病史两问法在判断良性阵发性位置性眩晕受累半规管中的意义  

Significance of typical complaints in judging the kind of semicircular canal affected in benign paroxysmal positional vertigo

作　　者：俞琳琳[1] 刘洋[2] 李原[2] 赵建辉[2] 刘剑锋[2] 王娜亚[2] 

机构地区：[1]北京煤炭总医院耳鼻咽喉科,北京100028 [2]中日友好医院耳鼻咽喉科,北京100029

出　　处：《中日友好医院学报》2012年第6期329-330,347,共3页Journal of China-Japan Friendship Hospital

摘　　要：目的：探讨病史两问法（①起卧后反复出现短暂眩晕和②床上翻身后反复出现短暂眩晕）在良性阵发性位置性眩晕（BPPV）中对判断受累半规管的意义。方法：回顾性分析2011年9月~2012年3月门诊符合病史两问法的位置性眩晕患者158例,进行Dix-Hallpike及滚转试验明确诊断,和同期确诊的84例BPPV患者进行统计分析,明确病史两问法对判断BPPV受累半规管的敏感性和特异性。结果：158例主诉符合病史两问法的位置性眩晕患者中,99例主诉有第①种眩晕症状、变位试验中出现不同程度的眼震并伴有眩晕的主观感觉,其中确诊垂直半规管类型的BPPV 63例;同期确诊的67例垂直半规管类型的BPPV患者中63例有第①种眩晕症状。第①种眩晕症状诊断垂直半规管类型的BPPV的敏感性为63.6%（63/99）、特异性94%（63/67）。158例中26例主诉有第②种眩晕症状、变位试验中出现不同程度的眼震,并伴有眩晕的主观感觉,确诊水平半规管类型的BPPV 16例。同期确诊的17例水平半规管类型的BPPV患者,16例有第②种眩晕症状,第②种眩晕症状诊断水平半规管类型的BPPV的敏感性为61.5%（16/26）、特异性94.1%（16/17）。结论：病史两问法可以初步判断BPPV受累半规管。Objective：To explore the significance of two-question method（repeated transient vertigo during roll or up and down on bed）in judging the affected semicircular canal.Methods：One hundred and fifty eight cases with the chief complaints of repeated transient vertigo during 2011.9 to 2012.3 were included in this study. Dix-Hallpike and roll test were selected as the golden standard method for diagnosis.The sensitivity and specificity of two-question method for screening diagnosis of the affected semicircular canal in BPPV were i- dentified.Results：Of all 158 cases,125 cases with the chief complaints of vertigo during up and down on bed,99 cases presented positional nystagmus and vertigo,in which 63 cases fulfilled the Guiyang BPPV stan- dard.During the same period,there were 67 identified BPPV cases presented in the clinic,63 cases were fitted with a history of two-question.The sensitivity and specificity of the method for the diagnosis posterior or supe- rior semicircular canals of BPPV were 63.6% and 94%.And the sensitivity and specificity of two-question method for the diagnosis of horizontal semicircular canal of BPPV were 61.5% and 94.1%.Conclusion：Two- question method can diagnose the affected semicircular canal in BPPV screening.

关 键 词：两问法 良性阵发性位置性眩晕 半规管 

分 类 号：R764.34[医药卫生—耳鼻咽喉科]