神经损伤与功能重建2018，Vol.13Issue(4)：172-176,5.DOI:10.16780/j.cnki.sjssgncj.2018.04.004
水平半规管良性阵发性位置性眩晕患者82例诊治分析
Clinical Analysis of Diagnosis and Treatment of 82 Patients with Horizontal Canal Benign Paroxysmal Positional Vertigo
摘要
Abstract
Objectives: To explore the clinical features, diagnosis and treatment of horizontal canal benign paroxysmal positional vertigo (HC-BPPV). Methods: A total of 82 consecutive HC-BPPV patients were enrolled.The clinical baseline data of the patients were registered to analyze the clinical features,diagnosis and treatment of HC-BPPV patients.Results:①Of the 82 HC-BPPV patients,62(75.6%)were positional vertigo, 12(14.6%)were positional dizziness,and 8(9.8%)were walking unsteady.②Onset-to-visit intervals:39 cases (47.6%)within 3 days,14 cases(17.1%)in 4~7 days,9 cases(11.0%)in 7~14 days,20 cases over 14 days (24.4%).③Inducements:43 cases(52.4%)had fatigue,31 cases(37.8%)had sleep disorders,10 cases(12.2%) had emotional agitation,6 cases(7.3%)had head injuries,and 3 cases(3.7%)had precursor infection.④Attack duration:16 patients(19.5%)lasted for several seconds,35 patients(42.7%)lasted for 10 seconds to 1 minute, and 19 patients(23.2%)lasted for 1 to 2 minutes,2 patients lasted for 2 to 5 minutes and 10 patients(12.2%) lasted for more than 5 minutes. ⑤Vestibular function examination: 28 cases (35.0%) had unilateral peripheral vestibular dysfunction,22(78.6%)were consistent with the side of the affected semicircular canal.⑥In the Roll test, there were 46 cases (56.1%) had transient geotropic direction-changing positional nystagmus (DCPN), 6 cases (7.3%) had persistent geotropic DCPN, and 30 cases (36.6%) had persistent apogeotropic DCPN. Fifty cases (61.0%) were affected on the right side and 32 cases (39.0%) on the left side. ⑦The instantaneous cure rates for patients with transient DCPN, continuous DCPN, and persistent DCPN was 86.5% (45/52), 0%, and 73.3%(18/30),respectively.The recovery rate was 92.3%(48/52),33.3%(2/6),and 80.0%(24/30)respectively after 1 week. Conclusion: Repositioning maneuver is an effective way to treat patients with HC-BPPV, especially for the transient geotropic HC-BPPV and persistent apogeotropic HC-BPPV. Non-otolith mechanism may exist in persistent geotropic DCPN.关键词
良性阵发性位置性眩晕/水平半规管/诊断/治疗Key words
benign paroxysmal positional vertigo/horizontal canal/diagnosis/treatment分类
医药卫生引用本文复制引用
凌霞,李康之,申博,司丽红,杨旭..水平半规管良性阵发性位置性眩晕患者82例诊治分析[J].神经损伤与功能重建,2018,13(4):172-176,5.基金项目
院级课题资助(No.YN201305) （No.YN201305）
