快速轴位滚转试验对水平管良性阵发性位置性眩晕定位诊断的意义  

Significance of rapid axial roll test in determining the responsible semicircular canal for horizontal canal benign paroxysmal positional vertigo

作　　者：邢娟丽[1] 张婷[1] 张姝 程子君 张少强[1] 韩鹏 XING Juanli;ZHANG Ting;ZHANG Shu;CHENG Zijun;ZHANG Shaoqiang;HAN Peng(Department of Otorhinolaryngology Head and Neck Surgery,First Affiliated Hospital of Xi’an Jiaotong University School of Medicine,Xi'an,710048,China;Department of Otorhinolaryngology Head and Neck Surgery,First Affiliated Hospital of Inner Mongolia Medical University)

机构地区：[1]西安交通大学第一附属医院耳鼻咽喉头颈外科,西安710048 [2]内蒙古医科大学附属第一医院耳鼻咽喉头颈外科

出　　处：《临床耳鼻咽喉头颈外科杂志》2022年第6期419-422,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：西安交通大学第一附属医院院基金(No:2021ZYTS-25)。

摘　　要：目的:比较快速轴位滚转试验(RART)与传统滚转试验(SRT)对于水平半规管良性阵发性位置性眩晕(HC-BPPV)责任半规管定位的准确性。方法:收集2020年1—12月确诊为HC-BPPV的患者共400例,随机分为RART组(202例)和SRT组(198例)。RART法的诱发特点为仰卧正中位→右侧轴位→仰卧正中位→左侧轴位→仰卧正中位,完成全部序列头位转换为滚转试验的1个循环,记为1圈。两组患者分别采用相应的方法进行1次体位诱发试验,根据诱发出的眼震类型决定是否复位,其中诱发出典型HC-BPPV眼震者,进行2圈改良的Barbecure复位。通过典型眼震的引出率评价两种体位诱发试验对责任半规管判定的准确性。最后,通过比较两组患者复位后的眼震恢复情况评价两种方法对复位疗效的影响。结果:RART法对HC-BPPV患者眼震的引出率显著高于SRT法(χ^(2)=10.73,P<0.01)。HC-BPPV患者经RART法诱发后复位的有效性显著高于SRT法(χ^(2)=6.08,P<0.05)。结论:RART法可显著提高HC-BPPV责任半规管判定的准确性,值得临床深入研究。Objective:To compare the diagnostic performance of the rapid axial roll test(RART)and the traditional roll test(SRT)in determining the responsible semicircular canal for horizontal canal benign paroxysmal positional vertigo(HC-BPPV).Methods:A total of 400 patients diagnosed with HC-BPPV from January 2020 to December 2020 were collected and randomly divided into two groups.Among them,there were 202 cases in the RART group and 198 cases in the SRT group.The patients in the two groups performed corresponding positional test respectively,and the following treatment was based on the types of induced nystagmus.The patients with typical HC-BPPV nystagmus underwent two rounds of modified Barbecure procedure.The diagnostic accuracies of the two positional tests in locating the responsible semicircular canal were evaluated by the elicitation rate of typical nystagmus.Finally,the effects of the two tests were evaluated by comparing the recovery rate of nystagmus between the two groups after repositioning procedures.Results:The elicitation rate of nystagmus in HC-BPPV patients by RART was significantly higher than that by SRT(χ^(2)=10.73,P<0.01).The effectiveness of repositioning procedure by RART in HC-BPPV patients was significantly higher than that of SRT(χ^(2)=6.08,P<0.05).Conclusion:RART could significantly improve the accuracy in determining the responsible semicircular canal in HC-BPPV,and future studies are warranted.

关 键 词：良性阵发性位置性眩晕 快速轴位滚转试验 责任半规管 

分 类 号：R764.3[医药卫生—耳鼻咽喉科]