眼震电图监视下改良手法复位在良性阵发性位置性眩晕中的应用

Application of the reformed canalith repositioning maneuver by videonystagmography guarding for benign paroxysmal positional vertigo

目的探讨眼震电图监视下改良手法复位治疗良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)的临床价值。方法经眼震电图监视下行位置诱发试验(Dix-Hallpike test)及滚转试验(turning head test)确诊为BPPV的56例患者,对其中44例PC-BPPV的患者采取改良Epley或改良Semont加改良Epley手法复位法,对12例HC-BPPV患者用改良Barbecue手法复位法。结果改良Epley或改良Semont加改良Epley手法复位法治疗PC-BPPV患者,治愈38例(86.36%),有效4例(9.09%),无效2例(4.55%)。改良Barbecue手法复位法治疗HC-BPPV患者,治愈8例(66.67%),有效4例(33.33%)。复位过程中1例后半规管结石误入水平半规管,经采用改良Barbecue手法复位治愈。结论眼震电图监视下手法复位治疗良性位置性眩晕,治疗效果好,简单,安全,值得推广。

Objective To investigate the clinical value of the modified eanalith repositioning maneuver by videonystagmography guarding for benign paroxysmal positional vertigo （BPPV）. Methods Dix-Hallpike test and turning head test were applied to diagnose the 56 cases of BPPV. The modified Epley maneuver or modified Semont and Epley maneuver was applied to 44 cases of PC-BPPV, the modified Barbecue maneuver was applied to 12 cases of HC-BPPV. Results After treatment of modified Epley maneuver or modified Semont and Epley maneuver in 44 cases of PC-BPPV,positional vertigo disappeared completely in 38 cases（86.36%） ,and in 4 eases（9.09%）the therapy was effective. In 2 case （4.55%）the therapy had no effect. After treatment of modified Barbecue maneuver in 12 cases of HC-BPPV, positional vertigo disappeared completely in 8 eases（66.67%）,and in 4（33. 330%） the therapy was effective. 1 patient transformed from PC-BPPV to HC-BPPV during modified Epley maneuver, and which got well by modified Barbecue maneuver. Conclusion For benign paroxysmal positional vertigo, the eanalith repositioning maneuver by videonystagmography guarding was recommended.