与头位改变相关眩晕患者的临床分析

Clinical Analysis of 112 Cases of Vertigo Associated with Changes of Head Position

目的探泔与头位改变相关的眩晕的诊断与治疗方法。方法对112例与头位改变相关的眩晕患者进行体位试验及影像学检查，对确诊和可疑为BPPV的患者进行复位治疗，对诊断为颈性眩晕的患者采用戴颈托和全身应用扩血管、营养神经类药物治疗。结果112例患者中，男45例，女67例，年龄12～75岁。确诊为良性阵发性位置性眩晕（BPPV）88例，其中后半规管BPPV76例，水平半规管BPPV9例，上半规管BPPV3例；可疑BPPV9例，这97例均用耳石复位法治疗，1周后痊愈90例，有效4例，近期总有效率96．9％。确诊为颈性眩晕15例，治疗2周后眩晕消失4例．明显好转11例。结论体位试验及影像学检查是诊断与头位改变相关的眩晕最简明的方法，物理疗法和药物治疗疗效好。

Objective To investigate the diagnosis and treatment of vertigo associated with changes of head position. Methods 112 patients of vertigo associated with changes of head position were analyzed from June 2006 to December 2007 through the positional tests and imaging examination. Results 45 men and 67 women from ages 12 to 75 （median 50） were included with a total of 112 patients. 88 patients were diagnosed as benign paroxysmal posi- tional vertigo（BPPV）, 76 patients as posterior semicircular canals BPPV, 9 patients as horizontal semicircular canal BPPV,3 patients as anterior semicircular canals BPPV,9 patients as suspicious BPPV. They were treated by eana- lith repositioning procedure, the total improvement rate was 96.9~ after 1 week . 15 eases of cervical vertigo were treated by physical therapy and medication, the vertigo of 4 patients disappeared and of 11 patients was improved significantly after 2 weeks. Oonclusion The positional tests and cervical plain x--ray are the simplest ways to diagnose vertigo associated with changes of head position. Physical therapy and medication are effective. It is suitable to promote in the grass--roots hospitals.