摘要
目的探讨良性阵发性位置性眩晕(benign paroxysmal positional vertigo, BPPV)患者延迟诊治相关因素及改进方法。方法选择明确诊断的延迟诊治BPPV患者40例(延迟诊治组),随机选取同期非延迟诊治患者40例(正常诊疗组)。采用适当的复位方法治疗。比较2组患者的就诊次数、病程、诊治费用、患者就诊前对BPPV的了解程度、诱发试验经历、大型检查经历、首诊科室、既往诊断、治疗效果。结果延迟诊治组和正常诊治组患者的性别、年龄、1周时治疗效果差异无统计学意义(P> 0.05);2组就诊次数分别为3(3,5.8)次和1.5(1,2)次,病程分别为17(12~25)d和7(6~9)d,诊治费用分别为(5 260.4±724.5)元和(329.5±58.5)元,大型检查经历分别为39例(97.5%)和20例(50.0%),差异均有统计学意义(P<0.05);而2组患者对BPPV的了解分别为3例(7.5%)和10例(25%),诱发试验经历分别为40例(100%)和3例(7.5%),差异均有统计学意义(P<0.05)。正常诊治组患者首次就诊科室多为神经内科(20例,50.0%)和急诊科(10例,25.0%),或有神经内科会诊或被分流至神经内科就诊的经历。延迟诊治组首次就诊科室则多为基层全科或综合内科(25例,62.5%)和急诊科(10例,25.0%),多误诊为椎基底动脉供血不足、脑供血不足等。结论良性阵发性位置性眩晕延迟诊治对患者产生较多不利影响。优化眩晕诊治流程、加强医患双方BPPV知识的培训可减少BPPV延迟诊治。
Objective To investigate the factors for delayed diagnosis and treatment of benign paroxysmal position- al （BPPV）. Methods Forty patients with delayed diagnosis and treatment of BPPV （delayed group） and 40 patients with timely diagnosis and treatment of BPPV （routine group） were included. Baseline data, number of visits, duration of BPPV, diagnosis and treatment costs, recognition of BPPV, and diagnosis and treatment experience were compared between 2 groups. Results There were no statistically significant differences in gender, age, and 1 week efficacy after repositioning maneuvers between 2 groups （P 〉 0.05）, but there were statistically significant differences between 2 groups in the num- ber of visits [3 （3,5.8） vs. 1.5 （1,2）, P 〈 0.05], the duration of BPPV [17 （12, 25） days vs. 7 （6, 9） days, P 〈 0.05], the diag- nosis and treatment costs [（5 260.4±724.5） yuan vs. （329.5±58.5） yuan, P 〈 0.05], major examination items [39 cases （97.5%） vs. 20 cases （50.0%）, P 〈 0.05]. Patients in routine group commonly firstly visited to Department of Neurology [20 cases （50.0%）] or Department of Emergency [10 cases （25.0%）]. In delayed group, 25 cases （62.5%） were misdiag- nosed at general practice or General Internal Medicine, and 10 cases （25.0%） at Department of Emergency, with initial di- agnoses of vertebrobasilar insufficiency, cerebral circulation insufficiency, and cerebral infarction. Conclusion Delayed diagnosis and treatment of BPPV has adverse effects on patients. Optimizing the diagnosis and treatment process of verti- go and strengthening the training of BPPV knowledge between doctors and patients are expected to reduce the delay in di- agnosis and treatment of BPPV.
作者
王崇
王建明
杨威
刘冬
董娜
Wang Chong;Wang Jianming;Yang Wei;Liu Dong;Dong Na(Department of Neurology,Jianhu Hospital Affiliated to School of Medicine,Nantong University,Yancheng 224700,China)
出处
《北京医学》
CAS
2018年第8期748-750,共3页
Beijing Medical Journal
基金
盐城市医学科技发展计划(YK2017085)
关键词
良性阵发性位置性眩晕
物理治疗
延迟诊治
治疗结果
benign paroxysmal positional vertigo （BPPV）
physiotherapy
delayed diagnosis and treatment
treatment outcome
