倍他司汀联合利多卡因对良性阵发性位置性眩晕患者管石复位治疗成功后残余头晕的疗效  

Effect of Betahistine combined with Lidocaine on residual dizziness in patients with benign paroxysmal positional vertigo after successful canalith repositioning

作　　者：刘大为 夏菲[2] 任媛媛[2] LIU Da-wei;XIA Fei;REN Yuan-yuan(Department of Otolaryngology,Beijing Huairou Hospital,Chinese Academy of Sciences,Beijing 101400,China;Department of Otolaryngology and Head and Neck Surgery,Beijing Chaoyang Hospital Affiliated to Capital Medical University,Beijing 101400,China)

机构地区：[1]中国科学院大学附属北京怀柔医院耳鼻喉科,北京101400 [2]首都医科大学附属北京朝阳医院耳鼻咽喉头颈外科,北京101400

出　　处：《临床和实验医学杂志》2020年第13期1390-1394,共5页Journal of Clinical and Experimental Medicine

基　　金：中国高校医学期刊临床专项资金项目(编号:NO11221409)。

摘　　要：目的探究倍他司汀联合利多卡因对良性阵发性位置性眩晕(BPPV)患者管石复位(CRP)治疗成功后残余头晕的疗效。方法采用前瞻性研究方法,选取2017年5月至2019年6月中国科学院大学附属北京怀柔医院收治的BPPV经CRP治疗成功后残余头晕患者86例,按照随机数字表法将患者分为两组:对照组和研究组,每组各43例。对照组患者给予倍他司汀治疗,研究组患者给予倍他司汀联合利多卡因治疗。比较两组患者的残余头晕持续时间、治疗前后头晕症状(DHI)、跌倒恐惧心理(ABC)、前庭诱发肌源性动作电位(VEMP)异常率、皮肤交感反应(SSR)、血液流变学指标及BPPV复发情况。结果研究组患者的残余头晕持续时间(10.12±3.58 d)短于对照组(14.97±4.72 d),差异具有统计学意义(P<0.05);治疗1、2周后,研究组患者的DHI评分(25.38±3.36分,8.87±2.46分)低于对照组(30.19±3.85分,16.91±2.93分),ABC评分(59.39±8.24分,88.64±10.25分)高于对照组(52.47±8.51分,80.59±9.66分),差异均具有统计学意义(P<0.05);研究组患者治疗1、2周后的眼性VEMP异常率(16.27%、6.98%)、颈性VEMP异常率(4.65%、2.33%)低于对照组眼性VEMP异常率(37.21%、25.58%)、颈性VEMP异常率(18.60%、18.60%),差异均具有统计学意义(P<0.05);治疗1、2周后,研究组患者的SSR潜伏期(1.80±0.23 ms,1.84±0.26ms)高于对照组(1.69±0.21 ms,1.73±0.24 ms),SSR波幅(1.53±0.32 m V,1.50±0.29 m V)低于对照组(1.74±0.30m V,1.71±0.31 m V),差异均具有统计学意义(P<0.05);治疗2周后,研究组患者的血浆黏度(1.18±0.19 m Pa·s)、全血高切黏度(4.26±0.35 m Pa·s)、纤维蛋白原(2.76±0.16 g/L)水平低于对照组血浆黏度(1.32±0.17 m Pa·s)、全血高切黏度(4.73±0.38 m Pa·s)、纤维蛋白原(3.15±0.19 g/L),差异均具有统计学意义(P<0.05);研究组患者治疗后3个月、6个月的BPPV复发率(0.00%、2.38%)与对照组(5.00%、10.00%)比较,差异无统计学意义(P>0.05)。结论采用倍Objective To explore the effect of betahistine combined with lidocaine on residual dizziness after successful canalith repositioning(CRP)treatment in patients with benign paroxysmal positional vertigo(BPPV).Methods A prospective study method was performed,86 patients with residual dizziness after CRP treatment of BPPV treated in Beijing Huairou Hospital,Chinese Academy of Sciences,from May 2017 to June 2019 were selected divided into two groups according to the random number table method:control group and study group,with 43 cases in each group.The control group was treated with Betahistine,and the study group was treated with Betahistine combined with Lidocaine.The duration of residual dizziness,dizziness symptoms(DHI),fear of falling(ABC),abnormal rate of vestibular evoked myogenic action potential(VEMP),skin sympathetic response(SSR),hemorheology,and BPPV recurrence before and after treatment were compared between the two groups.Results The duration of residual dizziness(10.12±3.58 d)in the study group was shorter than that in the control group(14.97±4.72 d),and the difference was statistically significant(P<0.05).After 1 and 2 weeks of treatment,the DHI score of the patients in the study group(25.38±3.36 points,8.87±2.46 points)was lower than that of the control group(30.19±3.85 points,16.91±2.93 points),and the ABC score(59.39±8.24 points,88.64±10.25 points)was higher than that of the control group(52.47±8.51 points,80.59±9.66 points).,and the differences were statistically significant(P<0.05).The ocular VEMP abnormal rate(16.27%,6.98%)and cervical VEMP abnormal rate(4.65%,2.33%)in the study group were lower than the ocular VEMP abnormal rate(37.21%,25.58%)and cervical VEMP abnormal rate(18.60%,18.60%)in the control group after 1 and 2 weeks of treatment,and the differences were statistically significant(P<0.05).After 1 and 2 weeks of treatment,the SSR latency(1.80±0.23 ms,1.84±0.26 ms)of the study group was higher than that of the control group(1.69±0.21 ms,1.73±0.24 ms),the SSR amplitude(1.53

关 键 词：良性阵发性位置性眩晕 管石复位 残余头晕 倍他司汀 利多卡因 皮肤交感反应 血液流变学 

分 类 号：R764.3[医药卫生—耳鼻咽喉科]