按眼震特点选择手法复位治疗水平半规管良性阵发性位置性眩晕疗效观察  

Observation the Effect of Repositioning Maneuvers Based on Characteristic of Nystagmus for the Treatment of Horizontal Semicircular Canal Benign Paroxysmal Positional Vertigo

作　　者：田从哲[1] 刘佳 陈向红[1] 李进让[3] Tian Congzhe;Liu Jia;Chen Xianghong;Li Jinrang(Department of Otolaryngology,Affiliated Hospital of Hebei University, Baoding,071000,China)

机构地区：[1]河北大学附属医院,保定071000 [2]河北大学医学院 [3]海军总医院全军耳鼻咽喉头颈外科中心

出　　处：《听力学及言语疾病杂志》2018年第5期480-483,共4页Journal of Audiology and Speech Pathology

摘　　要：目的分析水平半规管良性阵发性位置性眩晕(HC-BPPV)患者的眼震特点,并观察根据眼震特点选择手法复位治疗的疗效。方法根据红外线视频眼震电图仪(Chartr 200Type1068,丹麦尔听美公司)记录的56例HC-BPPV患者变位试验诱发的眼震特点进行定侧和分型,其中水平向地性眼震患者38例,有28例接受Barbecue翻滚法治疗,10例不适于翻滚或体位维持困难者接受Gufoni法治疗;水平背地性眼震18例,采用Appiani法复位后转变为水平向地性眼震13例,再按Barbecue翻滚法治疗或Gufoni法进行复位,方向不能转换者5例,按李氏复位法进行复位;每种方法循环复位2次。观察治疗效果。结果 1周后,治愈33例(58.93%,33/56),有效16例(28.57%,16/56),无效7例(12.50%,7/56),总有效率为87.50%(49/56);3个月后治愈42例(75.0%,42/56),有效8例(14.29%,8/56),无效2例(3.57%,2/56),复发4例(7.14%,4/56),总有效率为89.29%(50/56)。结论根据变位试验诱发的眼震特点选择不同的手法复位治疗HC-BPPV,可取得满意的疗效。Objective To analysis the characteristic of nystagmus of horizontal semicircular canal benign paroxysmal positional vertigo and the effect of repositioning maneuvers.Methods The positioning nystagmic features of 56 patients with HC-BPPV were recorded and analyzed with videonystagmography.Geotropic nystagmus was recorded in 38 cases,of whom 28 cases were treated with Barbecue maneuver,while the others were treated with Gufoni maneuver.Apogeotropicn ystagmus was recorded in 18 cases,of whom 13 cases could turn into geotropic nystagmus with Appiani maneuver,the other 5 cases who could not transform acceptted Li's repositioning maneuver.Results After 1 week,33 cases were cured(58.93%,33/56),16 cases were effective(28.57%,16/56),7 cases were invalid(12.50%,7/56).The total effective rate was 87.50%(49/56).After 3 months,42 cases were cured(75.0%,42/56),8 cases were effective(14.29%,8/56),2 cases were invalid(3.57%,2/56),4 cases relapsed(7.14%,4/56).The total effective rate was 89.29%(50/56).Conclusion It is necessary to apply the appropriate repositioning maneuvers to treat HSC-BPPV according to the nystagmic characteristic and type of HSC-BPPV.Satisfactory curative effect can be obtained.

关 键 词：水平半规管 良性阵发性位置性眩晕 眼震 手法复位 

分 类 号：R764.3[医药卫生—耳鼻咽喉科]