初发性与复发性多半规管良性阵发性位置性眩晕临床特点及复位疗效比较  

Clinical features and treatment outcomes of initial and recurrent multiple canal benign paroxysmal positional vertigo

作　　者：陈哲[1,2] 王恩彤 单希征[1] 高云[1] 余滋中[2] 朱俊 李国义 Chen Zhe;Wang Entong;Shan Xizheng;Gao Yun;Yu Zizhong;Zhu Jun;Li Guoyi(Institute of Vertigo Diseases,General Hospital of Chinese People＇ s Armed Police Forces,Beijing 100039,China)

机构地区：[1]武警总医院眩晕病研究所,北京100039 [2]十堰市太和医院湖北医药学院附属医院耳鼻咽喉头颈外科

出　　处：《北京医学》2018年第8期738-741,共4页Beijing Medical Journal

摘　　要：目的比较初发性与复发性多半规管良性阵发性位置性眩晕(multiple canal benign paroxysmal positionalvertigo, MC-BPPV)的临床特点、疗效及预后。方法选取2014年1月至2016年8月在武警总医院眩晕病研究所诊断为MC-BPPV的住院患者96例,分为初发病例组和复发病例组,比较2组的临床特点和复位治疗效果及愈后复发率。结果初发病例43例(44.8%),复发病例53例(55.2%),初发和复发病例在性别、年龄及病程分布差异无统计学意义,通过相应的复位治疗均可得到治愈,所需复位次数分别为(3.3±2.2)次和(3.9±1.9)次,差异无统计学意义。随访显示,治愈后有22例(22.9%)BPPV复发,但均系累及单一半规管,且多为原有半规管之一。复发病例组的复发率(17/53, 32.1%)明显高于初发病例组(5/43, 11.6%)(P <0.05),前者12个月累积复发率(44.7%, 17/38)也明显高于后者(5/32, 15.6%)(P <0.05)。BPPV复发者可经复位治疗再次治愈。结论 MC-BPPV以复发病例多见,但和初发病例一样可得到有效的复位治疗;而愈后复发病例组的复发率较高,也仍可得到成功的复位治疗。Objective To evaluate the clinical features, treatment outcomes and prognoses of initial and recurrent multiple canal benign paroxysmal positional vertigo （MC-BPPV）. Methods A retrospective study of cases with initial or recurrent MC-BPPV who were diagnosed and treated at the Vertigo Unit, the General Hospital of Chinese People＇ s Armed Police Forces between January 2014 and August 2016. All patients were regularly followed-up at 1, 3, 6, and 12 months after successful repositioning treatments. The clinical characteristics, repositioning treatment outcomes and recur- rent rates of initial or recurrent MC-BPPV were evaluated. Results Initial and recurrent MC-BPPV account for 43 cases （44.8%） and 53 cases （55.2%）, with no difference in age, sex or duration of disease between patients with initial and recur- rent MC-BPPV. Both initial and recurrent MC-BPPV were cured with repositioning treatment, respectively with （3.3±2.2） sessions and （3.9±1.9） sessions, showing no statistically difference between them. Follows-up showed BPPV recurrence existed in 22 cases （22.9%）, and recurrent rate （17/53, 32.1%） of recurrent MC-BPPV was higher than that of initial MC- BPPV （5/43, 11.6%; P 〈 0.05）. Cumulative recurrent rates for 12 months after successful repositioning treatment were re- spectively 44.7% （17/38） for recurrent MC-BPPV and 15.6% （5/32） for initial MC-BPPV （P 〈 0.05）. The cases of recur- rent BPPV were still cured by repositioning maneuvers. Conclusion Most MC-BPPV are recurrent cases. Both initial and recurrent MC-BPPV may be successfully treated with repositioning maneuvers, but with a high recurrent rate of BP- PV, especially in originally recurrent MC-BPPV. Successful repositioning treatment can be obtained again in these cases.

关 键 词：多半规管良性阵发性位置性眩晕 耳石复位治疗 复发 

分 类 号：R764[医药卫生—耳鼻咽喉科]