較正常組減小。結(jié)論:退行性腰椎滑脫患者腰大肌、多裂肌CSA減小,肌肉發(fā)生萎縮,而豎脊肌肉CSA變化較多裂肌變化小,就目前研究現(xiàn)狀而言,退行性腰椎滑脫患者椎旁肌的改變需要更為系統(tǒng)的研究。
[Abstract]:Objective: to investigate whether the cross-sectional area of paravertebral muscle in patients with degenerative lumbar spondylolisthesis (DLSs) and its clinical significance. Methods: 102 cases of degenerative lumbar spondylolisthesis from September 2013 to February 2015 were selected as DLS group with 45 males and 57 females aged 40-69 years with an average of 54.3 鹵8.11 years old. 102 healthy persons with complete physical examination in our hospital were selected as control group. There were 47 males and 55 females aged 45-67 years (mean 53.48 鹵6.45). Using T _ 2 weighted MRI images as the measuring plane, the paravertebral muscles, including the psoas major muscles, were measured by Image J2x software in two groups of lateral paravertebral muscles, including the psoas major muscle, at the horizontal level of the lower margin of the L3P L4 and L5 vertebrae, respectively. The difference of CSA in paravertebral muscles between the two groups was analyzed by t test, and the ratio of CSA to CSA was compared between the two groups. Results compared with the control group, the CSA of bilateral polyfissure muscle and the CSA of bilateral dorsal extensor psoas decreased, the CSA of right psoas major and the CSA of left extensor psoas decreased in L4, and CSA of bilateral psoas major decreased in L3. The CSA of bilateral polyfissure muscle and the CSA of bilateral dorsalis dorsalis muscle were increased. In DLS group, the right side CSA of polyfissure muscle was decreased in L3 / L4 level, the CSA of right side was decreased in L4 level, and the right CSA was decreased in L4 level compared with both sides of extensor psoas dorsalis muscle. Bilateral paravertebral muscles were compared in the control group, the CSA of the right side of the erector spinal muscle decreased at the L3 level. The ratio of CSA to CSA of the vertical spinal muscle was compared with that of the control group in the same segment. It was found that the ratio of CSA to CSA of erector spinal muscle in L3 DLS group was lower than that of normal group in both sides. Conclusion: in degenerative lumbar spondylolisthesis patients, the CSA of polyfissure muscle decreases and the muscle atrophy occurs, while the CSA of vertical spine muscle changes less than that of polycleft muscle. The changes of paravertebral muscles in degenerative lumbar spondylolisthesis need more systematic study.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R681.5

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