快速手法复位法治疗不同年龄段后半规管BPPV疗效分析

张昊; 李进让; 郭鹏飞; 田师宇; 李可亮

doi:10.13201/j.issn.1001-1781.2015.23.010

快速手法复位法治疗不同年龄段后半规管BPPV疗效分析

- 海军总医院全军耳鼻咽喉头颈外科中心

详细信息

通讯作者: 李进让,E-mail:entljr@sina.com

中图分类号: R764

收稿日期: 2015-09-08

Efficacy of quick repositioning maneuver for posterior semicircular canal benign paroxysmal positional vertigo in different age groups

- Department of Otorhinolaryngology Head and Neck Surgery, Navy General Hospital, Beijing, 100048, China

More Information

Corresponding author: LI Jinrang, E-mail: entljr@sina.com

Received Date: 08 September 2015

摘要

摘要: 目的: 观察不同年龄段后半规管良性阵发性位置性眩晕(PC-BPPV)患者沿冠状位快速翻转复位治疗后的近远期疗效。方法: 113例确诊为PC-BPPV并沿冠状位行快速手法复位的成年患者按照年龄分为青年组(<45岁)、中年组(45~60岁)、老年组(≥ 60岁)。患者均沿冠状位行快速手法复位治疗,并于3~4 d门诊复查。观察并分析随访1周及3个月的疗效。结果: 113例患者中,左侧受累者58例(51.3%),右侧受累者55例(48.7%);随访1周,青年组、中年组及老年组总有效率分别为92.5%、93.6%、92.3%,差异无统计学意义(P>0.05);随访3个月,青年组、中年组及老年组总有效率分别为90.0%、85.1%、73.1%,差异亦无统计学意义(P>0.05)。青年组、中年组及老年组复发率分别为5.0%、6.4%、15.4%,差异无统计学意义(P>0.05)。结论: 沿冠状位行快速翻转复位法治疗各年龄组PC-BPPV效果确切,且方法简单迅速,容易掌握和普及,患者耐受性好,无明显不良反应。
- 眩晕 /
- 后半规管 /
- 手法复位 /
- 年龄
Abstract: Objective: To observe the short and long-term efficacy of quick repositioning maneuver for posterior semicircular canal benign paroxysmal positional vertigo (PC-BPPV) in different age groups.Method: The clinical data of 113 adult patients with single PC-BPPV who underwent quick repositioning maneuver from July 2009 to February 2015 were retrospectively analyzed. The quick repositioning maneuver was to roll the patient from involved side to healthy side in the coronal plane for 180ås quickly as possible. The patients were divided into 3 groups according to different ages:young group (<45 years), middle-age group(45 ≤ age<60 years) and old group(≥ 60 years). The short and long term outcomes of the three groups were observed.Result: The left ear was involved in 58 cases (51.3%) and the right ear in 55 cases (48.7%). The short term improvement rates of the young, middle-age and the old groups were 92.5%, 93.6% and 92.3% respectively, and the long term improvement rate was 90.0%, 85.1% and 73.1% respectively. There was no significant difference among the three groups in short and long term outcomes (P>0.05). The recurrence rate of the three groups was 5.0%, 6.4% and 15.4% respectively, also no significant difference (P>0.05).Conclusion: The quick repositioning maneuver along the coronal plane for PC-BPPV has a definite effect for every age groups. The method is simple, rapid and easy to master, and the patients are tolerated the maneuver well without evident side effect.
- vertigo /
- posterior semicircular canal /
- canalith repositioning procedure /
- age

HTML全文

参考文献(16)

[1]	BABAC S, DJERIC D, PETROVIC-LAZIC M, et al. Why do treatment failure and recurrences of benign paroxysmal positional vertigo occur[J]?Otol Neurotol, 2014,35:1105-1110.
[2]	LI J, LI H. New repositioning techniques for benign paroxysmal positional vertigo:the Li repositioning manoeuvres[J]. J Laryngol Otol, 2010,124:905-908.
[3]	李进让,李厚恩.良性阵发性位置性眩晕的手法复位治疗[J].中国耳鼻咽喉头颈外科, 2007,14(10):619-620.
[4]	KAPLAN D M, SLOVIK Y, JOSHUA B Z, et al. Head shaking during Dix-Hallpike exam increases the diagnostic yield of posterior semicircular canal BPPV[J]. Otol Neurotol, 2013,34:1444-1447.
[5]	中华耳鼻咽喉头颈外科杂志编辑委员会,中华医学会耳鼻咽喉科学分会.良性阵发性位置性眩晕的诊断依据和疗效评估(2006年,贵阳)[J].中华耳鼻咽喉头颈外科杂志, 2007,42(3):163-164.
[6]	VON BREVERN M, RADTKE A, LEZIUS F, et al. Epidemiology of benign paroxysmal positional vertigo:a population based study[J]. J Neurol Neurosurg Psychiatry, 2007,78:710-715.
[7]	STEENERSON R L, CRONIN G W, MARBACH P M. Effectiveness of treatment techniques in 923 cases of benign paroxysmal positional vertigo[J]. Laryngoscope, 2005,115:226-231.
[8]	BRANDT T, HUPPERT D, HECHT J, et al. Benign paroxysmal positioning vertigo:a long-term follow-up (6-17 years) of 125 patients[J]. Acta Otolaryngol, 2006,126:160-163.
[9]	徐丹,袁凤易,王新民.钙与维生素D防治骨质疏松的循证医学研究进展[J].国外医学(内分泌学分册), 2005, 25(5):338-341.
[10]	刘学军.骨质疏松症[J].中国矫形外科杂志, 2006,14(21):1668-1670.
[11]	BATUECAS-CALETRIO A, TRINIDAD-RUIZ G, ZSCHAECK C, et al. Benign paroxysmal positional vertigo in the elderly[J]. Gerontology, 2013,59:408-412.
[12]	WHITE J, SAVVIDES P, CHERIAN N, et al. Canalith repositioning for benign paroxysmal positional vertigo[J]. Otol Neurotol, 2005,26:704-710.
[13]	RE GANS,PA HARRINGTON-GANS. Treatment efficacy of benign paroxysmal positional vertigo (BPPV) with canalith repositioning maneuver and Semont liberatory maneuver in 376 patients[J]. Seminars in Hearing, 2002,23:129-142.
[14]	CASANI A P, DALLAN I, BERRETTINI S, et al. Therapeutic maneuvers in the treatment of paroxysmal positional vertigo:can they indicate a central genesis[J]?Acta Otorhinolaryngol Ital, 2002,22:66-73.
[15]	BERTHOLON P, BRONSTEIN A M, DAVIES R A, et al. Positional down beating nystagmus in 50 patients:cerebellar disorders and possible anterior semicircular canalithiasis[J]. J Neurol Neurosurg Psychiatry, 2002,72:366-372.
[16]	VAN DER ZAAG-LOONEN H J, VAN LEEUWEN R B, BRUINTJES T D, et al. Prevalence of unrecognized benign paroxysmal positional vertigo in older patients[J]. Eur Arch Otorhinolaryngol, 2015,272:1521-1524.