摘要
目的探讨主观视觉垂直线/水平线(subjective visual vertical/subjective visual horizontal,SVV/SVH)。方法选取90例就诊于厦门大学附属第一医院耳鼻咽喉头颈外科眩晕门诊的原发性单侧后半规管良性阵发性位置性眩晕(BPPV)患者为实验组,以健康志愿者(40例)作为对照组。所有患者均成功行Epley/Semont复位治疗,并根据复位后有无残余症状分为有残余症状组和无残余症状组,分别在复位前、复位后1天及复位后2周、3个月行直立位SVV/SVH检测,两组均记录其偏离值(d±SD)。结果所有BPPV患者成功复位后有残余症状者35例,无残余症状者55例,残余症状的发生率约39%;两组患者复位前直立位SVV/SVH偏离值均大于对照组(P<0.05),且方向偏向患侧;复位后1天偏离值均明显减小,与复位前相比差异具有统计学意义(P<0.05),但复位后1天的偏离值与对照组之间仍存在差异(P<0.05),且随着时间的推移,两组患者直立位SVV/SVH偏离值逐渐减小,呈动态变化。无残余症状组复位后2周偏离值与对照组之间无明显差别(P>0.05);有残余症状组复位2周偏离值与对照组之间仍有差别(P<0.05),直至复位3个月后有残余症状组与对照组之间无明显差别(P>0.05)。结论 BPPV患者在复位前耳石器功能均有不同程度的损害,成功复位后两组患者耳石器功能改善但均未完全恢复,随着病程和前庭功能的代偿建立,两组患者SVV/SVH的偏离角度逐渐变小,呈动态变化;约2周后无残余症状组患者耳石器的代偿功能逐渐建立,有残余症状组患者的耳石器代偿功能建立较慢,约需3个月的时间;主观视觉重力线(SVV/SVH)对BPPV患者耳石器功能及代偿状态的评估可提供一定的参考价值。
OBJECTIVE To evaluate the function of otolith in benign paroxysmal positional vertigo(BPPV) patients with subjective visual vertical.METHODS Ninety patients with primary unilateral posterior semicircular canal BPPV were selected as experimental group and normal healthy volunteers(40 patients) as normal control group.All the patients were successfully treated with Epley or Semont repositioning manuver,and were divided into residual symptom group and non-residual symptom group according to the residual symptoms after repositioning manuver treatment.Before manipulative reduction,one day after manipulative reduction and two weeks and three months after repositioning manuver,the vertical position SVV/SVH were measured respectively,and the average deviation from the absolute value was recorded(mean±SD).RESULTS There were 35 cases with residual symptoms after successful reposition,55 cases without residual symptoms,the incidence of residual symptoms was about 39%.The average deviation values of vertical position SVV/SVH were higher than those of normal control group(P<0.05) and the direction was deviated to the affected side.Both values were significantly reduced at 1 day after reposition,statistically significant compared with that before repositioning(P<0.05),but deviation values at 1 day after reposition were still different between experimental group and normal controls(P<0.05).Over time,the upright position SVV/SVH deviation value in the two groups gradually decreased,with dynamic changes.There was no significant difference in the average deviation value at two weeks after repositioning manuver between non-residual symptom group and the normal control group(P>0.05).There was still a difference in the deviation values at 2 weeks after repositioning manuver between the residual symptom group and the normal control group(P<0.05),and there was no difference between the residual symptom group and the normal control group after three months of repositioning treatment(P>0.05).CONCLUSION The patients of BPPV had different
作者
汪晓锋
周燚
苏文玲
何静
黄江峰
骆献阳
WANG Xiaofeng;ZHOU Yi;SU Wenling;HE Jing;HUANG Jiangfeng;LUO Xianyang(Department of Otolaryngology Head and Neck Surgery,the First Affiliated Hospital of Xiamen University,Teaching Hospital of Fujian Medical University,Xiamen Key Laboratory of Otolaryngology Head and Neck Surgery,Xiamen,Fujian,361003,China)
出处
《中国耳鼻咽喉头颈外科》
CSCD
2022年第1期37-40,51,共5页
Chinese Archives of Otolaryngology-Head and Neck Surgery
基金
福建省卫生计生委青年科研课题(2018-2-61)
厦门市医疗卫生指导性项目(3502Z20199010)
福建省自然科学基金卫生联合面上项目(2020J011225)。
关键词
眩晕
良性阵发性位置性眩晕
主观视觉垂直线/水平线
Vertigo
benign paroxysmal positional vertigo
subjective visual vertical/subjective visual horizontal