SRM-Ⅳ诊疗系统与手法复位对不同类型良性位置性眩晕的诊疗效果比较  

Comparison of SRM-Ⅳ vestibular diagnosis and treatment system and re-position maneuver for diagnosis and treatment of horizontal and posterior semicircular benign positional vertigo

作　　者：孙家兰[1] 计海峰[1] 吴大玉 胡荣郭 江梅[1] 李龙宣[1] 

机构地区：[1]上海市浦东新区公利医院神经科,上海200135

出　　处：《内科理论与实践》2017年第1期54-58,共5页Journal of Internal Medicine Concepts & Practice

基　　金：国家自然科学基金项目(项目编号:81571203);上海市科学技术委员会科技发展基金(项目编号:15ZR1437200);上海市浦东新区科技发展基金创新资金(医疗卫生)项目(项目编号:PKJ2014-Y21);上海市浦东新区科技发展基金创新基金(项目编号:PKJ2013-Y01);上海市浦东新区卫生系统重点学科建设(项目编号:PWZx2014-08);上海市浦东新区卫生系统领先人才培养计划(项目编号:PWR12014-05);上海市医学重点专科建设计划项目(项目编号:ZK2015B16);上海市卫生和计划生育委员会科研课题(项目编号:201540157)

摘　　要：目的:通过手法复位与SRM-Ⅳ前庭功能检查及诊疗系统2种方法对后半规管及水平半规管良性阵发性位置性眩晕(BPPV)患者的诊断、疗效及复发率进行评估。方法:纳入采用Dix-Hallpike、滚转试验确诊的水平及后半规管BPPV患者,通过SRM-Ⅳ前庭功能检查及诊疗系统进行眼震评估,判断两者诊断(半规管类型)符合率。同时将患者分组,分别进行经典方法手法复位及SRM-Ⅳ仪器复位,从而评估2种复位方法的有效率。结果:采用经典方法与SRM-Ⅳ仪器进行半规管类型判断,两者符合率为100%。SRM-Ⅳ仪器复位组第1次复位痊愈率为73.8%,有效率为95.2%,第2次复位痊愈率为84.5%,有效率为97.6%。而手法复位组第1次复位分别为61.5%及80.8%,第2次为75.0%及82.7%。2组2次痊愈率及有效率均存在显著差异(均P<0.05)。其中后半规管BPPV患者中,手法复位组1次治愈率及总治愈率分别为65.8%和78.0%,SRM-Ⅳ仪器复位组1次治愈率及总治愈率分别为84.1%和92.1%,2组间差异均有统计学意义(均P<0.05)。而水平半规管BPPV患者中,手法复位组1次治愈率及总治愈率分别为45.4%和63.6%,SRM-Ⅳ仪器复位组1次治愈率及总治愈率分别为57.1%和85.7%,2组1次复位治愈率差异无统计学意义(P>0.05),总治愈率差异有统计学意义(P<0.05)。在疾病复发率上,各组均无统计学差异。结论:与经典方法相比,SRM-Ⅳ仪器对于不同类型BPPV治愈率及有效率更高。Objective To evaluate the diagnosis and therapeutic efficacy and recurrence rate of SRM-IV vestibular diagnosis and treatment system and re-position maneuverin patients with horizontal semicircular and posterior semicircular benign paroxysmal positional vertigo （BPPV）. Methods Patients were diagnosed by Dix-Hallpike and roll test to identify the horizontal semicircular and posterior semicircular type BPPV and were re-evaluated by SRM-IV vestibular diagnosis and treatment system to test the coincidencerate of diagnosis. The patients were divided into two groups, treated with re-posi- tion maneuvers and SRM-IV vestibular diagnosis and treatment system, and to compare the effectiveness of these two methods. Results The classical method and SRM-IV system diagnosed semicircular canal type had a coincidence rate of 100%. In SRM-IV system treated group, first round treatment had a recovery rate 73.8%, effective rate 95.2%, second round treatment had a recovery rate 84.5%, effective rate 97.6%. In re-position maneuver treated group, first round treat-ment had a recovery rate 61.5%, effective rate 80.8%, second round treatment had a recovery rate 75.0%, effective rate 82.7%. There were significant differences （P〈0.05） in recovery rate and effective rate between the two groups. In patients with posterior semicircular BPPV, re-position maneuver treated group had a first round recovery rate 65.8% and total recov- ery rate 78.0%; SRM-IV system treated group had a first round recovery rate 84.1% and total recovery rate 92.1%. There were significant differences （P〈0.05） in first round recovery rate and total recovery rate between the two groups. In patients with horizontal semicircular BPPV, re-position maneuver treated group had a first round recovery rate 45.4% and total recov- ery rate 63.6%; SRM-IV system treated group had a first round recovery rate 57.1% and total recovery rate 85.7%. There was no significant difference （P〉0.05） in first round recovery rate, but there was significant difference （P�

关 键 词：良性阵发性位置性眩晕 SRM-Ⅳ前庭功能检查及诊疗系统 手法复位 

分 类 号：R764[医药卫生—耳鼻咽喉科]