良性阵发性位置性眩晕视频眼震图分型及其对手法复位临床疗效的影响
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摘要
目的:观察临床使用手法复位治疗良性阵发性位置性眩晕(BPPV)的治疗效果,同时分析讨论视频眼震图在手法复位中起到的作用。方法:选取2016年8月至2017年8月154例BPPV患者作为主要研究对象。根据视频眼震图下变位实验诱发的眼震特点对BPPV进行定侧和分型,根据分型结果选择合适的手法复位,后半规管(PC-BPPV)采用Eply手法复位,上半规管(SC-BPPV)采用Semont手法复位,水平规管(HC-BPPV)采用Barbecue翻滚法复位,混合型BPPV(C-BPPV)采用Eply和Barbecue手法复位。术后随访1周及3个月的手法复位治疗有效率及术后3个月的复发率。结果:154例BPPV患者检出106例PC-BPPV(68.83%),检出27例HC-BPPV,检出14例SC-BPPV(9.09%),检出7例C-BPPV(4.55%);所有患者术后1周、3个月后治疗总有效率分别为85.71%和93.51%,差异有统计学意义(P<0.05);术后随访3个月后的总复发率为5.19%。结论:视频眼震图能够有效对BPPV定侧分型,在其监视下进行手法复位,能有效控制复位手法,提高临床手法复位对BPPV的治疗效果,且术后复发率低,具有临床应用价值。
Objective: To observe the therapeutic effect of the method of clinical application on benign paroxysmal positional vertigo( BPPV). Methods: A total of 154 suspected BPPV patients treated in our hospital from August 2016 to August 2017 were selected as the main study subjects. According to the characteristics of nystagmus induced by video-ocystagmus transposition experiment,BPPV was used to determine the side and type. According to the results of typing,the appropriate manual reduction was selected. The posterior semicircular canal( PC-BPPV) was treated by Eply manual reduction and the upper semicircular canal( SCBPPV) by semont manual reduction. Horizontal Regulation( HC-BPPV) was reset by Barbecue tumbling and mixed BPPV( C-BPPV) by Eply and 3-month follow-up. Results: Of the 154 BPPV patients,106 PCBPPV( 68.83%) were detected; 27 cases of HC-BPPV were detected; 14 cases of SC-BPPV( 9.09 %) were detected; 7 cases of C-BPPV( 4.55 %) were detected; and the total effective rates were 85.71 %and 93.51 % after 1 week and 3 months after operation. Conclusions: The video nystagmus can effectively classify the BPPV side. Under the surveillance,the manipulative reduction can effectively control the reset technique and improve the therapeutic effect of the clinical manipulation to the BPPV,and the recurrence rate is low after the operation,which has the clinical value.
Objective: To observe the therapeutic effect of the method of clinical application on benign paroxysmal positional vertigo( BPPV). Methods: A total of 154 suspected BPPV patients treated in our hospital from August 2016 to August 2017 were selected as the main study subjects. According to the characteristics of nystagmus induced by video-ocystagmus transposition experiment,BPPV was used to determine the side and type. According to the results of typing,the appropriate manual reduction was selected. The posterior semicircular canal( PC-BPPV) was treated by Eply manual reduction and the upper semicircular canal( SCBPPV) by semont manual reduction. Horizontal Regulation( HC-BPPV) was reset by Barbecue tumbling and mixed BPPV( C-BPPV) by Eply and 3-month follow-up. Results: Of the 154 BPPV patients,106 PCBPPV( 68.83%) were detected; 27 cases of HC-BPPV were detected; 14 cases of SC-BPPV( 9.09 %) were detected; 7 cases of C-BPPV( 4.55 %) were detected; and the total effective rates were 85.71 %and 93.51 % after 1 week and 3 months after operation. Conclusions: The video nystagmus can effectively classify the BPPV side. Under the surveillance,the manipulative reduction can effectively control the reset technique and improve the therapeutic effect of the clinical manipulation to the BPPV,and the recurrence rate is low after the operation,which has the clinical value.
引文
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[13]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.
[14]张姝娟,刘彩云.良性阵发性位置性眩晕视频眼震图分析[J].中西医结合心脑血管病杂志,2015(17):2010~2011.
[2]彭帆,向园花,宋建新.自制视频眼震记录仪在良性阵发性位置性眩晕的应用[J].中国眼耳鼻喉科杂志,2013,13(1):34~37.
[3]赵晓明,刘劲,林春梅,等.良性阵发性位置性眩晕复位短期疗效不佳的分析[J].中华耳科学杂志,2016,14(4):473~477.
[4]刘绮明,严小玲,丘理子,等.手法复位治疗特发和继发性良性阵发性位置性眩晕的疗效[J].广东医学,2012,33(21):3277~3279.
[5]张云美,杨振栋,于亚峰.眼震视图在多管性良性阵发性位置性眩晕精确定位中的作用[J].临床耳鼻咽喉头颈外科杂志,2016(18):1435~1437.
[6]张波,孙敬武.良性阵发性位置性眩晕患者裸眼及视频眼震图下眼震特征及定位诊断分析[J].听力学及言语疾病杂志,2012,20(3):235~237.
[7]中华耳鼻咽喉头颈外科杂志编辑委员会.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.
[8]尹时华,韦顺莲,舒竞铖,等.2118例良性阵发性眩晕患者手法复位疗效观察[J].中华耳科学杂志,2015,26(4):707~711.
[9]Saberi A,Nemati S,Sabnan S,et al.A safe-repositioning maneuver for the management of benign paroxysmal positional vertigo:Gans vs.Epley maneuver;a randomized comparative clinical trial.[J].European Archives of Oto-Rhino-Laryngology,2016,27(8):1~7.
[10]Imai T,Takeda N,Ikezono T,et al.Classification,diagnostic criteria and management of benign paroxysmal positional vertigo[J].Auris Nasus Larynx,2017,44(1):1~6.
[11]覃继新.良性阵发性位置性眩晕患者发病特点及手法复位疗效分析[J].听力学及言语疾病杂志,2016,24(1):24~27.
[12]侯涛,尹时华,朱子昂,等.384例良性阵发性位置性眩晕患者发病特点与临床分析[J].临床耳鼻咽喉头颈外科杂志,2017,31(8):601~605.
[13]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.
[14]张姝娟,刘彩云.良性阵发性位置性眩晕视频眼震图分析[J].中西医结合心脑血管病杂志,2015(17):2010~2011.