管石复位术对老年良性阵发性位置性眩晕患者跌倒的影响  

The effect of particle repositioning maneuver on the falls of elderly patients with 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：《中华全科医学》2014年第1期6-8,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);绍兴市科技计划资助项目(2009A33015)

摘　　要：目的研究老年良性阵发性位置性眩晕(BPPV)患者经管石复位术(PRM)后能否减少跌倒发作。方法回顾性研究过去5年中因BPPV跌倒的60岁以上老年患者。所有患者根据受累半规管进行相应的PRM。消除位置性眩晕和眼震后,患者接受1年期随访,并观察跌倒次数。采用Wilcoxon’s检验比较复位前后跌倒次数。结果147例患者入组,后半规管121例,水平半规管18例,前半规管8例。前半规管和后半规管BPPV采用Epley法复位,水平半规管BPPV采用Lempert法复位。患者经PRM后跌倒次数减少,所有患者复位前后跌倒次数比较(P<0.01),后半规管BPPV复位前后跌倒次数比较(P<0.01),水平半规管BPPV复位前后跌倒次数比较(P=0.01),前半规管BPPV复位前后跌倒次数比较(P=0.016),差异具有统计学意义。结论 PRM能减少BPPV老年患者跌倒发作。Objective To study whether there will be a reduction on the falls of elderly patients with BPPV after the parti- cle repositioning maneuver（PRM）. Methods The elderly above 60 with BPPV who had falls during the past 5 year was studied retrospectively. All patients accepted the PRM according to the affected semicircular canal. After positioning verti- go and nystagmus subsidised, the patients accepted a 12 month follow-up and were investigated about the number of falls. Wilcoxon＇ s test was performed to compare the number of falls before and ＇after 12 months of the PRM. Results One hun- dred and forty seven patients were included in the study. One hundred and twenty one patients involved the posterior semi- circular canal, 18 of the lateral and 8 of the anterior. The Epley maneuver was used for posterior semicircular canal and su- perior semicircular canal BPPV, and the Lempert maneuver was used for lateral semicircular canal BPPV. We noticed a re- duction on the number of falls, with statistically significant difference when all the patients were analyzed together （ P 〈 0.01 ）, the posterior canal BPPV patients （P 〈 O. 01 ）, the lateral canal BPPV patients （P = O. 001 ） and the anterior canal BPPV patients （ P = 0.016）. Conclusion The PRM could reduce the number of falls of elderly patients with BPPV.

关 键 词：位置性眩晕 物理治疗 跌倒 管石复位术 

分 类 号：R441.2[医药卫生—诊断学] R764.3[医药卫生—临床医学]