前庭外周损伤患者自发眼震的特点及临床价值探讨

发布时间：2018-05-21 14:23

本文选题：前庭 + 代偿　；参考：《临床耳鼻咽喉头颈外科杂志》2017年09期

【摘要】：目的:探讨前庭外周损伤患者自发眼震(SN)的特点及其临床价值。方法:以60例急性单侧前庭外周损伤眩晕患者为研究对象,均为前庭神经炎(VN),分别完成自发眼震、冷热试验测评。以SN强度和方向、冷热试验的优势偏向(DP)值及单侧半规管反应减退(UW)值为评定指标(异常者分别称为DP、UW),结合病程,分析SN的特点及其与病程、DP及UW间的关系。结果:60例中有SN者49例(81.7%),无SN者11例(18.3%)。SN强度范围0.5°/s~20.4°/s,与病程呈负相关(r=-0.478,P0.01)。将SN强度按轻、中、重分组,病程中位数分别为6.5、5.0、3.0d,差异有统计学意义(χ~2=9.071,P0.01)。有SN者中冷热试验DP 44例(89.8%),DP值正常5例(10.2%),SN强度与DP值呈正相关(r=0.513,P0.01);存在UW者35例(71.4%)(UW侧别与SN方向不同者31例、相同者4例),双侧半规管反应减退者7例(14.3%),双侧半规管反应正常者7例(14.3%),SN强度与冷热试验UW值无相关关系(r=-0.321,P0.05)。有SN和无SN者UW值分别为(40.9±26.3)%和(29.9±18.2)%,差异有统计学意义(F=4.497,P0.05)。结论:急性前庭外周损伤者的SN强度多为中重度,强度随病程延长逐渐减弱或改变方向,且较无SN者的前庭损伤程度重。SN对前庭外周损伤侧别及代偿状态评估具有临床指导价值。
[Abstract]:Objective: to investigate the characteristics and clinical value of spontaneous nystagmus in patients with vestibular peripheral injury. Methods: 60 patients with acute unilateral vestibular peripheral injury vertigo were studied. The strength and direction of SN, the dominant bias of the cold and hot test and the UW value of unilateral semicircular canal reaction were taken as the evaluation index (abnormal cases were called DPUWN respectively). The characteristics of SN and its relationship with the course of disease and the course of disease were analyzed. Results among 60 cases, 49 cases had SN (81.7%), 11 cases without SN had intensity range of 0.5 掳/ s (20.4 掳/ s), which was negatively correlated with the course of disease (P 0.01). SN intensity was divided into light, medium and heavy groups, the median course of disease was 6.5V 5.0 / 3.0d, and the difference was statistically significant (蠂 ~ (2 / 2) 9.071g / (P0.01). Among the patients with SN, 44 cases with DP-89.8 and 5 cases with normal DP value (10.2%) had a positive correlation between SN strength and DP value (P 0.01), 35 cases with UW and 31 cases with different direction between UW and SN. There was no correlation between the intensity of SN and the UW value of the cold and hot test in 7 patients with normal bilateral semicircular canal reaction and the UW value of the cold and hot test. There was no correlation between the intensity of SN and the UW value of the cold and hot test. The values of UW in patients with SN and without SN were 40.9 卤26.3% and 29.9 卤18.2, respectively. The difference was statistically significant (P 0.05). Conclusion: the SN intensity of patients with acute vestibular peripheral injury is moderate and severe, and the intensity decreases or changes with the course of disease. Moreover, the degree of vestibular injury in patients without SN was more severe than that in patients without SN, and had clinical guiding value for the evaluation of vestibular peripheral injury side and compensatory state.
【作者单位】：天津医科大学一中心临床学院;天津市第一中心医院耳鼻咽喉头颈外科天津市耳鼻咽喉科研究所;
【分类号】：R764

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