多半规管良性阵发性位置性眩晕仪器辅助诊疗效果分析

Clinical features, managements and outcomes of multicanal benign paroxysmal positional vertigo

目的总结多半规管良性阵发性位置性眩晕(multicanal benign paroxysmal positional vertigo,MC-BPPV)的临床特点、治疗及预后。方法对2014年1月至2016年8月在中国武警总医院眩晕科被诊断为BPPV的住院病例进行回顾性分析。针对MC-BPPV的临床特征、复位治疗策略与效果进行分析总结,并通过在治疗后1、3、6和12个月的定期随访,分析与评价其复发情况及预后。结果在96例多半规管BPPV病例中,双侧后半规管管石症型26例(27.1%);一侧后半规管管石症型合并对侧水平半规管管石症者5例(5.2%);一侧后半规管合并同侧水平半规管65例(67.7%)。平均复位(3.60±2.07)次;复位治疗后1、3、6和12个月的累积复发率分别为5.2%、11.5%、19.8%和31.4%。结论 MC-BPPV通过细致检查可得到明确诊断及有效地复位治疗,复位治疗后虽具有较高的复发率,但仍可得到成功复位治疗。

Objective To evaluate the clinical features, management, treatment outcomes and prognosis of multi- ple canal benign paroxysmal positional vertigo （MC-BPPV）. Methods A retrospective study of 96 cases with MC-BPPV who were diagnosed and treated at the Vertigo Unit, the General Hospital of Chinese People＇ s Armed Police Forces between January 2014 and August 2016 were included for analysis. All patients were regularly followed-up at 1, 3, 6, and 12 months after successful repositioning treatment. The clinical characteristics, repositioning treatment outcomes, and recurrence of MC-BPPV were evaluated. Results Of the 96 cases with MC-BPPV, 26 （27.1%） cases were with involvement of bilateral posterior canals, 5 （5.2%） cases were with BPPV of posterior canal and contralateral horizontal canal, and 65 cases （67.7%） were with BPPV of posterior canal and ipsilateral horizontal canal. All patients with MC-BPPV were cured with an average of 3.6 therapeutic sessions per patient. With follow-up, cumulative recurrent rates at 1, 3, 6 and 12 months after successful reposifioning treatment were 5.2%, 11.5%, 19.8%, and 31.4%, respectively. Conclusion Although with difficulty in management, definite diagnosis and successful repositioning treatment for MC-BPPV can be obtained. Recurrence is common in MC-BPPV, however, successful repositioning treatment can be obtained again in recurrent cases.