骨振子对良性阵发性位置性眩晕的疗效影响  

Mastoid Oscillation in Treatment of Benign Paroxysmal Positional Vertigo

作　　者：兰莉[1] 韩巍[1] 黄维[1] 叶清[1] 陶方英[1] 王志鹏 王敏[1] 曹祖威[1] 刘宇清[1] 杨雪 张嫄[1] 宋洪兰 杨可婕[1] LAN Li;HAN Wei;HUANG Wei;YE Qing;TAO Fangying;WANG Zhipeng;WANG Min;CAO Zuwei;LIU Yuqing;YANG Xue;ZHANGYuan;SONG Honglan;YANG Kejie(Hearing Center,Guizhou Provincial People's Hospital,Guiyang 550001,China)

机构地区：[1]贵州省人民医院听力中心,贵阳550001

出　　处：《中华耳科学杂志》2024年第6期895-899,共5页Chinese Journal of Otology

基　　金：贵州省科技厅科技计划合作项目临床专项(LH[2022]037)。

摘　　要：目的观察联合骨振子乳突振荡(mastoid oscillation,MO)治疗首诊手法复位后仍然再发眩晕的BPPV患者的疗效。方法选取2022年4月至2022年11月贵州省人民医院首诊手法复位治疗后仍发作眩晕的118例患者作为研究对象,除去3例不能耐受MO和11例失访者,最终纳入104例,其中(canalithrepositioning procedure,CPR)组53例,CRP+MO组51例。104例首诊BPPV经手法复位治疗CRP后仍再发眩晕的患者分为CRP组及CRP联合MO治疗的CRP+MO组。随访观察两组患者的眩晕障碍量表、总体视觉模拟量表评分、眼震消失时间、残余症状时间及不良反应。结果CRP+MO组治疗过程中DHI评分为12.79±3.67,VAS评分为2.34±1.31,低于CRP组19.44±2.12和4.58±1.29,结果有统计学意义(t=8.35,t=13.62,P<0.05);CRP+MO组复位后位置实验证实眼震阴性平均需要3.34±1.31 d,较CRP组5.58±1.29 d短(t=8.23,P<0.05);CRP+MO组治疗后残余症状平均持续7.85±3.37 d,与CRP组11.62±2.27 d相比,结果有统计学意义(t=15.32,P<0.05);两组不良反应率差异无统计学意义(χ^(2)=0.53,P>0.05)。结论联合MO治疗可缩短首诊未痊愈BPPV患者的疗程,改善治疗舒适度,提高生活质量。Objective To report outcomes and quality of life in patients with recurrent benign paroxysmal positional vertigo after initial manual reduction treated with mastoid oscillation(MO)using bone vibrators.Methods Patients who failed the first otolith repositioning procedure(CRP)(n=104)were selected to receive repeated CRP or CRP combined with MO(CRP+MO group).DHI and VAS scores,time of disappearance of nystagmus,and duration of residual dizziness were compared between the two groups.Results In the CRP+MO group,time to nystagmus disappearance after repositioning(3.34±1.31days)was shorter than in the CRP only group(5.58±1.29 days)(t=8.23,P<0.05),with lower DHI(12.79±3.67)and VAS(2.34±1.31)scores compared to the CRP group(19.44±2.12 and 4.58±1.29,respectively)(t=8.35,t=13.62,P<0.05).Duration of residual symptoms in the CRP+MO lasted 7.85±3.37 days after treatment,significantly shorter than in the CRP only group(11.62±2.27 days)(t=15.32,P<0.05).There was no significant difference in the rate of adverse reactions between the two groups(χ^(2)=0.53,P>0.05).Conclusion The combination of CRP and MO can shorten the course of treatment and improve the treatment outcomes in BPPV patients who have failed the first treatment.

关 键 词：良性阵发性位置性眩晕 眩晕残障量表 视觉模拟量表 乳突振荡 

分 类 号：R764[医药卫生—耳鼻咽喉科]