体位限制对后半规管良性阵发性位置性眩晕的疗效及复发率的影响  

Investigating the Effect of Postural Restrictions on the Symptom Improvement and Recurrence Rate in Patients with Posterior Semicircular Canal Benign Paroxysmal Positional Vertigo

作　　者：蒋敏[1] 罗伦[1] JIANG Min;LUO Lun

机构地区：[1]四川省成都市第二人民医院康复科,成都610001

出　　处：《中国听力语言康复科学杂志》2021年第4期248-251,共4页Chinese Scientific Journal of Hearing and Speech Rehabilitation

基　　金：四川省医学科研青年创新课题(Q18016)。

摘　　要：目的探讨体位限制对后半规管良性阵发性位置性眩晕的疗效及复发率的影响。方法选取我院康复科2015年4月~2018年3月后半规管良性阵发性位置性眩晕患者52例,根据患者入院先后顺序,随机分为实验组与对照组,每组各26例。实验组予以常规康复治疗加Epley法复位治疗后增加体位限制;对照组予以常规康复治疗加Epley法复位治疗。治疗1周、2周、1个月后(出院患者采用门诊复查和电话回访)对患者治疗效果分别采用眩晕症状和眼震情况进行评定。对出院后患者复发率进行跟踪随访,随访时间1年。结果治疗1周、2周、1个月后两组均有较好的康复效果,实验组与对照组有效率无明显差异(P>0.05),其中实验组26例患者中3例出现颈肩部不适症状,5例出现不同程度的入睡困难,对照组无患者出现颈椎不适和入睡困难现象。出院后1年内对照组无1例复发,实验组有1例复发,复发率3.8%。结论变换体位可能会提高后半规管良性阵发性位置性眩晕复位成功率,但体位限制对后半规管良性阵发性位置性眩晕复位后的疗效和复发率影响不明显,且有增加颈椎不适及影响睡眠质量的风险,建议Epley法手法复位治疗后不限制体位。Objective To investigate the effect of postural restrictions on the symptom improvement and recurrence rate in patients with posterior semicircular canal benign paroxysmal positional vertigo(PC-BPPV).Methods Fifty-two patients were recruited in the rehabilitation department of a hospital from April,2015 to March,2018 and were randomly allocated to the experimental group and the control group according to the admission order with 26 participants in each group.Subjects in the control group were treated with routine rehabilitation therapy and the Epley method,while subjects in the experimental group were treated with postural restrictions after routine rehabilitation therapy and the Epley therapy.The vertigo symptoms and Nystagmus assessed one week,two weeks and one months after treatment was recorded.Follow-up was conducted 1 year after discharge to assess the recurrence rate of patients.Results The improvement rate of the two groups was good at 1 week,2 weeks,and 1 month assessment and no significant difference was found between the two groups(P>0.05).Recurrence was not observed in the control group but was found in 1 case in the experimental group in 1 year after discharge with a recurrence rate of 3.8%.Conclusion Changing the body position may increase the success rate of PC-BPPV but the effect of postural restrictions is not significant.Moreover,there is an increased risk of cervical discomfort and sleep quality impairment for postural restrictions.It is recommended to apply Epley method of manual reduction without position restrictions.

关 键 词：后半规管良性阵发性位置性眩晕 EPLEY法 体位限制 复发率 

分 类 号：R764.3[医药卫生—耳鼻咽喉科]