-
摘要: 目的: 探讨良性阵发性位置性眩晕(BPPV)患者的发病特点及临床特征,观察并分析手法复位的疗效。方法: 回顾分析384例BPPV患者的发病特点及临床特征,并根据受累半规管的情况行手法复位治疗,观察并分析其疗效。结果: ①384例患者中,后半规管BPPV(PC-BPPV)331例(86.20%),水平半规管BPPV(HC-BPPV)47例(12.24%),上半规管BPPV(AC-BPPV)3例(0.78%),混合半规管BPPV 3例(0.78%)。②384例BPPV患者均行手法复位治疗,PC-BPPV首次有效率为93.66%,远期(半年)有效率96.68%;HC-BPPV首次有效率91.49%,远期(半年)有效率95.74%;AC-BPPV首次和远期(半年)有效率均为66.67%;混合型半规管BPPV首次和远期(半年)有效率均为66.67%。③PC-BPPV 331例中,管结石症319例(96.37%),嵴帽结石症12例(3.63%)。HC-BPPV 47例中,管结石症37例(78.72%),嵴帽结石症10例(21.28%)。④在半年随访期间,复发49例,复发率12.76%。结论: ①广西BPPV患者在发病年龄、男女占比、各半规管发病率与文献报道相近或相符,地域和民族因素并未影响上述结果。②手法复位治疗BPPV疗效好、见效快、方法简单,是治疗BPPV的最佳方法。③BPPV患者复位治疗后复发率较高。Abstract: Objective: To study the disease characteristics in cases with benign paroxysmal positional vertigo(BPPV).Method: The characteristics and clinical features of 384 cases with BPPV were retrospectively analyzed,and all cases were treated with repositioning maneuver.The treatment outcomes were observed and analyzed during the follow-up period.Result: ①Of the 384 cases,331(86.20%) cases were PC-BPPV, 47(12.24%) cases were HC-BPPV and 3(0.78%) cases were AC-BPPV, 3(0.78%) cases were combined semicircular canal BPPV. ②All cases underwent repositioning maneuver, PC-BBPV cases first efficiency was 93.66%, long-term (six months) efficiency was 96.68%; HC-BBPV cases first efficiency was 91.49%, long-term (six months) efficiency was 95.74%;AC-BPPV cases first efficiency and long-term efficiency were 66.67%;combined semicircular canal BPPV cases first efficiency and long-term efficiency were 66.67%.③Among 331 cases with PC-BBPV, cases diagnosed duct stones accounted for 96.37%,cases diagnosed crest stones accounted for 3.63%. Among 47 cases with HC-BBPV, cases diagnosed duct stones accounted for 78.72%,cases diagnosed crest stones accounted for 21.28%.④During the follow-up of six months,the recurrence rate was 12.76%(49/384).Conclusion: ①In BPPV cases of Guangxi,the ratio of male and female,age of onset and the incidence of BPPV in each semicircular canal are consistent with other literatures.Geographical and ethnic factors do not affect the above results.②Repositioning maneuver is an simple and effective treatment for cases with BPPV.③There is higher recurrence rate in cases with BPPV after repositioning maneuver.
-
Key words:
- vertigo /
- repositioning maneuver /
- treatment outcome
-
-
[1] FIFE T D.Recognition and management of horizontal canal benign positional vertigo[J].Am J Otol,1998,19:345-351.
[2] 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.
[3] CINIGLIO APPIANI G,CATANIA G,GAGLIARDI M,et al.Repositioning maneuver for the treatment of the apogeotrepic variant of horizontal canal benign paroxysmal positional vertigo[J].Otol Neurotol,2005,26:257-260.
[4] 洪渊,焉双梅,吴子明,等.水平半规管良性阵发性位置性眩晕[J].中华耳科学杂志,2016,14(4):490-494.
[5] YACOVINO D A,HAIN T C,GUALTIERI F.New therapeutic maneuver for anterior canal benign paroxysmal positional vertigo[J].J Neurol,2009,256:1851-1855.
[6] HAYNES D S,RESSER J R,LABADIE R F,et al.Treatment of benign positional vertigo using the semont maneuver:efficacy in patients presenting without nystagmus [J].Laryngoscope,2002,112:796-801.
