良性阵发性位置性眩晕的临床特征研究  

Clinical Features of Benign Paroxysmal Positional Vertigo

作　　者：章燕幸[1] 吴承龙[1] 钟芳芳[1] 肖桂荣[1] 

机构地区：[1]浙江省绍兴市人民医院(浙江大学绍兴医院)神经内科,312000

出　　处：《中国全科医学》2012年第2期145-147,共3页Chinese General Practice

基　　金：浙江省医药卫生科学研究基金计划A类资助项目(2009A207);绍兴市2009年科技计划项目(2009A33015)

摘　　要：目的探讨良性阵发性位置性眩晕(BPPV)的临床特征及各种类型对管石复位术的反应。方法对563例BPPV患者的临床表现、类型、合并症及管石复位术治疗后疗效进行回顾性分析。结果 563例患者,男196例(34.8%),女367例(65.2%),男女构成比比较,差异有统计学意义(P<0.01);年龄27～86岁。后半规管BPPV519例(92.2%),其中右耳受累311例(59.9%),左耳受累189例(36.4%),双耳受累19例(3.7%)。水平半规管BPPV 28例,前半规管BPPV 4例,后半规管合并水平半规管BPPV 12例。384例(68.2%)BPPV为特发性,179例(31.8%)为继发性,特发性与继发性比较,差异有统计学意义(P<0.01)。继发性患者中78例有偏头痛,47例有头部创伤史,31例有梅尼埃病,18例有前庭神经炎,5例曾患突发性耳聋。管石复位术后1周429例患者症状缓解,缓解率为76.2%,半年内复发者67例,复发率为11.9%。结论后半规管BPPV是最常见的类型,且右侧优势,女性好发。特发性BPPV为多,继发性BPPV中偏头痛、头部创伤和梅尼埃病是主要病因。管石复位术后症状缓解率较高,半年复发率达11.9%。Objective The aim of this study is to explore the clinical features of benign paroxysmal positional vertigo（BPPV） and its responses to particle repositioning maneuver.Methods Retrospective analysis was made about the clinical features,types,comorbidity and treatment effects of 563 patients with BPPV examined during the past three years.All patients included in the study were treated with an appropriate particle repositioning maneuver.Results Among the 563 patients aged 27~86,65.2% were females（367） and 34.8% were males（196）.The difference between genders was statistically significant（P0.01）.519 patients had the posterior semicircular canal,among which 311（59.9%） were in the right ear,189（36.4%）in the left ear and 19（3.7%） in both ears.28 patients had the horizontal canal,4 patients with the anterior canal,and 12 patients with both PC and HC.384 patients（68.2%） were regarded idiopathic and the remaining 179（31.8%） were regarded secondary.The difference was statistically significant（P0.01） between the idiopathic and the secondary.Among the secondary,78 patients were diagnosed with migraine,47 patients were identified a history of head trauma,31 with Menière′s disease,18 with vestibular neuritis,5 with a history of sudden deafness.After the particle repositioning maneuver 429 patients were symptomaticly relieved within one week,the remission rate was 76.2%;and recurrences were seen in 67 cases in following-up 6 months and the recurrence rate was 11.9%.Conclusion The right-sided posterior BPPV,mostly involving the females,was the most common type.Idiopathic BPPV was found on most patients and migraine,head trauma and Menière′s disease were the main causes for secondary BPPV.Particle repositioning maneuver,was effective with high rate of remission and low rate of recurrence（11.9%,within a half year）.

关 键 词：位置性眩晕 管石复位术 耳石膜 

分 类 号：R441.2[医药卫生—诊断学]