尽早耳石复位治疗对BPPV的疗效及对复发的影响

Effect of earlier canalith repositioning maneuver on BPPV and impact on reoccurrence

目的探讨尽早进行耳石颗粒复位对良性阵发性位置性眩晕(BPPV)患者的治疗效果及对其复发率的影响。方法不同病程(≤12 h组和>12 h组)的126例BPPV患者均行手法复位治疗,治疗1 w和1年后复查,分析比较两组的临床治愈率和1年内的复发率。结果病程越短的BPPV患者,其1 w(短期)临床治愈率越高(P<0.05);但病程不等的患者在1年时(长期)的临床治愈率相当(P>0.05)。病程越短的BPPV患者,1年内的复发率越低(P<0.05或P<0.01),达到临床治愈所需要的手法复位次数越少(P<0.05)。结论 BPPV患者的复发率与患病程密切相关,BPPV患者应尽早进行手法复位治疗。

Objective To discuss the curative effect of canalith repositioning maneuver performing as early as possible on patients with benign paroxysmal positional vertigo（BPPV）and the impact on reoccurrence. Methods 126 cases with BPPV were divided into 2 groups according to the length of disease course：group ≤12 h and group ﹥ 12 h;canalith repositioning maneuver was performed on all the patients in both groups;reexamination was made 1 week and 1 year after treatment;the cure rate and the reoccurrence within 1 year in the 2 groups were compared and analyzed. Results The short-term clinical cure rate（1 week）was higher in patients of shorter disease course（P ﹤ 0. 05）,while the long-term clinical cure rate（1 year）was equal in patients of different length of disease course（P ﹥ 0. 05）;the reoccurrence within 1 year was lower in patients of shorter disease course（P ﹥ 0. 05 or P ﹤0. 01）and less times of canalith repositioning maneuver was needed to achieve clinical cure（ P ﹤ 0. 05）. Conclusions The reoccurrence of BPPV is in close correlation with the length of disease course;canalith repositioning maneuver should be performed on patients with BPPV as early as possible.