齿状突加冠综合征诊疗特点分析

Analysis of diagnosis and treatment characteristics of crowned dens syndrome*

摘要:

【】 目的 总结齿状突加冠综合征 (crowned dens syndrome,CDS) 的临床特点,探讨其诊治方法及预后。方法 收集2021年4月至2023年1月我科收治的20例CDS患者的临床和影像学资料,并对其临床特点及治疗方法进行分析。结果 20例患者均因急性颈部疼痛伴活动受限就诊,其中非甾类抗炎药(non-steroidal antiinflammatory drugs,NSAIDs)治疗9例,NSAIDs联合神经阻滞治疗11例,所有患者症状均获得明显缓解。95%的患者C反应蛋白(CRP) 和红细胞沉降率(ESR) 水平升高,治疗后两者均出现不同程度下降,且CRP变化幅度明显高于ESR。出院后复发7例,与出院时ESR水平较高相关。结论 CDS在老年患者中并不罕见,典型的临床表现结合颈椎CT可以有效地避免误诊和漏诊。NSAIDs联合神经阻滞治疗较单独使用NSAIDs能更快地缓解CDS症状,具有临床推广价值。

Abstract:

【】 Objective? To summarize the clinical characteristics of crowned dens syndrome(CDS), and explore its diagnosis and treatment methods and prognosis. [1]Methods? The clinical and imaging data of 20 CDS patients admitted to our department from April 2021 to January 2023 were collected, and their clinical characteristics and treatment methods were analyzed. Results? All 20 patients presented to the hospital due to acute neck pain and restricted neck mobility, 9 patients were treated by non-steroidal antiinflammatory drugs (NSAIDs), and 11 patients were treated by NSAIDs combined with nerve block, and all patients achieved significant relief of symptoms. Increased levels of C-reactive protein(CRP) and erythrocyte sedimentation rate(ESR) were founded in 95% of patients, both decreased after treatment, and the amplitude of CRP change was significantly higher than that of ESR. Seven patients relapsed after discharge due to the high ESR levels. Conclusion? The CDS are not rare in elderly patients, and typical clinical manifestation combined with cervical computed tomography (CT) can effectively avoid misdiagnosis and missed diagnosis. NSAIDs combine with nerve block can relieve CDS symptoms more quickly than use NSAIDs alone, and has the clinical promotion value.