| 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].神经损伤功能重建,2018,13(4):172-176 |
| 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 BenignParoxysmal Positional Vertigo |
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| DOI： |
| 中文关键词: 良性阵发性位置性眩晕 水平半规管 诊断 治疗 |
| 英文关键词: benign paroxysmal positional vertigo horizontal canal diagnosis treatment |
| 基金项目:院级课题资助（No.
YN201305） |
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| 中文摘要: |
| 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。 |
| 英文摘要: |
| 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 |
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