oVEMP评估良性阵发性位置性眩晕患者耳石复位效果的临床价值  

The clinical values of oVEMP in the repositioning of otoconia of benign paroxysmal positional vertigo

作　　者：王铭歆 张静[1] 苏娟[1] 许轶[1] 周慧芳[1] 

机构地区：[1]天津医科大学总医院耳鼻咽喉头颈外科,天津300052

出　　处：《临床耳鼻咽喉头颈外科杂志》2016年第21期1706-1709,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:探讨眼性前庭诱发肌源性电位(oVEMP)对于评估良性阵发性位置性眩晕(BPPV)患者耳石复位效果的临床价值。方法:对2015-10-2016-03期间就诊的53例原发性单侧后半规管BPPV患者进行耳石复位前后的oVEMP测试,并根据复位效果分为痊愈组和有效组,比较各组复位前后oVEMP的引出率、N1振幅和N1-P1波幅以及不对称率的差异,应用SPSS 20.0软件进行统计学分析。结果:53例患者复位治疗前oVEMP引出率为84.9%,复位后引出率为88.7%。复位前后均可引出oVEMP者45例,按照疗效分为痊愈组(28例)和有效组(17例)。痊愈组:治疗前后相比,患侧N1振幅从(3.16±0.64)μV增长到(3.99±0.67)μV;患侧N1-P1波幅从(3.08±1.14)μV增长到(4.22±0.87)μV,均差异有统计学意义(P<0.05);健侧N1振幅平均增长0.02μV,健侧N1-P1波幅平均增长0.01μV,均差异无统计学意义(P>0.05);不对称率治疗后降低0.10,差异有统计学意义(P<0.05)。有效组:治疗前后相比,患侧N1振幅平均增长0.13μV,患侧N1-P1波幅平均增长0.01μV;健侧N1振幅前后水平一致,健侧N1-P1波幅平均增长0.04μV,不对称率前后水平一致,各项均差异无统计学意义(P>0.05)。结论:有效的耳石复位可使BPPV患者脱落的耳石回归椭圆囊,复位后oVEMP波幅增长,引出率提高;oVEMP可用于评估BPPV患者耳石复位后椭圆囊的功能恢复情况,评判该病的预后。Objective：To evaluate whether oVEMP amplitudes increase after successful repositioning of otoconia in patients diagnosed as benign paroxysmal positioning vertigo（BPPV）. Method： Fifty-three cases of unilateral pc-BPPV were prospectively examined with air-conducted oVEMP at two time points： before, and 1 week after reposition. A commercially available software package SPSS 20.0 was used for statistical analysis. Result：Prevalence was 84.9% before treatment, and it changed to 88.7% 1 week after reposition. During one week follow-up, 28 out of 45 cases were asymptomatic（healing group） ; vertigo could still be induced in the other 17（effective group） cases. In healing group the mean N1 amplitude on the affected side increased from （3. 16 ± 0. 64）μV at baseline （before the treatment） to（3.99±0.67）μV at 1 week after treatment; the mean N1-P1 amplitudes on the affected side increased from（3.08±1.14）μV at baseline（before the treatment） to （4.22±0.87）μV at 1 week after treat ment, and this increase was significant（P〈0.05）. However there is no significantly statistical difference on the no-affected side in the healing group（P〉0.05）. And no significantly statistical difference was found in the effective group（P〉0.05）. Conclusion： A repositioning of otoconia to the utricle may occur during the repositioning maneuver in BPPV, an increasing oVEMP amplitudes was found after the repositioning maneuver, oVEMP examinations could be useful to evaluate the the effect of repositioning in BPPV.

关 键 词：眼性前庭诱发肌源性电位 良性阵发性位置性眩晕 耳石复位 

分 类 号：R255.3[医药卫生—中医内科学]