水平半规管良性阵发性位置性眩晕的患侧定位方法与临床价值探讨

发布时间：2018-09-07 17:09

【摘要】：目的:探讨滚转试验(HRT)、俯曲仰头试验(BLT)及患者主观眩晕感觉(SVS)在水平半规管良性阵发性位置性眩晕(HSC-BPPV)中对于患侧定位的临床价值。方法:HSC-BPPV患者138例,其中HSC-Can 94例、HSC-Cup 44例,对所有患者先行HRT并询问患者SVS,随后行BLT。根据HRT、SVS及BLT结果,HSCCan、HSC-Cup分别采用Barbecue法、改良Kim法复位。分析分别经HRT、BLT、SVS患侧的检出率及疗效。结果:94例HSC-Can患者和44例HSC-Cup患者,分别经BLT诱发出BN和/或LN眼震81.91%、84.09%,经HRT诱发出双侧强弱不对称眼震90.43%、88.64%,SVS诉眩晕症状重侧60.64%、63.64%。经列联表χ~2检验和两两比较,HRT及BLT检出率差异无统计学意义(P0.05),与SVS比较差异均有统计学意义(P0.05)。排除4例经HRT、BLT、SVS均无法定位患侧的病例,将92例HSC-Can患者和42例HSC-Cup患者进行复位治疗,仅HRT阳性者首次治愈率分别为66.67%、60.00%,仅BLT阳性者分别为71.43%、66.67%,仅HRT阳性、仅BLT阳性与HRT、BLT均阳性且患侧为同侧(70.37%、62.50%)的差异无统计学意义(P0.05),而与HRT、BLT均阳性且患侧为异侧(37.50%、30.00%)的差异有统计学意义(P0.05)。结论:HRT为HSC-BPPV患侧定位最有效的体位检查方法,但BLT及SVS作为HSC-BPPV定位方法也具有一定的辅助诊断价值。
[Abstract]:Objective: to investigate the clinical value of rolling test (HRT), bent head test (BLT) and subjective vertigo sensation (SVS) in horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV). Methods one hundred and eight patients with HSC-BPPV, including 94 patients with HSC-Can and 44 patients with HSC-Cup, were enrolled in the study. All patients were treated with HRT and SVS, was asked to be followed by BLT.. According to the results of HRT,SVS and BLT, Barbecue method and modified Kim method were used to restore HSC-Cup. To analyze the detectable rate and curative effect of HRT,BLT,SVS. Results in 94 cases of HSC-Can and 44 cases of HSC-Cup, BN and / or LN nystagmus were induced by BLT 84.09, and bilateral strong or weak asymmetrical nystagmus 90.4388.64 were induced by HRT. The symptom of vertigo was 63.64% and 63.64% respectively. The positive rate of HRT and BLT by 蠂 ~ 2 test and pairwise comparison had no statistical significance (P0.05), but there was statistical significance compared with SVS (P0.05). 92 cases of HSC-Can and 42 cases of HSC-Cup were treated by reduction. The first cure rates of HRT positive cases were 66.6767 and 60.005, respectively, and only BLT positive cases were 71.43% and 66.67%, only HRT positive cases were positive, respectively, after the exclusion of 4 cases which could not locate the affected side by HRT,BLT,SVS, 92 cases of HSC-Can and 42 cases of HSC-Cup were treated by reduction therapy. The first cure rates of HRT positive cases were 66.67g and 66.67, respectively. There was no significant difference between BLT positive and HRT,BLT positive and ipsilateral (70.370.37%) (P0.05), but there was significant difference with HRT,BLT (37.50%) and the other side (30.00%) (P0.05). Conclusion: the BLT and SVS are the most effective methods for detecting the position of the affected side of HSC-BPPV, but BLT and SVS are also helpful in the diagnosis of HSC-BPPV.
【作者单位】：天津医科大学研究生院;天津市人民医院耳鼻咽喉头颈外科;
【分类号】：R764.3

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