前半规管良性阵发性位置性眩晕患者的诊断和治疗分析  

Diagnosis and Treatment of Anterior Canal Benign Paroxysmal Positional Vertigo

作　　者：高金颖[1] 马瑞[1] GAO Jin-ying;MA Rui(Aerospace Center Hospital,Peking University Aerospace School of Clinical Medicine,Beijing 100049,China)

机构地区：[1]航天中心医院(北京大学航天临床医学院),北京100049

出　　处：《神经损伤与功能重建》2020年第4期207-209,共3页Neural Injury and Functional Reconstruction

摘　　要：目的:探讨前半规管良性阵发性位置性眩晕(anterior canal benign paroxysmal positional vertigo,AC-BPPV)患者的眼震和管型受累特征。方法:回顾性收集AC-BPPV患者20例的临床资料,在眼震视图下行Dix-Hallpike试验,根据其眼震特征对其诊断,并采用Yacovino法对其进行手法复位治疗。结果:①本组20例患者中,左侧前半规管受累10例(50.0%),右侧前半规管受累5例(25.0%),侧别不能明确判定者5例(25.0%)。②眼震特征:Dix-Hallpike试验:单侧下跳性眼震11例(55.0%),单侧下跳伴扭转性眼震1例(5.0%),双侧下跳性眼震5例(25.0%),一侧下跳、另一侧下跳伴扭转性眼震2例(10.0%),双侧扭转伴下跳性眼震1例(5.0%)。坐起时出现眼震逆转5例(25.0%)。③Yacovino手法复位:首次手法复位治愈12例(60.0%),有效7例(35.0%),无效1例(5.0%)。1周后复查痊愈15例(75.0%),有效4例(20.0%),无效1例(5.0%)。结论:AC-BPPV患者在Dix-Hallpike试验中诱发出的眼震多样,单侧多见。多数为下跳眼震不伴有扭转成分,部分患者双侧Dix-Hallpike试验均能诱发出眼震;Yacovino法手法复位治疗常常效果较好。Objective:To investigate the nystagmus and affected canal features of anterior canal benign paroxysmal positional vertigo(AC-BPPV).Methods:A retrospective analysis was performed on 20 patients with AC-BPPV.All patients were diagnosed based on the presence of nystagmus during the Dix-Hallpike and were treated by Yacovino maneuver.Results:Among the 20 AC-BPPV patients admitted,left anterior semicircular canal was involved in 10(50.0%)patients,right anterior semicircular canal was involved in 5(25.0%)patients,and 5(25.0%)patients were unclear about the involved semicircular canal.In the Dix-Hallpike test,unilateral down-beating nystagmus(DBN)was observed in 11 patients(55.0%),unilateral DBN with torsional components was observed in 1 patient(5.0%),DBN was observed in 5 patients(25.0%),DBN in one side and DBN with torsional components in the other side was observed in 2 patients(10.0%),and bilateral DBN with torsional components was observed in 1 patient(5.0%).Reversal nystagmus was observed among 5 patients after returning to sitting up position(25.0%).12 patients(60.0%)and 15 patients(75.0%)were cured by Yacovino maneuver after the first time treatment and one week follow-up,respectively.7 patients(35.0%)and 4 patients(20.0%)were effectively treated by Yacovino maneuver after the first time treatment and one week follow-up,respectively.And the Yacovino maneuver was ineffective in 1 patient(5.0%)after the first time treatment and one week follow-up.Conclusion:Most of the patients with AC-BPPV showed no occurrence of the torsional component in the DBN nystagmus induced by the Dix-Hallpike test.In some patients,nystagmus could be induced by bilateral Dix-Hallpike test.The effect of Yacovino maneuver is often effective.

关 键 词：前半规管 良性阵发性位置性眩晕 眼震 Yacovino法 

分 类 号：R741[医药卫生—神经病学与精神病学] R741.02[医药卫生—临床医学]