外伤后良性阵发性位置性眩晕的临床特点和治疗  

Clinical characteristics and treatment of the posttraumatic benign paroxysmal positional vertigo

作　　者：刘宏建[1] 王广科[1] 马崧[1] 黄玮[1] 谢伟民[1] 

机构地区：[1]河南省人民医院耳鼻咽喉科,河南郑州450003

出　　处：《中国耳鼻咽喉头颈外科》2011年第8期427-429,共3页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的探讨外伤后良性阵发性位置性眩晕(posttraumatic benign paroxysmal positional vertigo,t-BPPV)的临床特点和治疗。方法回顾性分析2006年7月～2010年6月所诊治的17例t-BPPV患者的临床特点和治疗结果,并与同时间段治疗的43例特发性良性阵作性位置性眩晕(idiopathic benign paroxysmal positional vertigo,i-BPPV)进行对比。结果 t-BPPV组患者年龄(36.5±12.9)岁,t-BPPV组(52.5±9.6)岁,两者差异有统计学意义(t=4.12,P<0.05);t-BPV组中两个或两个以上半规管受累率为7/17(41.2%),高于i-BPV组5/43(11.6%),差异有统计学意义(χ2=6.65,P<0.01)。17例t-BPPV患者中有4例双侧半规管发病,发生率为23.5%;43例i-BPPV患者中有2例双侧半规管发病,发生率为5%,差异有统计学意义(χ2=4.82,P<0.05)。t-BPPV中首次复位成功率为61.5%(14/26),i-BPPV为87.5%(42/48),两组差异有统计学意义(χ2=10.38,P<0.001)。t-BPPV组复发率47.1%(8/17),i-BPPV组为20.9%(9/43),差异具有统计学意义(χ2=13.04,P<0.001)。两组患者眩晕潜伏期和持续时间之间的差异无统计学意义。结论 t-BPPV患者发病年龄较年轻;多个、多侧半规管受累率较高;首次复位成功率较低,复发率较高。OBJECTIVE To identify the clinical characteristics and treatment of posttraumatic benign paroxysmal positional vertigo（t-BPPV）.METHODS The clinical data of 17 patients with positional vertigo after head injury and 43 patients with idiopathic BPPV（i-BPPV） from July,2006 to June,2010 were reviewed.The clinical characteristics of t-BPPV and the clinical differences between the t-BPPV and i-BPPV groups were investigated.RESULTS The mean age of the patients in t-BPPV group and i-BPPV group was 36.5±12.9 years and 52.5±9.6 years respectively.There was a significant difference between the two groups（t=4.12,P0.05）.The rate of two or more semicircular canal involvement in the t-BPPV group（41.2%） was higher than that in i-BPPV group（11.6%）（χ2=6.65,P0.01）.Bilateral semicircular canals were involved in 4 of the 17 cases in t-BPPV group（23.5%） and 2 of the 43 cases in i-BPPV group（5%）.The difference was statistically significant（χ2=4.82,P0.05）.The success rate after first reposition maneuver was 61.5%（14/26） in t-BPPV group and 87.5%（42/48）in i-BPPv group,the difference was significant（χ2=10.38,P0.001）.The recurrence rate was 47.1%（8/17）in the t-BPPv group and 20.9%（9/43）in i-BPPV group,the difference was statistically significant（χ2=13.04,P0.001）.The latency and duration of vertigo attack were no significant difference between the two groups.CONCLUSION It is likely that t-BPPV is more difficult to be treated than i-BPPV.Further prospective clinical meta-analytic studies are needed to investigate the outcome of t-BPPV.

关 键 词：眩晕 变位性眼震 耳石膜 半规管 临床方案 脑震荡 

分 类 号：R764[医药卫生—耳鼻咽喉科]