良性阵发性位置性眩晕患者的静态平衡功能特点研究

The Characteristics of Postural Stability in Patients with Benign Paroxysmal Positional Vertigo

目的探讨良性阵发性位置性眩晕（benign paroxysmal positional vertigo，BPPV）患者视觉in／或本体觉受干扰后的静态平衡功能特点。方法对比分析132例BPPV患者及124例健康对照者在4种静态平衡测试模式[睁眼状态下站立于坚硬平板上（YEO）；闭眼状态下站立于坚硬平板上（YEC）；睁眼状态下站立于海绵垫上（HEO）；闭眼状态下站立于海绵垫上（HEC）]下动摇总轨迹长（L）。结果不同年龄组和管型的BPPV患者治疗前、后动摇总轨迹长（L）均高于健康对照组；治疗前BPPV患者动摇总轨迹长（L）高于治疗后。治疗前，老年P-BPPV及M-BPPV患者在YEC和HHEC模式下、中青年P-BPPV及M-BPPV患者在HEC模式下的L均与对照组有显著性差异（P〈0．05）；治疗后，老年M-BPPV与对照组在YEC模式下有显著性差异（P〈0．05）。治疗前后，老年P-BPPV及M-BPPV患者在HEC模式下测试结果有显著性差异（P〈0．05）。结论良性阵发性位置性眩晕患者存在平衡障碍问题，特别是老年患者。进行复位治疗后大部分患者的平衡障碍问题能够得到改善，不过部分患者仍存在平衡障碍问题。积极对这类患者实施复位以及康复训练，可以有效促进其平衡功能的康复。

Objective To investigate the characteristics of postural stability in patients with benign paroxysmal positional vertigo （BPPV） when visual and/or somatosensory input for upright standing is interrupted. Methods 132 BPPV patients and 124 age and gender matched healthy controls received the posturography including four conditions： firm surface with eyes open（YEO）; firm surface with eyes closed（YEC）; foam surface with eyes open（HEO）; foam surface with eyes closed（HEC）. The body sway length recorded by the posturography was analyzed as a parameter of postural stability. The postural stability of the BPPV patients was compared with that of the control group. Results The sway lengths of the BPPV patients were higher than those of the control group before and after treatment. After treatment, the sway lengths of BPPV pateints were less than those before treatment. Before treatment, there were significant differences between the elderly P-BPPV and M-BPPV patients under YEC and HEC mode, young P-BPPV and M-BPPV patients under HEC mode and the control group（P〈0.05）. There was no significant difference between the post-treatment result of elderly M-BPPV and that of control group under YEC mode（P〈0.05）. After treatment, elderly P-BPPV and M-BPPV patients showed significant improvement under HEC mode （P〈0.05）. Conclusion The balance disorders are commonly seen in patients with benign paroxysmal positional vertigo, particularly in elderly patients. Canalith repositioning maneuvers can improve the balance disorders in most BPPV patients, but is ineffective for some patients. Successful canalith repositioning maneuvers and vestibular rehabilitation training can effectively promote the rehabilitation of balance functions for these patients.