体位限制预防BPPV复发的随机对照临床研究  

Efficacy of postural restriction in preventing recurrence of Benign Paroxysmal Positional Vertigo:a randomized controlled clinical study

作　　者：刘明勇[1] 周立春[1] LIU Mingyong;ZHOU Lichun(Department of Neurology(west campus),Capital Medical Uiniversity,Beijing 100043,China)

机构地区：[1]首都医科大学附属北京朝阳医院西院神经内科,北京100043

出　　处：《中风与神经疾病杂志》2021年第1期54-56,共3页Journal of Apoplexy and Nervous Diseases

摘　　要：目的评价体位限制预防良性阵发性位置性眩晕(BPPV)近期复发的疗效。方法将2018年3月至2019年2月在朝阳医院西区神经内科门诊就诊的217例单侧后半规管BPPV患者随机分为观察组和对照组。记录两组患者的一般资料,如年龄、性别、发病时间、伴随疾病及是否给予甲磺酸倍他司汀治疗。观察组Epley手法复位后采用床头抬高45度来限制患者体位,患者可以在45度斜坡上自由侧卧或仰卧,72 h内如果卧床即采用上述体位(不限制患者下床活动)。对照组Epley手法复位后不限制患者体位。手法复位72 h后门诊随访患者BPPV复发情况,患者体位变动后出现典型的眩晕或者体位试验时发现眼震定义为BPPV复发。结果观察组104例,对照组113例,两组的基线资料无明显差异,两组有可比性,无失访病例。Epley手法复位72 h后观察组BPPV的复发率是21.2%,对照组是41.6%,两组有显著的统计学差异,P<0.01,限制体位对于BPPV复发的OR值为0.377(95%CI 0.207~0.687)。结论BPPV Epley手法复位后,患者在卧床时45度头高位保持72 h有助于避免BPPV早期复发。Objective To evaluate the effect of postural restriction in preventing recurrence of Benign Paroxysmal Positional Vertigo(BPPV).Methods A total of 217 unilateral posterior semicircular canal BPPV patients were diagnosed clearly and divided into two groups randomly:104 caes(observation group)were demand postural restriction(head up 45 degrees for 72 hours,but did not restricted sleeping posture or departure from bed)after Epley maneuver,while 114 case(control group)could freely sleep.Demographic data,concomitant diseases and betahistine mesylate treatment were recorded.All patients were follow-uped at 72 hours after the Epley maneuver at outpatients of our hospital.A induced vertigo by position change or positional nystagmus were defined as recurrence of BPPV.Results There was no statics defferrence between two groups for base line data.After 72 hours of Epley maneuver,BPPV recurrence rates was 21.2%and 41.6%for observation group and control group,respectively(P<0.01).Odds ratio of postural restriction for BPPV recurrence was 0.377(95%CI 0.207~0.687).Conclusion Head up 45 degrees for 72 hours after Epley maneuver was helpful for preventing BPPV early recurrence.

关 键 词：良性阵发性位置性眩晕 BPPV Epley复位 体位限制 

分 类 号：R764[医药卫生—耳鼻咽喉科]