前庭康复训练联合改良Barbecue手法复位治疗水平半规管良性阵发性位置性眩晕  

Vestibular Rehabilitation Training Combined with Modified Barbecue Repositioning Maneuver for Horizontal Semicircular Canal Benign Paroxysmal Positional Vertigo

作　　者：连蕾[1] 韩海平[1] 冯志星[1] LIAN Lei;HAN Haiping;FENG Zhixing(Department of Otorhinolaryngology,Handan Central Hospital,Handan 056001,China)

机构地区：[1]邯郸市中心医院耳鼻喉科,邯郸056001

出　　处：《中华耳科学杂志》2024年第4期529-535,共7页Chinese Journal of Otology

基　　金：河北省医学科学研究课题(20211144)。

摘　　要：目的探讨前庭康复训练联合改良Barbecue手法复位治疗水平半规管良性阵发性位置性眩晕(horizontal semicircular canal benign paroxysmal positional vertigo,HC-BPPV)的效果。方法选取2018年12月至2020年12月邯郸市中心医院耳鼻喉科收治的HC-BPPV患者96例,根据随机数表法分为观察组和对照组,每组48例。对照组给予改良Barbecue手法治疗,观察组给予前庭康复训练联合改良Barbecue手法治疗。比较两组疗效、复位成功后残余症状发生率、复位成功后6个月内复发率,比较两组治疗前、治疗后1周、治疗后1个月眩晕残障程度评定量表(dizziness handicap inventory,DHI)评分、椎动脉血流动力学指标[阻力指数(resistance index,RI)、舒张末期血流速度(end diastolic velocity,EDV)、收缩期峰值流速(peak systolic velocity,PSV)]。结果观察组治疗总有效率93.75%高于对照组的77.08%,差异有统计学意义(χ^(2)=5.352,P=0.021);治疗后1周、治疗后1个月,观察组头重脚轻、头部昏沉不适、颈部僵硬、走路不稳发生率低于对照组,差异均有统计学意义(P<0.05,P<0.01);治疗后1个月,对照组和观察组DHI-P、DHI-E、DHI-F评分低于治疗前,差异有统计学意义(P<0.01);治疗后1周、治疗后1个月,观察组DHI-P、DHI-E、DHI-F评分低于对照组,差异有统计学意义(P<0.01)。治疗后1个月,对照组和观察组RI水平低于治疗前,EDV、PSV水平高于治疗前,差异均有统计学意义(P<0.01);治疗后1周、治疗后1个月,观察组RI低于对照组,EDV、PSV高于对照组,差异均有统计学意义(P<0.05,P<0.01)。复位成功后1个月、3个月、6个月,观察组总复发率低于对照组,差异有统计学意义(P<0.05)。结论前庭康复训练联合改良Barbecue手法可改善HCBPPV患者椎动脉血流动力学和复位成功后残余症状,降低复发率,治疗效果显著。Objective To report outcomes of treatment of horizontal semicircular canal benign paroxysmal positional vertigo(HC-BPPV)by vestibular rehabilitation training combined with modified Barbecue repositioning maneuver.Methods Patients with HC-BPPV admitted to the Department of Otorhinolaryngology,Handan Central Hospital,from December 2018 to December 2020(n=96)were randomly selected to receive modified Barbecue maneuver treatment(the control group)or additional vestibular rehabilitation training(the study group).The Dizziness Handicap Index(DHI),resistance index(RI),end diastolic velocity(EDV)and peak systolic velocity(PSV)before and 1 week after treatment,as well as residual symptoms and recurrence within 6 months were compared between the two groups.Results The overall rate effectiveness was 93.75%for the study group,compared to 77.08%in the control group(χ^(2)=5.352,P=0.021).At 1 week and 1 month after treatment,the rates of light-headedness,drowsiness and discomfort,neck stiffness and unsteady gait were all lower in the study group than in the control group(P<0.05 and P<0.01).At 1 month after treatment,DHI-P,DHI-E,DHI-F scores in both groups were lower than before treatment(P<0.01).The scores at 1 week and 1 month after treatment were lower in the study group than in the control group(P<0.01).At 1 month after treatment,RI was lower,while EDV and PSV levels were higher,than before treatment in both groups(P<0.01).At 1 week and 1 month after treatment,RI in the study group was lower than that in the control group,while EDV and PSV were higher(P<0.05 and P<0.01).At 1,3 and 6 months after successful reset,the rate of recurrence in the study group was lower than that in the control group(P<0.05).Conclusion Vestibular rehabilitation training combined with modified Barbecue maneuver can improve vertebral artery hemodynamics in patients with HC-BPPV and reduce residual symptoms after successful reset,improving recurrence and therapeutic effects.

关 键 词：前庭康复训练 改良Barbecue手法 水平半规管良性阵发性位置性眩晕 

分 类 号：R764[医药卫生—耳鼻咽喉科]