目的 研究交感神经型颈椎病(SCS)的临床症状表现规律。 方法 回顾性研究2017年至2019年门诊收治的SCS患者110例，分析其临床症状表现规律，包括不同系统的交感神经症状表现，头晕性质，临床症状出现的先后顺序、时间间隔及其与病程的相关性，肢体麻胀或麻木患者是否伴有神经根型和脊髓型颈椎病的症状体征等。 结果 SCS患者的交感神经症状表现复杂，分布在消化系统(71.82%)、心血管系统(83.64%)、呼吸系统(63.64%)、汗腺(48.18%)、眼睛(81.82%)、耳部(60.91%)、脑(68.18%)和四肢(70%)等器官，多表现为交感神经兴奋症状。头晕性质主要表现为单纯头脑昏沉(66.36%)，少数患者同时伴有外物或自身的旋转晃动(23.64%)，极个别患者单纯表现为外物或自身的旋转晃动(8.18%)。大多数患者表现为先出现慢性颈肩痛，后出现头晕及其他交感神经症状(58.18%)；从颈肩痛发展为头晕的时间为(68.98±64.42)个月。有肢体麻胀或麻木的77例患者均排除神经根型和脊髓型颈椎病，属于交感神经症状的四肢表现。头晕评分与病程呈正相关(r = 0.610, P < 0.001)，与交感神经症状评分呈正相关(r = 0.301, P = 0.004)。 结论 SCS的症状表现复杂，头脑昏沉是其主要的头晕表现，而不是眩晕。随着病程进展，头晕和交感神经症状逐渐加重。大部分SCS是由颈型颈椎病发展而来。神经根型和脊髓型颈椎病可能是在此基础上发生发展而来的更严重类型的颈椎病。
黄秀颖
,
杜良杰
,
李建军
,
杨明亮
,
李军
,
刘宏炜
,
高峰
,
宫慧明
,
陈亮
. 交感神经型颈椎病患者的临床症状表现规律[J]. 中国康复理论与实践, 2019
, 25(12)
: 1474
-1479
.
DOI: 10.3969/j.issn.1006-9771.2019.12.018
Objective To study the regularity of clinical symptoms of sympathetic cervical spondylosis. Methods A retrospective study was conducted on 110 patients with sympathetic cervical spondylosis admitted to the outpatient department from 2017 to 2019. The regularity of clinical symptoms of the patients was analyzed, including the sympathetic symptoms of different systems, the property of dizziness, the sequence, time interval and correlation of the symptoms, and whether the numbness of the limbs was accompanied by the symptoms and signs of cervical spondylotic radiculopathy and cervical spondylotic myelopathy. Results The sympathetic symptoms were complex, involved in digestive system (71.82%), cardiovascular system (83.64%), respiratory system (63.64%), sweat gland (48.18%), eyes (81.82%), ears (60.91%), brain (68.18%) and limbs (70%), mainly sympathetic excitatory. The dizziness of the patients was mainly manifested as muddled brain (66.36%), a few patients were accompanied by external objects or their own rotation and sloshing (23.64%), and a very few patients showed external objects or their own rotation and sloshing (8.18%). Most patients complained chronic neck pain before dizziness and other sympathetic symptoms, accounting for 58.18%. The mean time for progression from neck pain to dizziness was (68.98±64.42) months. There were 77 patients complaining limb numbness, but none of them was found symptoms or signs of cervical spondylotic radiculopathy or cervical spondylotic myelopathy. It seemed to be a part of sympathetic symptoms in the limbs. The severity of dizziness was positively correlated with the course of disease (r = 0.610, P < 0.001), and was also positively correlated with the score of sympathetic symptom (r = 0.301, P = 0.004). Conclusion The symptoms of sympathetic cervical spondylosis are complex. Muddled brain is the main symptom of dizziness, not vertigo. As the disease progresses, dizziness and sympathetic symptoms gradually worsen. Most sympathetic cervical spondylosis develops from cervical spondylosis. Cervical spondylotic radiculopathy or cervical spondylotic myelopathy may be the more severe forms of cervical spondylosis that develop on this basis。
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