复位治疗对良性阵发性位置性眩晕患者姿势稳定性的影响  

Effect of canalith repositioning procedure on the postural stability in patients with benign paroxysmal positional vertigo

作　　者：刘波[1] 孔维佳[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院耳鼻咽喉科,湖北武汉430022

出　　处：《中国耳鼻咽喉头颈外科》2009年第8期416-419,共4页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金："十一五"国家科技支撑计划(2007BAI18B13);国家杰出青年基金资助项目(39925035);中国高技术研究发展计划(863)项目(2008AA02Z428)联合资助

摘　　要：目的探讨耳石复位治疗(canalith repositioning procedure,CRP)对后半规管良性阵发性位置性眩晕(posterior semicircular canal benign paroxysmal positional vertigo,PSC-BPPV)患者姿势稳定性的影响。方法25例PSC-BPPV患者在CRP前、后进行4种站立条件下的姿势稳定性测试,①坚硬平板、睁眼(T1);②坚硬平板、闭眼(T2);③海绵垫、睁眼(T3);④海绵垫、闭眼(T4)。以配对的25名正常人为健康对照组。采用身体直立时足底压力中心的平均晃动速度(sway velocity,SV)为研究参数。结果①CRP前患者SV均较健康对照组增加,T1时有显著性差异(t=2.442,P=0.022);T2～T4有极显著性差异(t值分别为3.529、5.799和4.312,P<0.01);②CRP后除T1外(t=1.808,P=0.083),T2～T4时,患者身体晃动SV较治疗前降低,有显著性差异(t值分别为2.487、2.248和2.897,P<0.05);③CRP后患者姿势稳定性与健康对照组比较,T1和T2时SV间比较,无显著性差异(t分别为1.388和2.022,P>0.05);T3和T4时SV间比较,有显著性差异(t分别为1.488和2.327,P<0.05)。结论CRP可提高PSC-BPPV患者姿势稳定性,但与正常人仍有一定差异,提示PSC-BPPV患者可结合CRP和前庭康复治疗提高姿势平衡能力。OBJECTIVE To investigate the effect of canalith repositioning procedure （CRP） on the postural stability in patients with benign paroxysmal positional vertigo of the posterior semicircular canal （BPPV-PSC） . METHODS 25 patients with BPPV- PSC were taken the posturography before and after the CRP. The posturography test has four conditions including（1）firm surface with eyes open （EO） ; （2）firm surface with eyes closed （EC） ; Qfoam surface with EO; Qfoam surface with EO. The body sway velocity （SV） recorded by the posturography was analyzed as parameter of postural stability. The postural stability of the patients with BPPV-PSC was compared with that of the matched control group. RESULTS （1）The SVs of the BPPV-PSC patients before the CRP were greater than those of control group （P〈0.05 or P〈0.001） . （2） For the BPPV-PSC patients, the SVs showed decrease after the CRP except that test condition 1 （firm surface with EO） . （3）There were no differences of the SVs between the BPPV-PSC patients after the CRP and the control group in the test with the firm surface （PEo=0.178, PEC=0.055） , while there were significant differences in the test with foam surface （PEo=0.004, PEc=0.029） . CONCLUSION Treatment of BPPV-PSC by the CRP can result in improved postural stability in the patients with BPPV-PSC, but there was still somewhat difference compared with the normal subjects.

关 键 词：耳石膜 体位 半规管 眩晕 

分 类 号：R764[医药卫生—耳鼻咽喉科] R681.55[医药卫生—临床医学]