改良体位限制对首诊未痊愈水平半规管管石症疗效及生活质量的影响  

Outcomes and Quality of Life after Combined Canalith Repositioning and Modified Position Restriction in Patients with Horizontal Semicircular Canal Otolith Disorders Who Failed Initial Treatment

作　　者：王志斌 张金翠 陶祥明 吴子明[2] WANG Zhibin;ZHANG Jincui;TAO Xiangming;WU Ziming(The Vertigo Center,Bengbu Third People's Hospital Affiliated to Bengbu Medical College,Bengbu,Anhui 233000,China;Department of Otorhinolaryngology,Head and Neck Surgery and Vertigo Center,Chinese PLA General Hospital,Beijing 100853)

机构地区：[1]蚌埠医学院附属蚌埠第三人民医院眩晕中心,蚌埠233000 [2]解放军总医院耳鼻咽喉头颈外科眩晕诊疗中心,北京100853

出　　处：《中华耳科学杂志》2022年第3期417-421,共5页Chinese Journal of Otology

基　　金：蚌埠医学院自然科学基金重点资助项目(BYKY18166,2021byzd223);安徽省卫健委技术推广项目(SYJS202005);蚌埠市科技计划项目(20160325)。

摘　　要：目的观察联合改良体位限制(modified position restriction,MPR)治疗首诊手法复位未痊愈水平半规管良性阵发性位置性眩晕(HC-BPPV)管石症患者的疗效和生活质量。方法80例首诊耳石复位治疗(canalith-repo‐sitioning procedure,CRP)未痊愈HC-BPPV管石症患者,将CRP单独治疗的患者分为CRP组,CRP联合MPR治疗的患者分为CRP+MPR组。随访观察2组患者眼震消失时间,DHI、VAS评分及残余头晕时间。结果CRP+MPR组复位后Roll test达到眼震阴性结果平均时间为3.24±1.56天,较CRP组4.07±1.37天短(t=2.45,P=0.017),CRP+MPR组治疗过程中总体舒适度VAS评分及DHI评分分别为4.07±1.37和14.79±6.62,低于CRP组4.92±1.38和18.44±6.77,结果有统计学意义(t=2.45,t=2.36,P<0.05);CRP+MPR组治疗后残余头晕持续平均10.98±4.21天,与CRP组11.51±5.15天相比,结果无统计学意义(P>0.05)。结论联合MPR可缩短首诊未痊愈HC-BPPV管石症患者的疗程,提高患者总体舒适度。Objective To report outcomes and quality of life following combined canalith repositioning and modified position restriction(MPR)in patients with horizontal semicircular canal benign paroxysmal positional vertigo(HCBPPV)after failing initial manipulative reduction.Methods A total of 80 patients with HC-BPPV who had failed initial manipulative reduction therapy were randomly divided into a canalith repositioning procedure(CRP)group and a CRP+MPR group.Time to disappearance of nystagmus,DHI score,VAS scores and duration of residual dizziness were assessed.Results The average time to negative Roll test(RT)after canalith-repositioning was 3.24±1.56 days in the CRP+MPR group,significantly less than in the CRP alone group(4.07±1.37 days).The overall VAS and DHI scores were 4.07±1.37 and 14.79±6.62 in the CRP+MPR group,respectively,also less than those in the CRP group(4.92±1.38 and 18.44±6.77,respectively,P<0.05).The average duration of residual dizziness in CRP+MPR group10.98±4.21 days)was not significantly different from that in the CRP group(11.51±5.15 days,P>0.05).Conclusion Combined CRP and MPR can shorten the course of treatment and improve overall comfort in patients with HC-BPPV.

关 键 词：良性阵发性位置性眩晕 生活质量 眩晕残障量表 视觉模拟量表 体位限制 

分 类 号：R764[医药卫生—耳鼻咽喉科]