86例位置性眩晕患者的临床分析

Clinical Analysis of 86 Patients with Positional Vertigo

目的探讨位置性眩晕的可能病因及诊断治疗方案。方法回顾性分析2011年10月-2015年1月就诊于荆门市康复医院的86例位置性眩晕患者的临床资料。结果86例位置性眩晕患者中良性阵发性位置性眩晕66例、偏头痛性眩晕8例、前庭阵发症6例、精神源性眩晕1例、中枢性位置性眩晕5例（小脑梗死2例、小脑出血1例、多发性硬化1例、脑干梗死1例）。良性阵发性位置性眩晕患者中后半规管58例，其他类型半规管8例。58例后半规管良性阵发性位置性眩晕患者经复位法治疗，治愈52例、改善5例、无效1例；其他类型半规管良性阵发性位置性眩晕8例，治愈7例、改善1例；偏头痛性眩晕、前庭阵发症、中枢性位置性眩晕及精神源性眩晕行保守治疗症状缓解。结论位置性眩晕的病因诊断、规范化检查和系统治疗是避免误诊误治的关键。

Objective To explore the possible causes, diagnosis and treatment of positional vertigo. Methods The clinical data of 86 patients with positional vertigo in Jingmen Recovery Hospital from October 2011 to January 2015 was retrospectively analyzed. Results In 86 patients with positional vertigo, there were 66 cases of benign paroxysmal positional vertigo, 8 cases of migrainous vertigo, 6 cases of paroxysmal vestibular disease, one case of psychogenic vertigo, 5 cases of central positional vertigo （2 cases of cerebellar infarction, one case of cerebellar hemorrhage, one case of multiple sclerosis and one case of brain stem infarction）. There were 58 cases of posterior semicircular duct in patients with benign paroxysmal positional vertigo, and after reset therapy, 52 cases were cured, 5 cases were improved and one case showed no effect. There were 8 cases of other types of semicircular duct in patients with benign paroxysmal positional vertigo, in which 7 cases were cured and one case was improved. The patients with migrainous vertigo, paroxysmal vestibular disease, central positional vertigo and psychogenic vertigo underwent conservative treatment and the symptoms were relieved. Conclusion It is crucial for the prevention from misdiagnosis and wrong treatment to diagnose the cause of positional vertigo and standardize the examination and treatment of the disease.