管石复位术对老年良性阵发性位置性眩晕患者跌倒的影响

The effect of particle repositioning maneuver on the falls of elderly patients with benign paroxysmal positional vertigo

目的研究老年良性阵发性位置性眩晕(BPPV)患者经管石复位术(PRM)后能否减少跌倒发作。方法回顾性研究过去5年中因BPPV跌倒的60岁以上老年患者。所有患者根据受累半规管进行相应的PRM。消除位置性眩晕和眼震后,患者接受1年期随访,并观察跌倒次数。采用Wilcoxon’s检验比较复位前后跌倒次数。结果147例患者入组,后半规管121例,水平半规管18例,前半规管8例。前半规管和后半规管BPPV采用Epley法复位,水平半规管BPPV采用Lempert法复位。患者经PRM后跌倒次数减少,所有患者复位前后跌倒次数比较(P<0.01),后半规管BPPV复位前后跌倒次数比较(P<0.01),水平半规管BPPV复位前后跌倒次数比较(P=0.01),前半规管BPPV复位前后跌倒次数比较(P=0.016),差异具有统计学意义。结论 PRM能减少BPPV老年患者跌倒发作。

Objective To study whether there will be a reduction on the falls of elderly patients with BPPV after the parti- cle repositioning maneuver（PRM）. Methods The elderly above 60 with BPPV who had falls during the past 5 year was studied retrospectively. All patients accepted the PRM according to the affected semicircular canal. After positioning verti- go and nystagmus subsidised, the patients accepted a 12 month follow-up and were investigated about the number of falls. Wilcoxon＇ s test was performed to compare the number of falls before and ＇after 12 months of the PRM. Results One hun- dred and forty seven patients were included in the study. One hundred and twenty one patients involved the posterior semi- circular canal, 18 of the lateral and 8 of the anterior. The Epley maneuver was used for posterior semicircular canal and su- perior semicircular canal BPPV, and the Lempert maneuver was used for lateral semicircular canal BPPV. We noticed a re- duction on the number of falls, with statistically significant difference when all the patients were analyzed together （ P 〈 0.01 ）, the posterior canal BPPV patients （P 〈 O. 01 ）, the lateral canal BPPV patients （P = O. 001 ） and the anterior canal BPPV patients （ P = 0.016）. Conclusion The PRM could reduce the number of falls of elderly patients with BPPV.