儿童眩晕症82例临床分析  

Vertigo and dizziness in children： a clinical analysis of 82 cases

作　　者：曾祥丽[1] 岑锦添[1] 梁茵菲 张姝琪 黎志成[1] 尹根蒂[1] 袁涛[1] 柯卓丽[1] Zeng Xiangli;Cen Jintian;Liang Yinfei;Zhang Shuqi;Li Zhicheng;Yin Gendi;Yuan Tao;Ke Zhuoli(Department of Otorhinolaryngology, Head and Neck Surgery, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China)

机构地区：[1]中山大学附属第三医院耳鼻喉头颈外科,广州510630

出　　处：《中华全科医师杂志》2018年第2期109-113,共5页Chinese Journal of General Practitioners

摘　　要：目的了解儿童眩晕症病种构成、临床表现及诊疗过程特点。方法回顾性分析2006年1月至2016年12月诊治的82例儿童眩晕症患儿的临床表现、诊断和治疗。结果82例中，女性46例、男性36例，女：男为1．28：1。中位年龄9．0岁（14个月-18．0岁），其中≤6周岁者21例．主诉为不明原因的反复摔倒、哭闹、行走不稳、挠耳及〉5岁患儿“屋顶或者帐篷顶旋转”；〉6-〈15岁者34例，主诉为较笼统的“晕”；≥15-≤18岁者27例，主诉“晕”，能较明确地诉说“旋转感”或者“昏沉感、头重脚轻感”以及伴随耳聋、耳闷、耳鸣等。儿童良性发作性眩晕（BPV）15例（18．3％），分泌性中耳炎（SOM）12例（14．6％），前庭性偏头痛（VM）11例（13．4％），良性阵发性位置性眩晕（BPPV）9例（11．0％），内耳畸形8例（9．8％），梅尼埃病8例（9．8％），前庭神经炎7例（8．5％），突发性聋伴眩晕6例（7．3％），中枢性眩晕4例（4．9％），先天性尿素循环障碍和精神心理性眩晕各1例（1．2％）。女性患儿患病较多的疾病为BPV、VM及梅尼埃病。随年龄增长，BPV有自愈倾向，8例12岁以后、3例14岁以后未再发，4例随访中；VM发作频率减少、发作程度减轻。〉6岁患儿可配合完成绝大部分的前庭功能检查。先天性尿素循环障碍患儿发病1周死亡。结论眩晕症患儿BPV、SOM、VM较多，女性多于男性。随着年龄增长，BPV有自愈趋势，中枢性眩晕及以头晕为首发症状的罕见遗传病，病情变化快，危害性大，需要对病情进行密切观察并及时多学科会诊。Objective To analyze etiology, clinical manifestation and diagnosis process of vertigo and dizziness in children. Method The clinical data of 82 children with vertigo and dizziness treated in our hospital from January 2006 to December 2016 were retrospectively analyzed. Results There were 46 girls and 36 boys with a female： male ration of 1.28： 1. The median age of patients was 9.0 years （ 14 months - 18.0 years） and 21 cases were less than 6 years old. The chief complaints were repeatedly falling, crying, walking unsteadily and scratching the ear for unknown reasons. For children aged 〉 5 years may express ＂ roof or tent rotation＂ ; for those aged 〉6 - 〈 15 years （n =34） , the main complaint was more ambiguous ＂dizziness＂ ; for those aged ≥ 15 - ≤ 18 years （n = 27 ） with the main complaint of ＂ dizziness＂ may clearly express the ＂ sense of rotation＂ or ＂ the feeling of feeling drowsy, the top-heavy sense,＂ and the accompanying deafness, earfullness, tinnitus and so on. Among 82 cases, there were 15 cases of benign paroxysmal vertigo （ BPV, 18. 3% ）, 12 cases of secretory otitis media （ SOM, 14. 6% ）, 11 cases of vestibular migraine （VM, 13.4% ）, 9 cases of benign paroxysmal positional vertigo （BPPV, 11.0% ）, 8 cases of inner ear malformation （9.8%）, 8 cases of Meniere＇s disease （9.8%）, 7 cases of vestibular neuritis （8.5%） , 6 cases of sudden deafness with vertigo （7.3%） , 4 cases of central vertigo （4.9%） , 1 case of rare genetic disease （ 1.2% ） and 1 case of vertigo due to mental psychological （ 1.2% ）. The incidence of BPV, VM and Meniere＇s disease in girls was higher than that in boys. There was a tendency to self heal in BPV with the age increasing,in 15 BPV cases, 8 after 12 years of age, 3 after 14 years old had no vertigo attacks, and 4 cases were still in follow-up. The attack frequency of VM was decreased, and the extent was reduced with the age. Children older than 6 years were able to cooperate to vestibula

关 键 词：儿童 眩晕 病理状态 体征和症状 诊断 诊断 鉴别 

分 类 号：R764[医药卫生—耳鼻咽喉科]