单侧前庭功能低下患者前庭康复治疗前后前庭自旋转试验的动态变化  

Dynamic changes of vestibular autorotation test in patients with unilateral vestibular dysfunction during rehabilitation

作　　者：刘丹[1] 郭兆琪 田娥 王军[1] 陈镜羽 孔维佳[1] 张甦琳 Liu Dan;Guo Zhaoqi;Tian E;Wang Jun;Chen Jingyu;Kong Weijia;Zhang Sulin(Department of Otorhinolaryngology,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China)

机构地区：[1]华中科技大学同济医学院附属协和医院耳鼻咽喉科,武汉430022

出　　处：《中华耳鼻咽喉头颈外科杂志》2022年第3期270-275,共6页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：“十二五”国家科技支撑计划(2012BAI12B02);国家自然科学基金面上项目(81873701,82171152)。

摘　　要：目的:观察前庭自旋转试验(vestibular autorotation test,VAT)在单侧前庭功能低下(unilateral vestibular hypo function,UVH)患者前庭康复治疗前后的动态变化。方法:回顾性研究2019年1月至2021年1月就诊于华中科技大学同济医学院附属协和医院耳鼻咽喉科、诊断为UVH且行前庭康复治疗的48例患者。其中男21例,女27例;平均年龄46.9岁;梅尼埃病25例,突发性聋伴眩晕13例、前庭神经炎10例;病程5 d~10年。全部患者均进行4~6周个体化前庭外周康复训练(包括前庭眼反射训练和前庭脊髓反射训练)。所有患者均采集详细病史及相关检查资料,收集康复治疗前后VAT不同频率的增益、相移及非对称性等参数,采用SPSS 23.0统计软件分别对康复前后2.0~5.9 Hz实测值与标准值差值的绝对值进行分析比较。结果:UVH患者在前庭康复治疗前,VAT增益异常发生率为62.5%(30/48),相移异常发生率为56.3%(27/48),非对称性发生率为16.7%(8/48);康复治疗4~6周后,增益异常发生率为22.9%(11/48),相移异常发生率为31.3%(15/48),非对称性发生率为12.5%(6/48);与康复前相比,康复后增益和相移异常发生率明显下降,差异有统计学意义(P值均<0.05)。VAT水平增益在2.0~3.9 Hz显示康复前后差异具有统计学意义(P值均<0.05),在4.3~5.9 Hz显示康复治疗前后差异无统计学意义(P值均>0.05);水平相移在5.9 Hz显示康复前后差异有统计学意义(P=0.043),在2.0~5.5 Hz显示康复治疗前后差异无统计学意义(P值均>0.05);VAT垂直增益在4.3 Hz显示康复前后差异有统计学意义(P=0.020),余频率康复前后差异均无统计学意义(P值均>0.05);康复治疗前后的VAT垂直相移和非对称性在各个频率差异均无统计学意义(P值均>0.05)。结论:VAT可用于监测UVH患者前庭康复治疗前后多频率段的变化趋势,以期为个性化康复策略的制定提供参考。Objective To explore the dynamic changes of vestibular autorotation test(VAT)before and after vestibular rehabilitation treatment in patients with unilateral vestibular hypofunction(UVH).Methods A retrospective study was carried out,48 patients who were diagnosed with UVH and under vestibular rehabilitation in department of otorhinolaryngology,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,from January 2019 to January 2021 were enrolled.Among them,there were 21 males and 27 females,with an average age of 46.9 years old,including 25 cases of Meniere′s disease,13 cases of sudden deafness with vertigo and 10 cases of vestibular neuritis.The course of disease ranged from 5 days to 10 years.Demographic characteristics,detailed case data and routine examination were collected for the patients.The horizontal gain/phase,vertical gain/phase,and asymmetry of VAT at different frequencies before and after vestibular rehabilitation were collected.The absolute value of the difference between the measured value of 2.0-5.9 Hz before and after rehabilitation and the standard value were statistically analyzed.Results Before vestibular rehabilitation,the incidence of abnormal gain was 62.5%(30/48),the incidence of abnormal phase was 56.3%(27/48),and the incidence of asymmetry was 16.7%(8/48).After 4-6 weeks of vestibular rehabilitation,the incidence of gain abnormality was 22.9%(11/48),the incidence of phase abnormality was 31.3%(15/48),and the incidence of asymmetry was 12.5%(6/48).The horizontal gain at frequency of 2.0-3.9 Hz showed statistically significant difference compared with before vestibular rehabilitation(P<0.05),and the horizontal gain at frequency of 4.3-5.9 Hz showed that there was no significant difference(P>0.05);the horizontal phase at 5.9 Hz showed that the difference was statistically significant(P=0.043),and there was no significant difference before and after rehabilitation treatment at 2.0-5.5 Hz(P>0.05);the vertical gain at 4.3 Hz showed the difference was statisticall

关 键 词：前庭功能低下 前庭自旋转试验 前庭康复 

分 类 号：R764[医药卫生—耳鼻咽喉科] R493[医药卫生—临床医学]