健侧Dix-Hallpike及Roll-test诱发眼震的单侧后半规管良性阵发性位置性眩晕复位疗效分析

刘日钊; 郑锦泉; 董洪松; 向登; 何贵华; 温演伟; 聂国辉

doi:10.13201/j.issn.2096-7993.2020.11.016

健侧Dix-Hallpike及Roll-test诱发眼震的单侧后半规管良性阵发性位置性眩晕复位疗效分析

- 深圳市第二人民医院耳鼻咽喉头颈外科(广东深圳，518000)
基金项目:
深圳市发改委关于深圳眩晕诊疗与前庭功能重塑公共服务平台项目深发改〔2017〕436号(No：s2016005470013)

详细信息

通讯作者: 聂国辉，E-mail：nghui@21cn.com

中图分类号: R764.3

收稿日期: 2020-03-09

刊出日期: 2020-11-05

Analysis of reduction effect of the evoked nystagmus in the non-affect side during Dix-Hallpike or Roll-test in unilateral posterior semicircular canal benign paroxysmal positional vertigo

- Department of Otolaryngology Head and Neck Surgery, Shenzhen Second People's Hospital, Shenzhen, 518000, China

More Information

Corresponding author: NIE Guohui, E-mail: nghui@21cn.com

Received Date: 09 March 2020

Publish Date: 05 November 2020

摘要

摘要: 目的比较健侧Dix-Hallpike(D-H)及Roll-test诱发眼震的单侧后半规管良性阵发性位置性眩晕(PC-BPPV)与未出现上述眼震的单侧PC-BPPV的复位疗效并分析其原因。方法回顾性分析诊断为单侧PC-BPPV患者210例, 其中18例仅于健侧D-H诱发眼震(A组), 30例仅于Roll-test诱发眼震(B组), 26例于健侧D-H及Roll-test均诱发眼震(C组), 136例无出现上述眼震(D组)。以上患者均通过G-Force BPPV诊疗仪确诊并模拟Epley或者Semont方法复位, 比较其复位效果。结果首次复位, D组复位效果优于A组和C组(P < 0.05);D组与B组比较, 复位效果差异无统计学意义(P>0.05);A组与C组复位效果差异无统计学意义(P>0.05)。A、B、C、D组患者予以复位治疗达到眼震消失或最终眼震减轻(再次复位眼震无改善)所需要的平均复位次数分别为(1.44±0.63)次、(1.46±0.65)次、(1.52±0.87)次、(1.48±0.73)次, 4组间两两比较差异均无统计学意义(P>0.05)。而对于多次复位的效果, 组间的差异与首次复位结果相同。结论单侧PC-BPPV行位置试验时, 若健侧D-H诱发眼震, 首次复位效果欠佳。若仅Roll-test诱发眼震, 并不影响其首次复位效果。4种情况的PC-BPPV复位次数无明显差异, 但健侧D-H诱发眼震的单侧PC-BPPV患者多次复位后效果仍欠佳。
- 眩晕 /
- 后半规管 /
- 眼震 /
- 耳石复位
Abstract: Objective Comparative analysis of the reduction effect of the evoked nystagmus in the non-affect side during Dix-Hallpike(D-H) or Roll-test in unilateral posterior semicircular canal benign paroxysmal positional vertigo(PC-BPPV) and PC-BPPV without above evoked nystagmus.Method Retrospective analysis of 210 patients diagnosed with unilateral PC-BPPV by G-Force BPPV CRP system was made. Among them, 18 patients exhibited positive nystagmus only when the non-affected side was stimulated by D-H test(Group A), 30 was evoked only when stimulated by Roll-test(Group B), 26 was evoked when stimulated by both Roll-test and the non-affected side D-H test(Group C), 136 without nystagmus in the above positions(Group D). All the patients were diagnosed by G-Force BPPV and were treated through simulative Epley or Semont CRP. Compare the reduction effect among the groups.Result At the first time, the reduction effect of nystagmus in Group D was superior to those in Group A and Group C(P < 0.05). There was no difference between Group D and Group B(P>0.05). The difference between Group A and Group C was also non-significant(P>0.05). The average CRP times of the four groups(CRP until nystagmus disappeared or no longer alleviated) were 1.44±0.63(Group A), 1.46±0.65(Group B), 1.52±0.87(Group C) and 1.48±0.73(Group D)respectively. There were no statistic difference between four groups(P>0.05). The differences of final reduction effect between groups were the same as those at the first time.Conclusion The first time reduction effect was less effective when nystagmus evoked the non-affect side during D-H test in unilateral PC-BPPV, while it might be irrelevant to the nystagmus evoked only in Roll-test. Although the times of CRP were similar among the groups, the final reduction effect of groups with nystagmus evoked the non-affect side during D-H was poorer.
- vertigo /
- posterior semicircular canal /
- nystagmus /
- canalith repositioning

HTML全文

表 1 A组与B组首次复位及多次复位效果比较

项目	A组	B组	Z	P
首次复位秩平均值	19.32	25.95	-1.782	0.075
多次复位秩平均值	19.32	25.95	-1.878	0.060
秩和检验：无效赋值为1，改善赋值为2，治愈赋值为3

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表 2 A组与C组首次复位及多次复位效果比较

项目	A组	C组	Z	P
首次复位秩平均值	21.76	20.46	-0.389	0.697
多次复位秩平均值	22.82	19.71	-0.927	0.354

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表 3 A组与D组首次复位及多次复位效果比较

项目	A组	D组	Z	P
首次复位秩平均值	48.18	76.30	-3.014	0.003
多次复位秩平均值	50.65	75.97	-3.000	0.003

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表 4 B组与C组首次复位及多次复位效果比较

项目	B组	C组	Z	P
首次复位秩平均值	31.36	21.73	-2.498	0.012
多次复位秩平均值	32.02	20.94	-2.910	0.004

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表 5 B组与D组首次复位及多次复位效果比较

项目	B组	D组	Z	P
首次复位秩平均值	72.62	80.45	-0.987	0.323
多次复位秩平均值	75.86	79.71	-0.552	0.581

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表 6 C组与D组首次复位及多次复位效果比较

项目	C组	D组	Z	P
首次复位秩平均值	46.58	82.11	-4.163	0.000
多次复位秩平均值	45.71	82.27	-4.624	0.000

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