单侧特发性后半规管良性阵发性位置性眩晕的病例特征分析  

Clinical characteristics of unilateral idiopathic posterior canal-benign paroxysmal positional vertigo

作　　者：陈钢钢[1] 樊辉如 高伟[1] 张春明[1] 郑智英[1] 皇甫辉[1] 于文永[1] 温树信[1] 张芩娜[1] 杨向茹[1] 张海利[1] 王建明[1] 王娜 王斌全[1] 

机构地区：[1]山西医科大学第一医院耳鼻咽喉-头颈外科,耳鼻咽喉头颈肿瘤山西省重点实验室,山西医科大学耳鼻咽喉研究所,太原030001 [2]山西医科大学临床技能教学模拟医院,太原030001

出　　处：《第二军医大学学报》2017年第11期1379-1383,共5页Academic Journal of Second Military Medical University

摘　　要：目的分析单侧特发性后半规管良性阵发性位置性眩晕患者的病例特征。方法总结分析2013年11月至2015年2月在山西医科大学第一医院诊治的214例单侧特发性后半规管良性阵发性位置性眩晕患者的病例特点。结果单侧特发性后半规管良性阵发性位置性眩晕患者Dix-Hallpike试验时的眼震平均潜伏期为(2.02±1.19)s,平均持续时间为(21.3±14.5)s,其眼震平均潜伏期、平均持续时间均无性别、年龄差异。184例(86.0%)患者1~2次Dix-Hallpike试验即可诱发出典型眼震。162例(75.7%)患者在醒后起床时或夜间睡眠翻身时首次发病。51例(23.8%)患者出现反转相眼震。患者痊愈率为88.3%(189/214),有效率为98.1%(210/214)。14例(6.5%)患者复位后出现耳石转管现象,67例(31.9%)患者复位后残留头晕或走路不稳症状。210例治疗有效的患者中,1、3、6、12、18个月电话随访时复发率分别为0(0/210,0例失访)、5.7%(12/210,0例失访)、8.7%(18/208,2例失访)、11.8%(23/195,15例失访)、17.4%(31/178,32例失访)。结论单侧特发性后半规管良性阵发性位置性眩晕患者首次发病的高发时段为醒后起床时或夜间睡眠翻身时。大部分患者经过Epley法复位治疗后可痊愈,但长期疗效仍需继续随访观察。Objective To analyze the clinical characteristics of patients with unilateral idiopathic posterior canalbenign paroxysmal positional vertigo(PC-BPPV).Methods We retrospectively analyzed and summarized the clinical characteristics of 214 patients with unilateral idiopathic PC-BPPV who were diagnosed in the First Hospital of Shanxi Medical University from Nov.2013 to Feb.2015.Results In the Dix-Hallpike displacement test(D-H test),the average latency of nystagmus in patients with unilateral idiopathic PC-BPPV was(2.02±1.19)s,and the average duration was(21.3±14.5)s.There were no gender or age differences in the latency or duration of nystagmus.Typical nystagmus was induced in 184 cases(86.0%)by one or two D-H tests.The first onset time of 162 cases(75.7%)was in wake up or sleep-tuning at night.Fifty-one cases(23.8%)displayed the reversal phase of nystagmus.The cure rate of patients was 88.3%,and the effective rate was 98.1%.Among 210 patients sensitive to treatment,the recurrence rates were 0(0/210,0 case lost to follow-up),5.7%(12/210,0),8.7%(18/208,2),11.8%(23/195,15)and 17.4%(31/178,32)on 1 st,3 rd,6 th,12 th and 18 th month,respectively.Forteen cases(6.5%)had canal switch phenomenon after reduction,and 67 cases(31.9%)had residual dizziness or unstable symptoms after reduction.Conclusion The most common first onset time of patients with unilateral idiopathic PC-BPPV is in wake up or sleep-tuning at night.Most patients can be cured by Epley method,but the long-term efficacy still need follow-up observation.

关 键 词：良性阵发性位置性眩晕 眼震 耳石转管 残留头晕 

分 类 号：R764.34[医药卫生—耳鼻咽喉科]