摘要
目的比较初发性与复发性多半规管良性阵发性位置性眩晕(multiple canal benign paroxysmal positionalvertigo, MC-BPPV)的临床特点、疗效及预后。方法选取2014年1月至2016年8月在武警总医院眩晕病研究所诊断为MC-BPPV的住院患者96例,分为初发病例组和复发病例组,比较2组的临床特点和复位治疗效果及愈后复发率。结果初发病例43例(44.8%),复发病例53例(55.2%),初发和复发病例在性别、年龄及病程分布差异无统计学意义,通过相应的复位治疗均可得到治愈,所需复位次数分别为(3.3±2.2)次和(3.9±1.9)次,差异无统计学意义。随访显示,治愈后有22例(22.9%)BPPV复发,但均系累及单一半规管,且多为原有半规管之一。复发病例组的复发率(17/53, 32.1%)明显高于初发病例组(5/43, 11.6%)(P <0.05),前者12个月累积复发率(44.7%, 17/38)也明显高于后者(5/32, 15.6%)(P <0.05)。BPPV复发者可经复位治疗再次治愈。结论 MC-BPPV以复发病例多见,但和初发病例一样可得到有效的复位治疗;而愈后复发病例组的复发率较高,也仍可得到成功的复位治疗。
Objective To evaluate the clinical features, treatment outcomes and prognoses of initial and recurrent multiple canal benign paroxysmal positional vertigo （MC-BPPV）. Methods A retrospective study of cases with initial or recurrent MC-BPPV who were diagnosed and treated at the Vertigo Unit, the General Hospital of Chinese People＇ s Armed Police Forces between January 2014 and August 2016. All patients were regularly followed-up at 1, 3, 6, and 12 months after successful repositioning treatments. The clinical characteristics, repositioning treatment outcomes and recur- rent rates of initial or recurrent MC-BPPV were evaluated. Results Initial and recurrent MC-BPPV account for 43 cases （44.8%） and 53 cases （55.2%）, with no difference in age, sex or duration of disease between patients with initial and recur- rent MC-BPPV. Both initial and recurrent MC-BPPV were cured with repositioning treatment, respectively with （3.3±2.2） sessions and （3.9±1.9） sessions, showing no statistically difference between them. Follows-up showed BPPV recurrence existed in 22 cases （22.9%）, and recurrent rate （17/53, 32.1%） of recurrent MC-BPPV was higher than that of initial MC- BPPV （5/43, 11.6%; P 〈 0.05）. Cumulative recurrent rates for 12 months after successful repositioning treatment were re- spectively 44.7% （17/38） for recurrent MC-BPPV and 15.6% （5/32） for initial MC-BPPV （P 〈 0.05）. The cases of recur- rent BPPV were still cured by repositioning maneuvers. Conclusion Most MC-BPPV are recurrent cases. Both initial and recurrent MC-BPPV may be successfully treated with repositioning maneuvers, but with a high recurrent rate of BP- PV, especially in originally recurrent MC-BPPV. Successful repositioning treatment can be obtained again in these cases.
作者
陈哲
王恩彤
单希征
高云
余滋中
朱俊
李国义
Chen Zhe;Wang Entong;Shan Xizheng;Gao Yun;Yu Zizhong;Zhu Jun;Li Guoyi(Institute of Vertigo Diseases,General Hospital of Chinese People＇ s Armed Police Forces,Beijing 100039,China)
出处
《北京医学》
CAS
2018年第8期738-741,共4页
Beijing Medical Journal
关键词
多半规管良性阵发性位置性眩晕
耳石复位治疗
复发
multiple canal benign paroxysmal positional vertigo （MC-BPPV）
repositioning maneuver
recurrence
