自制视频眼震记录仪在良性阵发性位置性眩晕的应用

Clinical application of self-made video-nystagmography in benign paroxysmal positional vertigo

目的探讨自制视频眼震记录仪在良性阵发性位置性眩晕(BPPV)中的临床应用价值。方法回顾分析2011年2月～2012年2月在本院治疗的84例BPPV患者的资料。对所有患者全面采集病史,并利用自制视频眼震记录仪记录眼震,根据眼震特点判断并行耳石手法复位。结果 84例确诊BPPV患者在变位试验中,自制视频眼震记录仪记录眼震清晰,逆时针眼震36例(42.9%)、顺时针眼震24例(28.6%);水平向地性眼震17例(20.2%)、水平背地性眼震6例(7.1%)(其中经Gufoni法可转变为向地性眼震4例、不能转变2例);无眼震1(1.2%)例。所有确诊患者均行耳石手法复位治疗,一次性治愈率72.2%,其中有7例在手法复位中检测眼震方向改变为反向,给予重新复位后治愈。所有患者经1～6次耳石复位后均治愈。结论自制视频眼震记录仪价格低廉、操作方便、可重复性强、眼震记录较清晰、易存储、资料提取方便,有助耳石类型及侧别判断,在其辅助下耳石手法复位可提高复位的精确度和准确性,同时成本低廉,尤其适合基层医院的临床专科人员进一步开展眩晕疾病诊治工作,值得推广。

Objective To explore the clinical value of self-made video--nystagmography （VNG） in benign paroxysmal positional vertigo（BPPV）. Methods Data of 78 patients with BPPV accepted from Feb. 2011 to Feb. 2012 were analyzed retrospectively. All patients were investigated and analyzed by history taking and nystagmus recording, then underwent appropriate positioning maneuvers according to the characteristics of the nystagmus. Results Among 84 BPPV patients, all kinds of nystagmus were recorded clearly by self-made VNG. Involvement of counterclockwise nystagmus, clockwise nystagmus horizontal geotropic nystagmus and horizontal apogeotropic nystagmus were seen in 36 （42.9%）, 24（28.6% ） ,17（20.2% ） and 6（7.1% ） patients respectively. No nystagmus was seen in one （ 1.2% ） patient. All patients underwent canalith repositioning maneuver （CRM） with the cure rate being 72. 2% after once canalith repositioning maneuver. A reversed nystagmus occured in 7 patients during maneuver, but disappeared after receiving maneuvers again. All patients could be cured after undergoing maneuvers for 1 -6 times. Conclusions Self- made VNG could be helpful for clinical diagnosis and treatment of BPPV. Because of its cheapness, conveniency, repeatability and clearness, it is especially suitable for physicians in primary hospitals to deal with vertigo diseases.