Gufoni法与barbecue法治疗向地性眼震型水平半规管良性阵发性位置性眩晕的疗效比较
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摘要
目的比较Gufoni法与barbecue法治疗向地性眼震型水平半规管良性阵发性位置性眩晕(HSC-BPPV)的短期疗效。方法采用前瞻性、开放登记研究方法纳入100例连续就诊于眩晕门诊的向地性眼震型HSC-BPPV患者,并随机分为两组,每组50例,分别采用Gufoni法与barbecue法进行手法复位,每种方法循环复位2次,复位结束30min后采用平卧侧头试验评估并比较两组患者复位后即刻疗效。结果经过最多2次循环治疗,Gufoni法复位成功率为90.0%,明显高于barbecue法的68.0%(P<0.05)。Gufoni复位患者中,年龄<60岁组与≥60岁组单次复位成功率、二次复位成功率比较,差异均无统计学意义(均P>0.05);barbecue复位患者中,年龄<60岁组单次复位成功率、二次复位成功率均高于≥60岁组(均P<0.05)。在<60岁患者中,Gufoni法与barbecue法单次复位成功率、二次复位成功率比较,差异均无统计学意义(均P>0.05);在≥60岁患者中,Gufoni法单次复位成功率、二次复位成功率均明显高于barbecue法(均P<0.05)。2种方法复位后BPPV类型转换发生率比较,差异无统计学意义(P>0.05)。结论 Gufoni法治疗向地性眼震型HSC-BPPV短期疗效优于barbecue法,尤其适用于高龄患者。
Objective To compare the efficacy of Gufoni and barbecue maneuvers for treatment of patients with geotropic type of benign paroxysmal positional vertigo of horizontal semicircular canal(HSC-BPPV). Methods A randomized, controlled clinical trial was conducted in the dizziness clinic of Zhejiang Provincial Hospital, 100 consecutive patients with geotropic HSC-BPPV were randomly assigned to Gufoni(n=50) and barbecue rotation(n=50) for treatment. The immediate therapeutic efficacy was compared within 30 min after each maneuvers. Results After a maximum of 2 maneuvers, Gufoni method showed better responses than barbecue rotation(90.0% vs. 68.0%, P <0.05). The therapeutic effects with Gufoni maneuvers were also better than that with barbecue maneuver in elderly patients(≥60y)(91.7% vs. 40.0%, P<0.05). There was no significant difference in transition into other BPPV types after treatment between two maneuvers(P >0.05). Conclusion Gufoni maneuver shows a better immediate responses than barbecue rotation in treating geotropic HSC-BPPV, especially for the elderly patients.
Objective To compare the efficacy of Gufoni and barbecue maneuvers for treatment of patients with geotropic type of benign paroxysmal positional vertigo of horizontal semicircular canal(HSC-BPPV). Methods A randomized, controlled clinical trial was conducted in the dizziness clinic of Zhejiang Provincial Hospital, 100 consecutive patients with geotropic HSC-BPPV were randomly assigned to Gufoni(n=50) and barbecue rotation(n=50) for treatment. The immediate therapeutic efficacy was compared within 30 min after each maneuvers. Results After a maximum of 2 maneuvers, Gufoni method showed better responses than barbecue rotation(90.0% vs. 68.0%, P <0.05). The therapeutic effects with Gufoni maneuvers were also better than that with barbecue maneuver in elderly patients(≥60y)(91.7% vs. 40.0%, P<0.05). There was no significant difference in transition into other BPPV types after treatment between two maneuvers(P >0.05). Conclusion Gufoni maneuver shows a better immediate responses than barbecue rotation in treating geotropic HSC-BPPV, especially for the elderly patients.
引文
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[2]Imai T,Ito M,Takeda N,et al.Natural course of the remission of vertigo in patients with benign paroxysmal positional vertigo[J].Neurology,2005,64(5):920-921.
[3]Kim J S,Zee D S.Clinical practice Benign paroxysmal positional vertigo[J].N Engl J Med,2014,370(12):1138-1147.
[4]Kim J S,Oh S Y,Lee S H,et al.Randomized clinical trial for geotropic horizontal canal benign paroxysmal positional vertigo[J].Neurology,2012,79(7):700-707.
[5]Von B M,Bertholon P,Brandt T,et al.Benign paroxysmal positional vertigo:Diagnostic criteria[J].J Vestib Res,2015,25(3~4):105-117.
[6]施天明,耿昱.水平半规管良性阵发性位置性眩晕诊治进展[J].中华耳鼻咽喉头颈外科杂志,2014,49(8):693-697.
[7]Casani A P,Nacci A,Dallan I,et al.Horizontal semicircular canal benign paroxysmal positional vertigo:effectiveness of two different methods of treatment[J].Audiol Neurootol,2011,16(3):175-184.
[8]Shim D B,Ko K M,Lee J H,et al.Natural history of horizontal canal benign paroxysmal positional vertigo is truly short[J].J Neurol,2015,262(1):74-80.
[9]Korres S,Riga M G,Xenellis J,et al.Treatment of the horizontal semicircular canal canalithiasis:pros and cons of the repositioning maneuvers in a clinical study and critical review of the literature[J].Otol Neurotol,2011,32(8):1302-1308.