耳石复位法治疗良性阵发性位置性眩晕后体位限制的必要性研究

The necessity of post-maneuver postural restriction in treatingbenign paroxysmal positional vertigo

目的:良性阵发性位置性眩晕(BPPV)多采用耳石复位法治疗,为了确保疗效及防止复发,在治疗后一般进行限制性体位,本文对限制体位的必要性进行评价。方法:将符合本研究纳入标准的68例后半规管BP-PV患者进行Epley手法复位治疗,之后再随机分成限制体位组及自由体位组,限制体位组患者在复位后48h内严格控制体位活动方式,自由体位组患者则不进行任何限制。分别于治疗后1周及3个月进行随访,了解治疗结果及复发情况。结果:1周内及3个月后随访其治愈率略有差异,但无统计学意义。结论:复位法治疗BPPV疗效确切,治疗后限制体位会对患者生活及心理产生负面影响,并且对治疗效果无显著影响,建议Epley手法复位治疗之后不限制体位。

Objective：To evaluate the necessity ofpostural restrictions after repositioning maneuvers in posteri- or canal benign paroxysmal positional vertigo（BPPV）. Method： Sixty-eight consecutive patients diagnosed of poste rior canal BPPV with a positive Dix-Hallpike test. Thirty-two patients were instructed to follow postural restric- tions after repositioning maneuvers, and 36 patients did not receive any postural restriction after treatment. All the patients were reevaluated at 1 week and 3 months later respectively. Result：There was no statistical difference in number of maneuvers needed to resolve symptoms between two groups. Conclusion： Epley maneuver is effective to treat patients with posterior canal BPPV, and postural restrictions does not improved the efficacy. Above all, we do not recommend any postural restrictions to patients with posterior canal BPPV.