外周性眩晕患者的感觉结构与稳定极限能力分析  

The sensory organization and limit of stability in patients with peripheral vestibular disorders

作　　者：刘博[1] 黄小兵[1] 陈秀伍[1] 段金萍[1] 赵小燕[1] 左丽静[1] 

机构地区：[1]首都医科大学附属北京同仁医院耳鼻咽喉头颈外科,北京市耳鼻咽喉科研究所,耳鼻咽喉头颈科学教育部重点实验室(首都医科大学),北京100005

出　　处：《中华耳科学杂志》2010年第2期137-140,共4页Chinese Journal of Otology

基　　金：前庭中枢代偿机制及眩晕疾病规范化诊断与康复治疗方案研究(2007BAI18B13)

摘　　要：目的通过对突发性聋伴发眩晕、梅尼埃病和良性阵发性位置性眩晕患者的平衡功能进行分析,了解典型外周性眩晕疾病的平衡特点。方法正常对照组:47例健康成年人,20-58岁,男性21例,女性26例,平均年龄36.2±13.3岁。眩晕组:40例外周性眩晕患者,20-68岁,男性17例,女性23例,平均年龄48.3±13.2岁;其中突发性聋伴发眩晕10例,20-67岁,男性7例,女性3例,平均年龄45.0±17.9岁;梅尼埃病14例,25-64岁,男性8例,女性6例,平均年龄48.9±11.0岁;良性阵发性位置性眩晕16例,25-68岁,男性2例,女性14例,平均年龄49.8±12.0岁。对所有受试者进行稳定极限范围测试和硬平板和泡沫板的睁、闭眼共计六种模式的平衡功能评价。结果 (1)正常对照组和眩晕组的身体压力中心移动面积平均值在T2、T3及T5时有差异,分别是P=0.006,P=0.024,P=0.000。(2)外周性眩晕患者的稳定极限范围较正常对照组减小,P=0.000。(3)突发性聋伴发眩晕、梅尼埃病和良性阵发性位置性眩晕患者的身体压力中心移动面积没有统计学差异,P=0.148-0.660;三种典型外周性眩晕疾病的稳定极限范围没有统计学差异P=0.678。结论 (1)外周性眩晕患者保持平衡的能力下降,其损伤后平衡维持和康复需要借助视觉和本体觉补偿;(2)外周性眩晕疾病的稳定极限范围减小,在眩晕患者的平衡康复训练中应适当训练以增加下肢肌肉的力量,降低跌倒的风险。Objectives In order to characterize balance function of peripheral vestibular disorders, three typical peripheral vestibular disorders such as sudden hearing loss with vertigo, Meniere＇s disease and benign paroxysmal posi- tional vertigo was analyzed. Methods The control group： 47 healthy volunteers aged 20 - 58 years, of 21 males and 26 females, mean age 36.2 ± 13.3 years; The group of peripheral vertigo： 40 cases, aged 20 - 69 years, of 17 males and 23 females, mean age 48.3 ± 13.2 years, including 10 cases of sudden hearing loss with vertigo, aged 20 - 67 years, of 7 males and 3 females, mean age 45.0 ± 17.9 years; 14 cases of Meniere＇s disease, aged 25 - 64 years, of 8 males and 6 fe- males, mean age 48.9 ± 11.0 years; 16 cases of benign paroxysmal positional vertigo, aged 25 - 68 years, of 2 males and 14 females, mean age 48.9 ± 11.0 years. All subjects were assessed by computerized posturography under six upright stance conditions： including standing on the firm surface and foam with eyes open and closed. Results （1） On the con- dition of 2, 3 and 5, the surface of statokinesigram were significantly larger in the patients with peripheral vestibular dis- orders than the control group with P = 0.006, P = 0.024, P = 0.000. （2） Compared with the normal adults, the limit of sta- bility was significantly smaller in patients, P= 0.001. 3. The surface of the statokinesigram was not significantly different in patients with sudden hearing loss with vertigo, Meniere’s disease and benign paroxysmal positional vertigo, P = 0.148-0.660. There was no significant difference on the limit of stability, P = 0.678. Conclusions （1） The postural stability de- creases in patients with peripheral vestibular disorders. The compensation of vision and proprioception are needed to keep postural stability and which is also important in the rehabilitation therapy. （2） The limit of stability was significantly smaller in patients with peripheral vestibular disorders. In order to prevent falling, appropriat

关 键 词：外周性眩晕 平衡功能 稳定极限范围 

分 类 号：R764.33[医药卫生—耳鼻咽喉科] R764.34[医药卫生—临床医学]