水平半规管良性阵发性位置性眩晕的眼震特点和治疗  

Characteristic of nystagmus and treatment of horizontal semicircular canal benign paroxysmal positional vertigo

作　　者：户红艳[1] 董明敏[1] 曹华琳[1] 

机构地区：[1]郑州大学第一附属医院耳科,河南郑州450052

出　　处：《河南医学研究》2011年第2期201-203,共3页Henan Medical Research

摘　　要：目的:探讨水平半规管(horizontal semicircular canal,HSC)良性阵发性位置性眩晕(benign paroxysmalpositional vertigo BPPV)的眼震特点和管石复位的疗效。方法:回顾分析2010年8月至2010年12月郑州大学第一附属医院耳科门诊诊治的48例水平半规管BPPV患者的资料。对所有的患者全面采集病史,并行红外视频眼动电图(Infrared video-oculography)记录变位试验的眼震结果。结果:48例确诊患者中,水平向地性眼震39(81.3%)例,水平背地性眼震9(18.8%)例,经变位试验和Gufoni法可转变为向地性眼震的4例,不能转变的5例。所有确诊患者均行Barbecue复位和联合强迫侧卧位疗法。随访半年治愈36(75%)例,有效48(100%)例,复发7(14.6%)例。结论:根据典型病史和体位诱发试验的眼震特点,可明确区分HSC-BPPV及其它原因引起的眩晕,并可判断耳石症的类型。不论是管结石还是嵴顶结石均可行Barbecue翻滚法,在VNG的辅助下复位可提高复位的精确度和准确性。Objective： To clarify characteristic of nystagmus and treatment of horizontal semicircular canal benign paroxysmal positional vertigo.Methods： Forty-eight patients with HSC-BPPV who diagnosis and treated between August 2010 and December 2010 in Zhengzhou University were recorded and analyzed with medical history and Infrared video-oculography.Results： Of 48 patients with HSC-BPPV diagnosed in our center,geotropic nystagmus was recorded in 39 cases,apogeotripic nystagmus was recorded in 9 cases,one of which could turn into geotropic nysragmus with positoning test or Gonfini maneuver（in 4 cases）,the other type could not（in 5 cases）.Every patient was given barbecue maneuver and combined with forced prolonged position maneuver.Follow-up half a year the total improvement rate was 48（100%）.Conclusion： According to the typical history and nystagmic characteristics of positioning test,we can have a clear distinction of HSC-BPPV and other causes of vertigo.We can also diagnosis the type of HSC-BPPV.Both two types can accept barbecue maneuver,the maneuver under VNG can improve precision and accuracy.

关 键 词：眩晕 水平半规管 红外视频眼动电图 手法复位 

分 类 号：R764[医药卫生—耳鼻咽喉科]