复位治疗椅辅助治疗后半规管良性阵发性位置性眩晕的疗效观察

The Treatment Outcomes of 58 Cases of Posterior Semicircular Canal Benign Paroxysmal Positional Vertigo

谭俊;于栋祯;冯艳梅;杨光;时海波;殷善开;

1:上海交通大学附属第六人民医院耳鼻咽喉科

2:上海交通大学耳鼻咽喉科研究所

3:上海东方耳鼻咽喉科研究所

4:上海交通大学眩晕疾病诊治中心

摘要
目的评估复位治疗椅辅助治疗后半规管良性阵发性位置性眩晕(posterior semicircular canal benign paroxysmal positional vertigo,PSC-BPPV)的疗效。方法采用复位治疗椅辅助的Epley法治疗58例PSC-BPPV患者,观察首次治疗后一周、一个月、三个月的治疗效果。结果首次治疗后一周(第1次随访)时,41例(70.69%,41/58)治愈,13例(22.41%,13/58)好转,4例(6.90%,4/58)无效,对17例未愈患者行第二次复位治疗,首次治疗后一个月(第2次随访)时,53例(91.38%,53/58)治愈,3例(5.17%,3/58)好转,2例(3.45%,2/58)无效,对5例未愈者立即行第三次复位治疗;首次治疗后三个月(第3次随访)时57例(98.28%,57/58)治愈,1例(1.72%,1/58)无效。结论复位治疗椅辅助治疗PSC-BPPV有效率达98.28%,无严重副反应,是一种可选择的治疗方案。
关键词
良性阵发性位置性眩晕;后半规管;眩晕复位治疗椅
基金项目(Foundation):
上海市级医院新兴前沿技术项目(SHDC12010119)资助
作者
谭俊;于栋祯;冯艳梅;杨光;时海波;殷善开;
参考文献

1 von Brevern M,Radtke A,Lezius F,et al.Epidemiology of benign paroxysmal positional vertigo:apopulation based study[J].J Neurol Neurosurg Psychiatry,2007,78:710.

2 Leveque M,Labrousse M,Seidermann L,et al.Surgical ther-apy in intractable benign paroxysmal positional vertigo[J].Otolaryngol Head Neck Surg,2007,136:693.

3中华耳鼻咽喉头颈外科杂志编辑委员会,中华医学会耳鼻咽喉科学分会.良性阵发性位置性眩晕的诊断依据和疗效评估(2006年,贵阳)[J].中华耳鼻咽喉头颈外科杂志,2007,42:163.

4 Alvarenga GA,Barbosa MA,Porto CC.Benign paroxysmal positional vertigo without nystagmus:diagnosis and treatment[J].Braz J Otorhinolaryngol,2011,77:799.

5 Parnes LS,Agrawal SK,Atlas J.Diagnosis and management of benign paroxysmal positional vertigo(BPPV)[J].CMAJ,2003,169:681.

6 Epley JM.The canalith repositioning procedure:for treatment of benign paroxysmal positional vertigo[J].Otolaryngol Head Neck Surg,1992,107:399.

7 Li JC,Epley J.The 360-degree maneuver for treatment of benign positional vertigo[J].Otol Neurotol,2006,27:71.

8 Blakley BW.A randomized,controlled assessment of the cana-lith repositioning maneuver[J].Otolaryngol Head Neck Surg,1994,110:391.

9 Bhattacharyya N,Baugh RF,Orvidas L,et al.Clinical prac-tice guideline:benign paroxysmal positional vertigo[J].Oto-laryngol Head Neck Surg,2008,139:S47.

10 Hilton M,Pinder D.The Epley(canalith repositioning)ma-noeuvre for benign paroxysmal positional vertigo[J].Co-chrane Database Syst Rev,2004:D3162.

11 Nakayama M,Epley JM.BPPV and variants:improved treat-ment results with automated,nystagmus-based reposition-ing[J].Otolaryngol Head Neck Surg,2005,133:107.

12 von Brevern M,Seelig T,Radtke A,et al.Short-term effi-cacy of Epley's manoeuvre:a double-blind randomised trial[J].J Neurol Neurosurg Psychiatry,2006,77:980.