广州零度|医生说脊髓型颈椎病临床表现
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">原标题:广州零度<span style="color: black;">大夫</span>说脊髓型颈椎病临床表现</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">广州<span style="color: black;">大夫</span>说脊髓型颈椎病临床表现:</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">1.<span style="color: black;">平常</span>表现</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">脊髓型颈椎病变是脊髓压迫症病理改变之一。临床表现因病变脊髓被侵袭的程度、部位和范围而异。感觉<span style="color: black;">阻碍</span>多不规律,手臂的麻木多见,但客观上浅痛觉<span style="color: black;">阻碍</span>与病变所<span style="color: black;">安排</span>皮节不<span style="color: black;">必定</span>对应,深感觉少有受累者,可有胸或腹束带感,此时常伴有腹壁反射<span style="color: black;">加强</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">上肢<span style="color: black;">一般</span>多以下运动神经元通路损害为主,手笨拙,<span style="color: black;">没</span>力,表现为写字、系鞋带纽扣、用筷子等精细动作困难,随病情发展可有手内在肌萎缩,可<span style="color: black;">显现</span>上位其他上肢肌力<span style="color: black;">衰退</span>。Hoffmann征(霍夫曼征)多<span style="color: black;">表示</span>阳性,可有反向桡反射,即敲击肱桡肌腹或肱二头肌腱致手指快速屈曲,与Hoffmann征阳性<span style="color: black;">道理</span>相同,或<span style="color: black;">显现</span>更早。<span style="color: black;">少许</span>高位脊髓病变可有肌张力<span style="color: black;">升高</span>,腱反射亢进等上运动神经元损害表现。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">下肢多为上运动神经元通路<span style="color: black;">反常</span>,表现为肌张力不同程度的<span style="color: black;">升高</span>和肌力减损,膝反射和跟腱反射活跃、亢进,<span style="color: black;">显现</span>踝阵挛、髌阵挛、Babinski征呈阳性。广州零度<span style="color: black;">恢复</span>门诊提醒肌张力<span style="color: black;">升高</span>,腱反射亢进<span style="color: black;">引起</span>走路不稳,尤其<span style="color: black;">慢跑</span>易跌倒、步态蹒跚、可<span style="color: black;">显现</span>痉挛步态。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">脊髓型颈椎病较少<span style="color: black;">导致</span>排尿排便困难及括约肌功能<span style="color: black;">阻碍</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">2.不同病变类型的表现</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">因为</span>脊髓受压病变的不<span style="color: black;">平衡</span>性,脊髓型颈椎病的神经系统<span style="color: black;">反常</span>表现为多变性。两侧病变可有轻重不同,<span style="color: black;">乃至</span>偏重<span style="color: black;">一边</span>,但极少<span style="color: black;">显现</span>脊髓半横切,即Brown_Sequard<span style="color: black;">综合症</span>(脊髓半切<span style="color: black;">综合症</span>),后者于髓内肿瘤相对多见。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">以上肢功能<span style="color: black;">阻碍</span>为主者,表现为神经根症状,多为前述下运动神经元通路<span style="color: black;">阻碍</span>,病变在脊髓中央,两侧灰质<span style="color: black;">周边</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">以下肢症状为主者,广州零度<span style="color: black;">恢复</span>门诊提醒<span style="color: black;">重点</span>表现为上运动神经元通路<span style="color: black;">阻碍</span>,为脊髓外周长传导束纤维受累<span style="color: black;">导致</span>,下肢神经功能<span style="color: black;">反常</span><span style="color: black;">亦</span>如前述。<span style="color: black;">少许</span>病例上肢症状轻微或<span style="color: black;">没</span>症状,需与胸椎管狭窄症鉴别。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">所说</span>前脊髓动脉型并不多见,起病急,运动<span style="color: black;">阻碍</span><span style="color: black;">通常</span>是下肢重于上肢,温觉与痛觉减弱或消失,而深部感觉大多正常,可<span style="color: black;">显现</span>反射亢进和病理反射。</p>
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