1240例良性阵发性位置性眩晕患者手法复位治疗  

Canalith repositioning procedures in treatment of 1240 patients with benign paroxysmal positional vertigo

作　　者：刘秋玲[1] 王跃建[1] 周晓娓[1] 林枫[1] 梁海荣[1] 虞幼军[1] 

机构地区：[1]广东省佛山市第一人民医院耳鼻咽喉-头颈外科,佛山528000

出　　处：《中华耳科学杂志》2010年第4期427-430,共4页Chinese Journal of Otology

摘　　要：目的总结分析1999年12月至2008年9月期间1240例良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)患者应用管石复位治疗后的短期和长期疗效。方法对1240例BPPV患者应用改良Epley手法和Barbecue 360°体位翻滚复位法进行手法复位治疗,并于一周后复查,随访一年。结果 1240名患者中,男500例,女740例,年龄5～92岁,平均(46.5±2.3)岁。其中单侧后半规管BPPV患者1149例,单侧水平半规管BPPV患者69例,同时性双侧后半规管BPPV患者17例,同时性双侧水平半规管BPPV患者2例,同时性后半规管与水平半规管BPPV患者3例;特发性BPPV 968例,继发性BPPV 472例,继发病因包括头部外伤、感染、各种耳部疾病、高血压、手术等。利用手法复位治疗后,首次治愈率85.6%(1062/1240),其中后半规管BPPV 86.2%(991/1149),水平半规管BPPV 81.2%(56/69),混合性半规管BPPV 68.2%(15/22);观察随访1年后,总治愈率94.2%(1168/1240),复发率5.7%。结论 BPPV患者采用手法复位治疗,疗效肯定,见效快,方法简单,短期复发率低,可作为治疗BPPV患者的首选治疗方法。Objective To review positioning therapy results in 1240 patients with benign paroxysmal positional vertigo（BPPV）.Methods 1240 cases of BPPV that were treated with particle repositioning maneuver and rolling maneuver therapy from December 1998 to September 2008 were retrospectively studied.Results Of the 1240 patients,500 were male and 740 female,with a mean age of 46.5 ± 2.3 years（5 to 92 years） old,Lesion was located in the posterior semicircular canal in 1149 patients（71.01%）,horizontal semicireular canal in 69 patients（20.32%）,bilateral posterior semicircular canal in 13 patients（2.97%）,bilateral horizontal semicircular canal in 17 patients（2.97%）,and combined posterior and horizontal semicircular canals in 13 patients（2.97%）.Idiopathic BPPV was considered in 968 patients,and secondary BPPV in the rest patients.Possible causes included head trauma,infection,various otologic diseases,hypertension,diabetes,operation,oral calcium pills,etc.When treated with Particlere Positioning maneuver,the initial suceess rate was 84.3%（86.2% or 991/1149 for posterior semicircular canal,81.2% or 56/69 for horizontal semicircular canal and 68.2% or 15/22 for combined semicircular canal）.At one year following up,our total success rate reached 98.3% with a 18.5% recurrence rate.Conclusion Our data suggest that canalith repositioning provides a safe and effective treatment in the majority of patients with BPPV,and is in fact responsible for resolution of symptoms at the early time of BPPV.

关 键 词：良性阵发性位置性眩晕(BPPV) 手法复位 疗效 

分 类 号：R764.3[医药卫生—耳鼻咽喉科]