[7] BHATTACHARYYA N, BAUGH R F, ORVIDAS L, et al. Clinical practice guideline: benign paroxysmal positional vertigo[J]. Otolaryngol Head Neck Surg,2008,139(5 Suppl 4):S47-81.
[8] HUGHES C A, PROCTOR L.Benign paroxysmal positional vertigo[J].Laryngoscope,1997, 107:607-613.
[9] YAKINTHOU A,MAURER J,MANN W.Benign paroxysmal positioning vertigo:diagnosis and therapy using video-oculographic control[J]. ORL J Otorhinolaryngol Relat Spec, 2003, 65:290-294.
[10] GACEK R R,GACEK M D.Update on the pathology and management of benign paroxysmal positional vertigo[J]. Otorhinolaryngol Nova,1998,8: 235-244.
[11] KARLBERG M,HALL K,QUICKERT N,et al.What inner ear diseases cause benign paroxysmal positional vertigo[J]?Acta Otolaryngol,2000,120:380-385.
[12] GIACOMINI P G,NAPOLITANO B,ALESSANDRINI M,et al.Recurrent paroxysmal positional vertigo related to oral contraceptive treatment [J].Gynecol Endecrinol,2009,22: 5-8.
[13] LEE S H,KIM J S.Benign paroxysmal positional vertigo[J].J Clin Neurol,2010,6:51-63.
[14] HALL S F,RUBY R R,MCCLURE J A.The mechanics of benign paroxysmal vertigo[J].J Otolaryngol,1979,8:151-158.
[15] SCHUKNECHT H F.Cupulolithiasis[J].Arch Otolaryngol,1969,90:765-778.
[16] 马鑫,静媛媛,余力生.良性阵发性位置性眩晕发病侧别和患者睡眠侧别的相关性[J].中国耳鼻咽喉头颈外科,2012,19(7):360-362.
[17] SHIM D B,KIM J H,PARK K C,et al.Correlation between the head-lying side during sleep and the affected side by benign paroxysmal positional vertigo involving the posterior or horizontal semicircular canal[J].Laryngoscope,2012,122:873-876.
[18] COHEN H S, KIMBALL K T, STEWART M G.Benign paroxysmal positional vertigo and comorbid conditions[J].ORL J Otorhinolaryngol Relat Spec, 2004, 66:11-15.
[19] 吴子明,张素珍,刘兴健,等. 内耳病变并发良性阵发性位置性眩晕[J].中华耳鼻咽喉头颈外科杂志,2007,42(11):821-825.
[20] VON BREVERN M,SEELIG T,NEUHAUSER H,et al.Benign paroxysmal positional vertigo predominantly affects the right labyrinth[J].J Neurol Neurosurg Psychiatry,2004,75:1487-1488.
[21] MIZUKOSHI K,WATANABE Y,SHOJAKU H,et al.Epidemiological studies on benign paroxysmal positional vertigo in Japan[J]. Acta Otolaryngol Suppl,1988,447:67-72.
[22] OAS J G. Benign paroxysmal positional vertigo: a clinician's perspective[J].Ann N Y Acad Sci,2001,942:201-209.
[23] PARNES L S,AGRAWAL S K,ATLAS J. Diagnosis and management of benign paroxysmal positional vertigo(BPPV)[J]. CMAJ,2003,169:681-693.
[24] ESCHER A,RUFFIEUX C,MAIRE R. Efficacy of the barbecue manoeuvre in benign paroxysmal vertigo of the horizontal canal[J].Eur Arch Otorhinolaryngol, 2007,264:1239-1241.
[25] 刘晓薇,孙敬武,罗彬,等.水平半规管良性阵发性位置性眩晕的临床特点及疗效分析[J].听力学及言语疾病杂志,2016,24(1):28-30.
[26] BEYNON G J,BAGULEY D M,DA CRUZ M J.Recurrence of symptoms following treatment of posterior semicircular canal benign positional paroxysmal vertigo with a particle repositioning manoeuvre[J]. J Otolaryngol,2000,29:2-6.
[27] NUNEZ R A,CASS S P, FURMAN J M.Short- and long-term outcomes of canalith repositioning for benign paroxysmal positional vertigo[J]. Otolaryngol Head Neck Surg,2000,122:647-652.
-
计量
- 文章访问数: 307
- PDF下载数: 253
- 施引文献: 0
下载: