突发性聋伴良性阵发性位置性眩晕的临床分析  

Clinical characteristics of sudden hearing loss with benign paroxysmal positional vertigo

作　　者：魏秀娟[1] 张莉[1] Wei Xiujuan;Zhang Li(Department of Otolaryngology,Affiliated Hospital of Inner Mongolia Medical University＇,Hohhot 010050,China)

机构地区：[1]内蒙古医科大学附属医院耳鼻喉科,呼和浩特010050

出　　处：《北京医学》2018年第8期754-756,760,共4页Beijing Medical Journal

摘　　要：目的分析突发性聋(突聋)伴良性阵发性位置性眩晕(benign paroxysmal positional vertigo, BPPV)的临床特点及诊疗效果。方法收集2015年2月至2018年2月内蒙古医科大学附属医院诊治的突聋伴眩晕患者169例,根据患者是否伴有BPPV分为突聋伴BPPV组(63例)和突聋伴眩晕组(106例),比较2组的临床特点及诊疗效果。结果伴BPPV组63例(37.3%),男29例,女34例,平均年龄45.7岁;不伴BPPV组106例(62.7%),男58例,女48例,平均年龄49.8岁,2组性别、年龄分布差异无统计学意义。BPPV于突聋发病2周内发生,平均间隔6.7 d,均与突聋同侧发病,累及水平半规管27例(42.8%),后半规管19例(30.2%),前半规管11例(17.5%)和多半规管6例(9.5%)。伴BP-PV组冷热试验半规管轻瘫异常率明显高于伴眩晕组(74.6%vs. 51.9%,P <0.01),听力曲线类型全聋型比例显著高于伴眩晕组(90.5%vs. 54.7%,P <0.01),治疗后听力改善总有效率低于伴眩晕组(47.6%vs. 64.2%,P <0.05)。BPPV经复位治疗均获治愈,其中经1～2次治疗即获治愈者占77.8%。愈后3个月随访BPPV复发率为27%,但仍可获得有效复位治疗。结论突聋伴BPPV临床常见,多见于全聋型突聋患者,听力改善效果降低;BPPV多累及水平半规管,多可获得较好的复位治疗效果,治愈后复发率偏高,但复发者仍可得到有效的复位治疗。Objective To evaluate the clinical characteristics and treatment outcomes of sudden hearing loss （SHL） with benign paroxysmal positional vertigo （BPPV）. Methods A total of 169 patients suffered from SHL with vertigo, in- cluding with and without BPPV, diagnosed and treated between February 2015 and February 2018 was included, and their clinical characteristics and treatment outcomes were evaluated. Results The 169 patients included 63 cases （37.3%） of SHL with BPPV, of them 29 males and 34 females, with a mean age of 45.7 years, and 106 cases （62.7%） of SHL without BPPV, of them 58 males and 48 females, with a mean age of 49.8 years. There were no significant differences in age and gender between two groups （P 〉 0.05）. BPPV occurred within 2 weeks after SHL, with an average interval of 6.7 days and both BPPV and SHL existed on the same side. BPPV involved mostly horizontal canal （42.8%）, followed by posterior ca- nal （32.2%）, anterior canal （17.5%）, or multiple canals （9.5%）. Caloric test showed abnormal canal paralysis in 74.6% of patients with BPPV, while in 51.9% of patients without BPPV （P 〈 0.01）. According to hearing curves, complete hearing loss accounted for 90.5% of patients with SHL and BPPV and 54.7% of patients only with SHL, with a significant differ- ence （P 〈 0.01）. The rate of improved hearing in patients with BPPV was lower than that in patients without BPPV （47.6% vs. 64.2%, P 〈 0.05）. All patients had their BPPV cured, and 77.8% of them showed resolution of BPPV after 1 or 2 repo- sitioning maneuvers. With foUowing-up for 3 months, a recurrent rate of 27% was showed, and the recurrent cases were treated successfully again by repositioning maneuvers. Conclusion BPPV occurs commonly in patients with SHL, espe- cially with severe hearing loss, and commonly shows a poor hearing improvement. BPPV often involves horizontal canal, with a high percentage for abnormal caloric test, and successful repositioning maneuvers can be obtained. Recurrent B

关 键 词：突聋 良性阵发性位置性眩晕 临床特点 预后 

分 类 号：R764[医药卫生—耳鼻咽喉科]