60岁以上老年眩晕临床分析

Clinical Analysis of Vertigo in Elderly Patients over 60 years of Age

目的分析60岁以上老年眩晕发病、治疗与预后情况,总结诊治经验。方法整群选取2015年1—12月该院门急诊收治老年眩晕患者441例,患者入院后,都进行详细的病史问询、体格检查,据伴随症状选择合适的辅助检查手段,转相关科室诊断,急诊入院患者,明确诊断前,保证休息,卧床,对症治疗,明确诊断后转科或门诊停留针对病因治疗,对比不同病种相关资料。结果除眩晕外,伴恶心/呕吐、耳鸣听力下降、肢体麻木、气促、头痛、肢体功能障碍;最终诊断BPPV、脑血管病、精神原因诱发眩晕、突发性耳聋/梅尼埃病、其它分别占44.90%、26.08%、13.83%、7.03%、其它8.16%,不同疾病年龄、院内停留时间、24 h明确诊断率、眩晕病史、门诊出院率、随访复发率差异具有统计学意义(P<0.05)。结论 60岁以上老年眩晕病因复杂,多见BPPV、后循环缺血,多数可在门诊治疗,部分需住院治疗,复发率高。

Objective To analyze the above 60 years old of vertigo, treatment and prognosis, summarize the experience of diagnosis and treatment. Methods Group selection January to Decembr 2015, outpatient and emergency patients were elderly vertigo in 441 Cases, all patients after admission, history inquiry, detailed physical examination, according to the accompanying symptoms to choose appropriate means of auxiliary examination, the relevant departments to diagnosis. Emergency patients, before the diagnosis, to ensure the rest, bed, symptomatic treatment after diagnosis, stay or outpatient treatment for the cause, comparison of different disease related data. Results Except with vertigo, nausea / vomiting, tinnitus, hearing loss, limb numbness, shortness of breath, headache, limb dysfunction; the final diagnosis of BPPV and cerebrovascular disease the spirit, cause dizziness, sudden deafness / Meniere＇s disease, other accounted for 44.90%, 26.08%, 13.83%, 7.03%,8.16%, different diseases, age, residence time in the hospital, 24 h definite diagnosis rate. History of halo, outpatient hospital discharge rate, recurrence rate, the difference was statistically significant（P〈0.05）. Conclusion Over the age of 60 elderly patients with vertigo complex etiology, common BPPV, posterior circulation ischemia. The majority of the therapy in the clinic, which need to be hospitalized and the recurrence rate is high.