前庭功能联合听力学检查在眩晕疾病中的应用研究  

Application of Vestibular Function Combined with Audiological Examination in Vertigo Diseases

作　　者：胡珍[1] 刘梅 龚丽梅 王建洪[1] HU Zhen;LIU Mei;GONG Limei;WANG Jianhong(Department of Otolaryngology,Head and Neck Surgery,the First People's Hospital of Yibin,Yibin 644000,China)

机构地区：[1]四川省宜宾市第一人民医院耳鼻咽喉头颈外科,644000

出　　处：《中国全科医学》2024年第35期4435-4438,4445,共5页Chinese General Practice

基　　金：宜宾市科技局重点项目(2020SF001)。

摘　　要：背景前庭功能检查项目种类众多,各检查项目靶点及阳性率各有不同,临床上眩晕患者如何恰当合理选择检查项目有不同观点。目的探讨前庭功能联合听力学检查在外周眩晕疾病中的应用价值,为临床眩晕疾病的诊断及鉴别诊断提供参考依据。方法选择2021年1月—2022年1月以头晕或眩晕为主诉就诊于宜宾市第一人民医院眩晕门诊的患者。所有患者在起病7d内完成纯音测听(PTA)、温度试验、视频头脉冲试验(vHIT)、摇头试验(HST),比较不同眩晕疾病的前庭功能及听力学检查的异常率。结果符合纳入、排除标准且病例资料完整的眩晕患者共120例,其中突发性聋伴眩晕(SDV)组、良性阵发性位置性眩晕(BPPV)组、前庭性偏头痛(VM)组各40例。SDV组患者PTA均为感音神经性聋,温度试验异常25例(62.50%),vHIT异常16例(40.00%),HST异常28例(70.00%)。BPPV组患者PTA异常9例(22.50%),其中7耳为感音神经性聋,2耳为传导性聋;温度试验异常18例(45.00%),vHIT异常21例(52.50%),HST异常20例(50.00%)。VM组患者PTA异常21例(52.50%),均为感音神经性聋,其中26耳为高频听力轻中度下降,7耳为低频轻中度下降,温度试验异常16例(40.00%),vHIT异常17例(42.50%),HST异常27例(67.50%)。三组患者PTA检查异常率比较,差异有统计学意义(χ^(2)=50.26,P<0.001);三组患者温度试验、vHIT、HST异常率比较,差异无统计学意义(P>0.05)。结论前庭功能联合听力学检查有助于周围性眩晕的定位诊断及鉴别诊断。Background There are many types of vestibular function examination,each with different targets and positive rates.Clinical opinions vary on how to appropriately select examination methods for vertigo patients.Objective To explore the application value of vestibular function combined with audiological examination in peripheral vertigo diseases,and provide a reference basis for the diagnosis and differential diagnosis of clinical vertigo diseases.Methods Patients with dizziness or vertigo as the main complaint were selected from January 2021 to January 2022 in the Vertigo Clinic of the First People's Hospital of Yibin.All patients finished the examination within 7 days including pure tone audiometry(PTA),caloric test,video head impulse test(vHIT)and head-shaking test(HST).The vestibular function examination and audiological examination results were compared.Results A total of 120 patients with vertigo who met the inclusion and exclusion criteria had complete case data,there were 40 cases of sudden deafness with vertigo(SDV),benign paroxysmal positional vertigo(BPPV),and vestibular migraine(VM).The PTA in SDV patients was sensorineural deafness,25 cases with caloric test abnormalities(62.50%),16 cases with vHIT abnormalities(40.00%),28 cases with HST abnormalities(70.00%).Nine BPPV patients had PTA abnormalities(22.50%),including 7 ears with sensorineural deafness,2 ears with conduction deafness,18 cases with caloric test abnormalities(45.00%),21 cases with vHIT abnormalities(52.50%),and 20 cases with HST abnormalities(50.00%).There were 21 cases(52.50%)of PTA abnormalities in VM patients,all with sensorineural deafness,of which 26 ears had high-frequency hearing-light-moderate decline and 7 ears had low-frequency light-moderate decline.There were 16 cases with caloric test abnormalities(40.00%),17 cases with vHIT abnormalities(42.50%),and 27 cases with HST abnormalities(67.50%).The proportion of hearing abnormalities in the three groups was statistically significant difference(χ^(2)=50.26,P<0.001),and there were n

关 键 词：眩晕 前庭功能检查 听力学检查 鉴别诊断 

分 类 号：R441.2[医药卫生—诊断学] R255.3[医药卫生—临床医学]