坐-卧位眼震在良性阵发性位置性眩晕诊断中的意义  

Significance of the seated supine positioning nystagmus for the diagnosis of benign paroxysmal positional vertigo

作　　者：梁旭晖[1] 孙培洋 彭新[2] 刘金梅[2] 陈哲[2] 单希征[2] 

机构地区：[1]安徽医科大学武警总医院临床学院,合肥230032 [2]武警总医院耳鼻咽喉头颈外科武警部队眩晕病研究所

出　　处：《临床耳鼻咽喉头颈外科杂志》2017年第9期703-707,共5页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:观察及评价坐-卧位眼震(SSPN)在良性阵发性位置性眩晕(BPPV)诊断中的意义。方法:收集200例诊断为BPPV的病例,所有病例先行坐-卧位试验观察SSPN,再行滚转试验及Dix-Hallpike试验。依据滚转试验、Dix-Hallpike试验确定BPPV类型并分组,统计分析不同类型BPPV的SSPN诱发率及特征。结果:200例BPPV患者中116例(58.0%)诱发出SSPN,其中PSC-BPPV组(136例)中72例诱发出SSPN,HSC-BPPV组(60例)中44例诱发出SSPN,ASC-BPPV组(4例)中无SSPN。PSC-BPPV组诱发出的SSPN均表现为以眼球上极为标志的、扭转成分向患侧、垂直成分向额侧的垂直扭转性眼震。管石型HSC-BPPV患者(41例)中28例诱发出SSPN,其中22例诱发出的SSPN指向健侧,6例诱发出的SSPN指向患侧;嵴顶结石型HSC-BPPV患者(19例)中16例诱发出SSPN,诱发出的SSPN均指向患侧。结论:SSPN对不同类型BPPV的诊断意义不同,可结合SSPN对BPPV诊断。Objective：To observe and assess the significance of seated supine positioning nystagmus（SSPN）in the diagnosis of benign paroxysmal positional vertigo（BPPV）.Method：Two hundreds patients who were diagnosed BPPV were tested with the seated supine positioning test（SSPT）to observe SSPN,then were tested Supine roll test（SRT）and Dix-Hallpike test（DHT）.According to the result of SRT and DHT,patients were divided into different groups.The positive rate and feature of SSPN in different types of BPPV was analyzed.Result：Among the 200 patients,116 cases（58.0%）of them showed SSPN.Among the 116 cases who were divided to the posterior semicircular canal BPPV（PSC-BPPV）group,72 cases of them showed SSPN.Horizontal semicircular canal BPPV（HSC-BPPV）group were 60 cases,44 cases showed SSPN.Anterior semicircular canal BPPV（ASC-BPPV）group were 4 cases and none of them showed SSPN.The direction of SSPN was a combination of torsional nystagmus with the upper pole of the eyes beating toward the affected side combined with vertical nystagmus beating upward（toward the forehead）typically in the PSC-BPPV group.Canalolithiasis of HSC were 41 cases,and 28 cases showed SSPN,and SSPN was contralesional in 22 cases（78.6%）and ipsilesional in 6 cases.Cupulolithiasis of HSC were 19 cases and 16 cases showed SSPN,and SSPN was ipsilesional in 16 cases.Conclusion：Significance of the seated supine positioning nystagmus in different types of BPPV is different.

关 键 词：坐-卧位眼震 良性阵发性位置性眩晕 诊断 

分 类 号：R441.2[医药卫生—诊断学]