oVEMP评估良性阵发性位置性眩晕患者耳石复位效果的临床价值

发布时间：2018-03-25 21:31

本文选题：眼性前庭诱发肌源性电位　切入点：良性阵发性位置性眩晕　出处：《临床耳鼻咽喉头颈外科杂志》2016年21期

【摘要】：目的:探讨眼性前庭诱发肌源性电位(oVEMP)对于评估良性阵发性位置性眩晕(BPPV)患者耳石复位效果的临床价值。方法:对2015-10-2016-03期间就诊的53例原发性单侧后半规管BPPV患者进行耳石复位前后的oVEMP测试,并根据复位效果分为痊愈组和有效组,比较各组复位前后oVEMP的引出率、N1振幅和N1-P1波幅以及不对称率的差异,应用SPSS 20.0软件进行统计学分析。结果:53例患者复位治疗前oVEMP引出率为84.9%,复位后引出率为88.7%。复位前后均可引出oVEMP者45例,按照疗效分为痊愈组(28例)和有效组(17例)。痊愈组:治疗前后相比,患侧N1振幅从(3.16±0.64)μV增长到(3.99±0.67)μV;患侧N1-P1波幅从(3.08±1.14)μV增长到(4.22±0.87)μV,均差异有统计学意义(P0.05);健侧N1振幅平均增长0.02μV,健侧N1-P1波幅平均增长0.01μV,均差异无统计学意义(P0.05);不对称率治疗后降低0.10,差异有统计学意义(P0.05)。有效组:治疗前后相比,患侧N1振幅平均增长0.13μV,患侧N1-P1波幅平均增长0.01μV;健侧N1振幅前后水平一致,健侧N1-P1波幅平均增长0.04μV,不对称率前后水平一致,各项均差异无统计学意义(P0.05)。结论:有效的耳石复位可使BPPV患者脱落的耳石回归椭圆囊,复位后oVEMP波幅增长,引出率提高;oVEMP可用于评估BPPV患者耳石复位后椭圆囊的功能恢复情况,评判该病的预后。
[Abstract]:Objective: to evaluate the clinical value of ocular vestibular evoked myogenic potentials (VEMPP) in the evaluation of otolithiasis reduction in patients with benign paroxysmal positional vertigo. Methods: 53 patients with primary unilateral posterior semicircular canal BPPV from May to March 2015-2016-03 were enrolled in this study. OVEMP test was performed before and after otolithiasis reduction. According to the effect of reduction, the patients were divided into two groups: the recovery group and the effective group. The differences of oVEMP elicitation rate, N1 amplitude, N1-P1 amplitude and asymmetry rate before and after reduction were compared. SPSS 20.0 software was used to carry out statistical analysis. Results the rate of oVEMP extraction was 84.9 before and after reduction in 53 cases, and that after reduction was 88.7.The oVEMP could be obtained in 45 cases before and after reduction. According to the curative effect, the patients were divided into two groups: the cured group (n = 28) and the effective group (n = 17). The N1 amplitude of the affected side increased from 3.16 卤0.64 渭 V to 3.99 卤0.67 渭 V, the amplitude of N1-P1 increased from 3.08 卤1.14 渭 V to 4.22 卤0.87 渭 V, the difference was statistically significant (P 0.05), the average amplitude of N1 in the healthy side increased 0.02 渭 V, the amplitude of N1-P1 in the healthy side increased 0.01 渭 V, the difference was not significant (P 0.05); the asymmetrical rate decreased after treatment, and the amplitude of N1 increased from 3.16 卤0.64 渭 V to 3.99 卤0.67 渭 V, and the amplitude of the affected side increased from 3.08 卤1.14 渭 V to 4.22 卤0.87 渭 V, respectively. Low 0.10, the difference was statistically significant (P 0.05). Effective group: compared with before and after treatment, The N1 amplitude of the affected side increased by 0.13 渭 V, the amplitude of the affected side increased by 0.01 渭 V, the amplitude of the contralateral N1 increased by 0.04 渭 V, the amplitude of the contralateral N1-P1 increased by 0.04 渭 V, and the asymmetry rate was the same. Conclusion: the effective reduction of otolithiasis can make the desquamated otolith of BPPV patients return to the elliptical sac, and the amplitude of oVEMP wave increases after reduction, and the increase of extraction rate can be used to evaluate the functional recovery of the elliptical sac of BPPV patients after the reduction of otolith. The prognosis of the disease was evaluated.
【作者单位】：天津医科大学总医院耳鼻咽喉头颈外科;
【分类号】：R764

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