实时组织弹性成像对中医推拿治疗小儿先天性肌性斜颈的疗效评估

摘要

Objective To evaluate the clinical curative effect of traditional Chinese medical massage for the treatment of congenital muscular torticollis in the infants with real-time tissue elastography technology, and to explore the clinical application value of real-time tissue elastography. Methods A retrospective analysis was carried out in 120 infants with clinical diagnosis of congenital muscular torticollis. All of the infants were treated with traditional Chinese medical massage once a day, 10 times for a course of treatment, and the treatment lasted 18 courses. The differences of image of the injured sternomastoid muscle were observed before and after treatment by real-time tissue elastography. Results Before massage therapy, the differences between the image scores of injured sternomastoid muscle and those of the healthy sternomastoid muscle were significant ( P<0.01), and the sensitivity of real-time tissue elastography for the diagnosis of congenital muscular torticollis was 93.3% . After massage therapy, the mass of injured sternomastoid muscle was reduced, and the myogenic torticollis was improved, the image scores of injured sternomastoid muscle were similar to those of the healthy sternomastoid muscle ( P>0.05) . The differences of the image scores of injured sternomastoid muscle were sternomastoid muscle ( P> 0.05) . The differences of the image scores of injured sternomastoid muscle were significant before and after therapy ( P<0.01) Conclusion Traditional Chinese medical massage has certain therapeutic effect for the treatment of congenital muscular torticollis in the infants, and real-time tissue elastography technology can reflect the changes of muscle tissue directly and noninvasively, which will provide objective basis for the clinical diagnosis and treatment of congenital muscular torticollis in the infants.%目的应用实时组织弹性成像技术评估中医推拿治疗小儿肌性斜颈的临床疗效，并探讨其临床应用价值。方法回顾性分析临床诊断为先天性肌性斜颈的患儿120例，采用中医推拿治疗，每日1次，10次为1个疗程，共治疗18个疗程。观察治疗前后患侧胸锁乳突肌实时组织弹性成像图像的差别。结果治疗前，患侧胸锁乳突肌（肌性斜颈侧）与健侧胸锁乳突肌之间超声弹性成像结果比较差异有统计学意义（P＜0．01），弹性成像技术诊断肌性斜颈的敏感性为93．3％。经中医推拿治疗后，包块较治疗前明显减小，肌性斜颈明显好转，超声弹性评分指数明显降低，与健侧胸锁乳突肌超声弹性成像结果比较差异无统计学意义（P＞0．05）；治疗前后患侧胸锁乳突肌弹性成像评分比较，差异有统计学意义（P＜0．01）。结论中医推拿治疗小儿肌性斜颈疗效肯定；超声弹性成像技术可直观、无创地评价肌性斜颈推拿治疗后肌肉组织修复变化情况，可为临床对小儿肌性斜颈的诊断和治疗提供客观依据。