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摘要: 目的:研究不同类型良性阵发性位置性眩晕(BPPV)的诊断、治疗及疗效。方法:回顾性分析318例BPPV患者的资料,根据变位试验诱发的眼震特点进行分型,并采用相应的耳石复位技术治疗,对治疗1次无效者间隔7 d重复治疗,重复3次无效者采用Brandt-Daroff习服练习;完成治疗后随访观察总有效率。结果:①后半规管BPPV患者221例(69.5%),采用Epley管石复位法;②水平半规管BPPV患者62例(19.5%),采用Barbecue翻滚加强迫侧卧体位疗法;③前半规管BPPV患者23例(7.2%),采用Epley管石复位法;④混合型BPPV患者12例(3.8%),采用Epley加Barbecue翻滚联合治疗。1周后随访总有效率为82.1%(261/318),3个月后随访总有效率为91.8%(292/318)。结论:结合病史,根据不同变位试验诱发的眼震特征对BPPV患者进行诊断并采用相应手法复位治疗是一种非常有效的方法,能有效缩短病程,减轻患者痛苦,可在临床广泛应用。Abstract: Objective: To investigate the diagnosis, treatment and therapeutic effect of various types of BPPV.Method: Three hundred and eighteen BPPV patients were retrospectively analyzed.After the types of BPPV were determined by nystagmus characteristics provoked by positioning test, the appropriate repositioning maneuvers were performed. For patients unresponsive to initial treatment, a repetitive treatment was given after seven days. If patients failed after three continuous treatments, other therapeutic methods were chosen and performed. Overall effectiveness in the next three months after treatment was observed.Result: Of 318 patients, 221(69.5%) with posterior semicircular canal involvement, Epley repositioning maneuver was performed; 62(19.5%) with horizontal semicircular canal involvement, Barbecue maneuver combined forced prolonged position maneuver were applied; 23(7.2%) with anterior canal involvement were treated with Epley maneuver; 12(3.8%) had the mixed type and were treated with corresponding repositioning maneuvers. After one week the total improvement rate was 82.1% (261/318) and 91.8% three months later(292/318).Conclusion: The different BPPV variants can be diagnosed according to the nystagmus characteristics during the appropriate provoking maneuvers, and appropriate repositioning maneuvers is a very effective method which can shorten disease period and relieve the symptoms. The method is easy to apply and could be widely performed clinically.
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Key words:
- positional vertigo /
- diagnosis /
- therapy
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