不同半规管类型良性阵发性位置性眩晕的平衡功能

发布时间：2018-03-09 18:56

本文选题：良性阵发性位置性眩晕　切入点：平衡功能　出处：《复旦大学》2012年硕士论文　论文类型：学位论文

【摘要】：目的探讨不同半规管类型良性阵发性位置性眩晕患者平衡功能的特点,明确静态和动态姿势图检查的意义及必要性。方法44例后半规管(PSC-BPPV)及22例水平半规管管内(HSC-BPPV)良性阵发性位置性眩晕患者,及44例匹配年龄、性别的健康志愿者。测试项目包括：静态平衡板试验：姿态稳定极限Limits of Stability (S max)和重心移动Statokinesigram曲线和面积描计；动态平衡板试验：获得动态姿态平衡图(Stabilogram);睁眼、闭眼左右和前后轴向移动幅度曲线及感觉结构测试SOT结果。记录所有静态姿势图参数及SOT结果。结果(?)PSC-BPPV组患者睁眼状态(E0)静态姿势图横向最大偏移Maximum X Amplitude及姿势图面积SSKG较HSC-BPPV组更大,两组间两参数比较差异有统计学意义(P值均0.05)；感觉结构分析(SOT), HSC-BPPV组姿势稳定性较PSC-BPPV组差(P0.05)。②PSC-BPPV组静态姿势图大多数参数较正常对照组差,即其平衡功能较对照组明显降低。睁眼(EO)状态下,Mean X、Mean Y、Max Y、SKGL、SKGS、LFS、Limits of Stability、Romberg Quotient差异均有明显统计学意义(p值均0.01),而Max X差异无统计学意义(p值均0.05)；闭眼(ES)状态下,Mean X、Mean Y、差异均有明显统计学意义(p值均0.01),Max Y、LFS差异有统计学意义(p值均0.05),而Max X、SKGL、SKGS差异无统计学意义(P值均0.05)；PSC-BPPV组动态姿势稳定较对照组差,差异有明显统计学意义(p0.01),在去除本体觉和视觉的参与下,前庭觉维持平衡的能力明显下降。③HSC-BPPV组静态姿势图大多数参数较正常对照组差,睁眼(E0)状态下,Mean X、Max X、SKGL、LFS、Romberg Quotient差异均有明显统计学意义(p值均0.01),Mean Y差异有统计学意义(p值0.05),而Max Y、SKGS差异无统计学意义(p值均0.05)；闭眼状态下,Mean X、Max X、LFS差异均有明显统计学意义(p值均0.01),Mean Y差异有统计学意义(p值0.05),而Max Y、SKGL、SKGS差异无统计学意义(P值均0.05)。HSC-BPPV组动态姿势稳定较对照组差,差异有明显统计学意义(p0.01),在去除本体觉和视觉的参与下,前庭觉维持平衡的能力明显下降。④PSC-BPPV组静态姿势图SSKG异常率与动态姿势图SOT异常率无差别,而HSC-BPPV组感觉结构测试与静态姿势SSKG结果对照表明感觉结构测试异常率更高。结论1)PSC-BPPV及HSC-BPPV组静态和动态姿势稳定性较对照组均表现出不同程度的下降。2)PSC-BPPV组静态姿势稳定性较HSC-BPPV组差,而与动态感觉结构测试结果相反,即HSC-BPPV组感觉结构测试较PSC-BPPV组差。3)HSC-BPPV组感觉结构测试与静态姿势SSKG结果对照表明感觉结构测试异常率更高,提示静态和动态姿势图同时检查,对比研究更能较为准确的评定BPPV患者的平衡功能。
[Abstract]:Objective to investigate the characteristics of balance function in patients with benign paroxysmal positional vertigo of different semicircular canal types and to determine the significance and necessity of static and dynamic postural examination. Methods 44 patients with posterior semicircular canal PSC-BPPVs and 22 patients with HSC-BPPVs benign paroxysmal positional vertigo, and 44 patients with matched age. Healthy volunteers of gender. Test items include: static balance board test: attitude stability limit Limits of Stability S max) and center of gravity moving Statokinesigram curve and area plotter; dynamic balance board test: obtain dynamic attitude balance map stabilogramma; open eyes, The amplitude curve of left and right axial movement and sensory structure of closed eyes were measured by SOT. All static postural parameters and SOT results were recorded. The result? In PSC-BPPV group, the maximal lateral deviation of Maximum X Amplitude and the area of SSKG were larger than those of HSC-BPPV group. The difference between the two groups was statistically significant (P = 0.05), and the postural stability of HSC-BPPV group was worse than that of PSC-BPPV group (P 0.05N .2PSC-BPPV group), and most of the static postural parameters in HSC-BPPV group were worse than those in normal control group. That is, the balance function was significantly lower than that of the control group. Under the condition of EO), there were significant differences between the two groups in the Quotient values of Max X, but not in the Max X, and in the condition of closed eyes, there were significant differences in the mean XMY, and the differences in the mean mean Y. under the condition of EOE) were statistically significant, and there were significant differences in the values of Max X between the two groups, and there was no significant difference in the Max X between the two groups under the condition of EO. the difference was significant under the condition of closed eyes (ESs). There was significant difference in P value between 0. 01 and 0. 01% Max YPPV. There was a significant difference between two groups (P < 0. 05). However, there was no significant difference in Max XX SKGLN SKGS. The dynamic postural stability of PSC-BPPV group was lower than that of the control group (P = 0. 05), but not significantly different from that of the control group (P = 0. 05). The difference was statistically significant (P 0.01). With the participation of propriocepts and vision, the ability of vestibule to maintain the balance of vestibule was significantly decreased. Most of the parameters of static postures in the group of 3 HSC-BPPV were worse than those in the normal control group. Under the condition of E0), there were significant differences in the Quotient of mean XX Max, SKGLG, LFSL, Romberg. There were significant differences in P value of 0. 01% and 0. 05% of mean Y, but there was no significant difference between Max and SKGS in all of them. There was a significant difference in mean Y between the two groups (P = 0.05), while there was no significant difference in the dynamic postural stability of the Max YSK GLN SKGS group (P = 0.05). The dynamic postural stability in the HSC-BPPV group was lower than that in the control group. The difference was statistically significant (P 0.01). The ability of vestibular sensation to maintain balance was significantly decreased with the removal of proprioceptive and visual involvement. There was no significant difference between the abnormal rate of SSKG on static postural map and that of SOT in dynamic postural map in the group of .4PSC-BPPV. The results of sensory structure test and static postural SSKG showed that the abnormal rate of sensory structure test was higher in HSC-BPPV group. Conclusion (1) the static and dynamic postural stability of PSC-BPPV and HSC-BPPV group were lower than that of control group. The static postural stability of PSC-BPPV group was worse than that of HSC-BPPV group, but the result was opposite to that of dynamic sensory structure test. That is, the sensory structure test of HSC-BPPV group was worse than that of PSC-BPPV group. Compared with the results of static postural SSKG, the abnormal rate of sensory structure test in HSC-BPPV group was higher than that in PSC-BPPV group, suggesting that both static and dynamic postures were examined at the same time. The comparative study was more accurate in assessing the balance function of BPPV patients.
【学位授予单位】：复旦大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R764

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