23例外伤后良性阵发性位置性眩晕临床分析

Posttraumatic benign paroxysmalpositional vertigo:analysis of 23cases

目的:比较外伤性良性阵发性位置性眩晕(t-BPPV)和特发性良性阵发性位置性眩晕(i-BPPV)患者的临床特点及预后的差异。方法:回顾性分析186例后半规管BPPV患者的临床资料,所有患者均经Dix-Hallpike试验诊断,并采用管石复位法(CRP)治疗,比较t-BPPV和i-BPPV患者的临床特点及转归。结果:186例BPPV患者中,23例符合t-BPPV诊断标准。t-BPPV患者男女发病比例为1∶1,而i-BPPV为1∶2.3(P<0.05);t-BPPV患者中8例(34.8%)经过1次CRP治疗后眩晕和眼震完全消失,而i-BPPV患者中139例(85.3%)经过1次CRP治疗后眩晕和眼震完全消失(P<0.05);在2年随访期间,有56.5%的t-BPPV患者和19.0%的i-BPPV患者复发(P<0.05)。结论:引发t-BPPV的创伤性质多种多样,t-BPPV比i-BPPV的复发率高。

Objective：To compare the clinical presentation and outcome between patients with traumatic-BPPV （t-BPPV）and idiopathic-BBPV（i-BPPV）.Method：The clinical records of 186patients with posterior canal BPPV were reviewed retrospectively.All patients were diagnosed using the Dix-Hallpike test and treated with the canalith repositioning procedure.The outcome of patients with t-BPPV was compared with patients with i-BPPV.Result：Twenty-three of 186patients with BPPV fulfilled the diagnostic criteria for t-BPPV.Women were affected i-BBPV more often than men（2.3∶1）,and women and men were equally affected t-BBPV（1∶1）.After one physical treatment,34.8%of patients with t-BPPV had complete resolution of signs and symptoms in comparison to 85.3%of patients with i-BPPV（P0.05）.During the 2-year follow-up,56.5%of t-BPPV patients and 19.0% of i-BPPV patients had recurrent attacks（P0.05）.Conclusion：The nature and severity of the traumas causing t-BPPV are diverse.It appears that t-BPPV is more difficult to treat than i-BPPV,and also has a greater tendency to recur.