外伤性良性发作性位置性眩晕的临床表现与预后

Traumatic benign paroxysmal positional vertigo:clinical features and prognosis

目的探讨外伤性良性发作性位置性眩晕(t-BPPV)的临床表现和预后。方法回顾性分析2003年1月至2006年9月所诊治的19例 t-BPPV 患者的临床表现和治疗结果,与51例特发性良性发作性位置性眩晕(i-BPPV)进行对比。结果 t-BPPV 组平均发病年龄(51.3±19.1)岁,i-BPPV 组(63.2±16.5)岁,差异有统计学意义(t=2.57,P<0.05),t-BPPV 组2个或2个以上半规管受累者9例,i-BPPV 组4例,差异有统计学意义(X^2=6.74,P<0.01)。t-BPPV 组眩晕发作的潜伏期为(2.64±2.01)s,持续时间为(16.73±10.92)s,而 i-BPPV 组两者分别为(2.87±O.92)s 和(12.57±10.03)s,差异均无统计学意义(P>0.05)。首次治疗成功率 t-BPPV 组为62.5%,i-BPPV 组为83.6%,差异有统计学意义(X^2=4.94,P<0.05),首次治疗所需的循环次数 t-BPPV 组为(3.91±3.11)次,而 i-BPPV 组为(2.58±1.47)次,差异有统计学意义(t=2.70,P<0.01)。残留症状发生率t-BPPV 组为42.1%,i-BPPV 组为17.6%,差异有统计学意义(X^2=4.50,P<0.05)。随访至今,t-BPPV 组11例复发,i-BPPV 组12例复发,差异有统计学意义(X^2=7.41,P<0.01)。结论 t-BPPV患者发病年龄轻,多个半规管受累率高,治疗所需的循环次数多,残留症状发生率和复发率高,预后相对较差。

Objective To evaluate the clinical features and prognosis of traumatic benign paroxysmal positional vertigo （t-BPPV）. Methods By retrospectively analyzing the results of clinical features and prognosis in 19 patients with t-BPPV from January 2003 to September 2006, the results were compared with 51 patients with idiopathic benign paroxysmal positional vertigo （i-BPPV）. Results The mean ages were （51.3 ± 19. 1） years in t-BPPV group and （63.2 ± 16.5） years in i-BPPV group, the difference was significant （t = 2. 57, P 〈 0. 05 ）, 2 or more than 2 semicircular canals involved were seen in 9 patients in t-BPPV group and 4 patients in i-BPPV group, the difference was significant （X^2 = 6. 74, P 〈 0. 01 ）, the latency and duration of vertigo attack were （2. 64 ±2. 01 ） s and （ 16. 73±10. 92） s in t-BPPV group and （2. 87 ±0. 92） s and （12. 57 ±10. 03） s in i-BPPV group, the differences were not significant （P 〉0. 05）. The one-stage success rates were 62.5% in t-BPPV group and 83.6% in i-BPPV group, the difference was significant （X^2 = 4. 94, P 〈 O. 05 ） ; The numbers of circulation in first management were （3.91 ±3.11） times in t-BPPV group and （2.58 ± 1.47） times in i-BPPV group, the difference was significant （ t = 2. 70, P 〈 0. 01 ）. The rates of residual symptom were 42. 1% in t-BPPV group and 17. 6% in i-BPPV group, the difference was significant （X^2 = 4.50, P 〈0. 05 ）. There were 11 patients recurred in t-BPPV group and 12 patients recurred in i-BPPV group during follow-up, the difference was also significant （X^2 = 7.41, P 〈 0. 01 ）. Conclusions The mean age of t-BPPV patients was younger than that of i-BPPV patients, more semicircle canals involved, need more circulation therapy and higher rates of residual symptom and recurrence were seen in t-BPPV patients compared with i-BPPV patients. Which indicate that the effectiveness of t-BPPV seems to be more unfavorable than that of i-BPPV.