水平半规管良性阵发性位置性眩晕患者82例 诊治分析

凌霞;李康之;申博;司丽红;杨旭

神经损伤与功能重建 ›› 2018, Vol. 13 ›› Issue (4) : 172-176.

PDF(618 KB)
中国科技核心期刊
美国《化学文摘》CAS数据库收录
日本科学技术振兴机构数据库收录
湖北省优秀期刊
中国知网网络首发期刊
PDF(618 KB)
神经损伤与功能重建 ›› 2018, Vol. 13 ›› Issue (4) : 172-176.
论著

水平半规管良性阵发性位置性眩晕患者82例 诊治分析

  • 凌霞,李康之,申博,司丽红,杨旭
作者信息 +

Clinical Analysis of Diagnosis and Treatment of 82 Patients with Horizontal Canal Benign Paroxysmal Positional Vertigo

Author information +
文章历史 +

摘要

目的:探讨水平半规管良性阵发性位置性眩晕(HC-BPPV)患者的临床特征、诊断和治疗。方法:收集 HC-BPPV患者82例,登记临床基线资料,分析HC-BPPV临床特征、诊断和治疗。结果:①本组患者以位置 性眩晕就诊者62例(75.6%),以位置性头晕就诊者12例(14.6%),以走路不稳就诊者8例(9.8%)。②发病至 就诊时间间隔:3 d内39例(47.6%),4~7 d 14例(17.1%),7~14 d 9例(11.0%),>14 d 20例(24.4%)。③诱 因:劳累43例(52.4%),睡眠障碍31例(37.8%),情绪波动10例(12.2%),头外伤6例(7.3%),前驱感染3例 (3.7%)。④发作持续时间:持续数秒钟16例(19.5%),持续数10 sec~1 min钟35例(42.7%),持续1~2 min 19例(23.2%),持续2~5 min 2例(2.4%),持续时间>5 min 10例(12.2%)。⑤前庭双温检查:28例患者存在 一侧前庭功能减低,其中22例(78.6%)与受累半规管侧别一致。⑥行Roll试验出现短暂向地性位置性眼震 (DCPN)46例(56.1%),持续背地性DCPN 30例(36.6%),持续向地性DCPN 6例(7.3%),其中右侧受累50例 (61.0%),左侧受累32例(39.0%)。⑦短暂向地性DCPN、持续向地性DCPN与持续背地性DCPN患者手法 复位即时痊愈率分别为 86.5%(45/52)、0%、73.3%(18/30),1 周痊愈率分别为 92.3%(48/52)、33.3%(2/6)、 80.0%(24/30)。结论:HC-BPPV患者手法复位治疗有效,其中短暂向地性和持续背地性HC-BPPV患者手法 复位有效率较高,持续向地性DCPN可能存在非耳石机制。

Abstract

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%). ③ Inducements: 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

引用本文

导出引用
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
Clinical Analysis of Diagnosis and Treatment of 82 Patients with Horizontal Canal Benign Paroxysmal Positional Vertigo[J]. Neural Injury and Functional Reconstruction. 2018, 13(4): 172-176

PDF(618 KB)

Accesses

Citation

Detail

段落导航
相关文章

/