良性阵发性位置性眩晕成功复位后残余头晕的研究  

Residual Dizziness after Successful Canalith Repositioning Maneuvers in Patients with Benign Paroxysmal Positional Vertigo

作　　者：章燕幸[1] 吴承龙[1] 肖桂荣[1] 钟芳芳[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：《中华全科医学》2013年第12期1840-1841,1862,共3页Chinese Journal of 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：目的评估良性阵发性位置性眩晕患者成功复位后残余头晕的发生率和特点，以及与之相关的因素。方法前瞻性研究109例复位成功的良性阵发性位置性眩晕患者，所有患者一直随访到头晕完全缓解。分析其残余头晕的特点和相关的临床因素。结果109例患者中男性42例，女性67例，平均（52．0±10．2）岁，61（54％）例有复位后残余头晕。残余头晕有2类：持续的头昏目眩和发生在头部运动、站立或行走时的短暂头晕不稳感。头晕持续（9．2±10．5）d，3个月随访期内多数患者残余头晕在20d内消退。多因素Logistic回归分析显示，年龄[OR=1．048，95％CI（1．002～1．095）]和复位前眩晕持续的时间[OR=1．200，95％CI（1．025～1．405）]是残余头晕的独立危险因素；性别、受累侧、病变半规管、眩晕持续时间、治疗前眩晕发作次数、复位次数、BPPV的病因以及合并症（包括高血压、糖尿病、冠心病、高脂血症）等人口特征和临床参数与结局无明显相关。结论良性阵发性位置性眩晕患者成功复位后残余头晕发生率高。未经特殊治疗3个月内都能自行缓解。早期成功复位能降低残余头晕发生率。Objective To study the prevalence and clinical factors associated with residual dizziness in patients with benign paroxysmal positional vertigo （BPPV） after successful canalith repositioning maneuvers. Methods One hundred and nine pa- tients after successful repositioning maneuvers for benign paroxysmal positional vertigo were recruited in the prospective study. All patients were followed up until the subjective dizziness and imbalance were completely relieved. The demographic features and clinical factors associated with residual dizziness were studied. Results Of the 109 patients ,42 were males and 67 were females, aged （52.0 ± 10.2 ） years. Sixty-one patients （54%） reported residual dizziness after successful repositioning maneuver. Two types of residual dizziness were defined： continuous lightheadedness and short-lasting unsteadiness occurring during head move- ment,standing,or walking. The mean duration of residual dizziness was （9.2 ± 10.5 ） days. Cumulative fractions of residual dizziness during the follow-up after successful repositioning indicated that the residual dizziness subsided within 20 days in most pa- tients. The age（ OR = 1. 048,95% CI 1. 002 - 1. 095 ） and longer symptom duration before successful reposition （ OR = 1. 200, 95% CI 1. 025 -1. 405） were associated with an increased risk of residual dizziness. No association was observed between resid- ual dizziness and gender,the duration of vertigo,the affected side,involved canal,the number of attacks before treatment and re- positioning maneuvers before resolution, etiology of BPPV and complications （ including hypertension, diabetes mellitus, coronary artery disease,and hyperlipidemia）. Conclusion Residual dizziness after successful repositioning can be observed in more than half of the patients with BPPV and disappeared within 3 months without specific treatment in all cases. The early successful repositioning can reduce the incidence of residual dizziness.

关 键 词：良性阵发性位置性眩晕 物理医学 半规管 复位 残余头晕 

分 类 号：R764.3[医药卫生—耳鼻咽喉科] R441.2[医药卫生—临床医学]