上半规管良性阵发性位置性眩晕的临床分析

Clinical analysis of anterior semicircular canal benign paroxysmal positional vertigo

目的探讨上半规管良性阵发性位置性眩晕(anterior semicircular canal benign paroxysmal positional vertigo,AC-BPPV)的临床特点。方法回顾性分析16例AC-BPPV患者临床特点,并对耳石复位的疗效进行评估。结果①在Dix-Hallpike检查中,16例患者都诱发出垂直向下的眼震,其中11例双侧出现眼震,5例单侧出现眼震。②13例患者能明确受累侧别,其中5例为左侧AC受累,8例为右侧AC受累;3例受累侧别难以判断。③对13例受累侧别明确的患者采取反向颗粒复位手法治疗,5例痊愈,4例有效、4例无效;对4例无效患者再行Semont方法治疗,其中2例有效,2例仍无效。对3例受累侧别难以判断的患者采用Yacovino方法治疗后均痊愈。结论 AC-BPPV在临床中并不少见,耳石复位法疗效明确,可根据患者实际情况选择适当的复位方式。

OBJECTIVE To investigate the clinical characteristics of anterior semicircular canal benign paroxysmal positional vertigo（AC-BPPV）.METHODS The clinical features in 16 patients with AC-BPPV and the efficacy of the canalith repositioning procedure（CRP） were analyzed retrospectively.RESULTS 1.During the Dix-Hallpike examination,16 patients presented positional down beating nystagmus,of which 11 cases appeared bilateral nystagmus,5 cases appeared.unilateral nystagmus.2.13 cases had unilateral lesion,of which 5 cases were the left AC involvement,8 cases were the right AC involvement;3 cases were difficult to judge the affected side.3.13 cases were treated by reverse particle repositioning maneuver,5 cases cured,4 cases effective,4 cases invalid;then 4 invalid cases were treated by Semont maneuver,of which 2 cases were cured,2 cases were still invalid;3 cases were recovered by Yacovino maneuver.CONCLUSION AC-BPPV is not rare in clinic.CRP was effective to AC-BPPV patients,and doctors may choose the appropriate repositioning maneuver.