改良体位限制治疗首诊未痊愈水平半规管管石症疗效初探  

Effects of Modified Position Restriction on Treatment of Unhealed Semicircular Canal Stone Diseases

作　　者：王志斌 张金翠 吴子明[2] WANG Zhibin;ZHANG Jincui;WU Ziming(Department of Otorhinolaryngology,Third People’s Hospital of Bengbu affiliated to Bengbu Medical College,Bengbu,Anhui 233000,China;Department of Otolaryngology Head and Surgery,Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]蚌埠医学院附属蚌埠市第三人民医院耳鼻喉科,蚌埠233000 [2]解放军总医院耳鼻咽喉头颈外科眩晕诊疗中心,北京100853

出　　处：《中华耳科学杂志》2018年第3期290-295,共6页Chinese Journal of Otology

基　　金：蚌埠市卫计委技术推广项目(2018-TGXM04);蚌埠市科技计划项目(20140322;20160325)~~

摘　　要：目的观察改良体位限制联合Barbecue复位法治疗首诊手法复位未痊愈水平半规管良性阵发性位置性眩晕(HC-BPPV)管石症的疗效。方法选取70例首诊2~3次手法复位治疗未痊愈HC-BPPV管石症患者,按门诊就诊卡单双号随机分成2组,A组为Barbecue复位法+改良体位限制治疗组,嘱患者睡眠时双枕(头与床面有30°角)平卧和健侧卧位交替。B组为单纯Barbecue治疗组,3天及1周后门诊复查,观察2组疗效,并记录治疗后的伴随症状。结果 A组3天及1周的有效率分别为90.91%和96.97%,伴随症状分别为19例和9例;B组3天及1周的有效率分别为71.88%和93.75%,伴随症状分别为21例和11例。2组3天治疗的效果差异有统计学意义(P<0.05),2组1周的治疗效果及伴随症状结果差异无统计学意义(P>0.05)。结论改良体位限制是一种治疗首诊未痊愈HC-BPPV管石症的有效方法,收效快,疗效可靠,可作为首诊未痊愈的HC-BPPV管石症手法复位治疗的补充治疗,患者眩晕症状消失可正常体位睡眠。Objective To report effects of modified position restriction on horizontal semicircular canal benign paroxysmal positional vertigo （HSC-BPPV） in which initial manipulative reduction therapies have failed. Methods A to-tal of 70 patients with HSC-BPPV were randomly divided into 2 groups to receive Barbecue manipulative reduction combined with modified sleep position restriction （Group A）, or simple Barbecue manipulative reduction （Group B）. Short-term therapeutic effects were examined at 3 days and 1 week. Results The rate of improvement at 3 days and 1 week was 90.91%and 96.97%for group A （with residual symptoms seen in 19 and 9 cases, respectively）, and 71.88%and 93.75%for group B （with residual symptoms seen in 21 and 11 cases, respectively）. The difference between the 2 groups was significant at 3 days （P＜0.05）, although not at 1 week （P＞0.05）. Conclusion Modified position restriction is effective in treating HSC-BPPV that has failed initial therapies and can be easily adopted as a supplement to regular therapies with rapid resolution of symptoms, which enables resumption of normal sleep positions.

关 键 词：良性阵发性位置性眩晕 Barbecue复位法 水平半规管 管石症 体位限制 

分 类 号：R764[医药卫生—耳鼻咽喉科]