高龄良性阵发性位置性眩晕患者的临床特点及短期疗效分析

Clinical characteristics and short term outcome of very old benign paroxysmal positional vertigo patients

目的:通过回顾性分析高龄良性阵发性位置性眩晕(v-BPPV)患者的临床特点及预后,为治疗v-BPPV提供临床依据。方法:共纳入19例符合条件的v-BPPV患者,年龄80~91岁;诊断为水平半规管BPPV(HCBPPV)10例,后半规管BPPV(PC-BPPV)4例,多个半规管受累5例。根据对应半规管的耳石症采取相应的手法复位方式,诊断为PC-BPPV的患者采取Epley复位法或李氏复位法;诊断为HC-BPPV的患者采取Barbecue复位法或李氏复位法。治疗中进行2次复位,期间间隔5~10 min。结果:3d治愈率和有效率分别为63.16%和94.74%,1周治愈率和有效率分别为89.47%和100.00%。结论:通过正确的复位方法,v-BPPV患者也能取得良好的复位效果。年龄因素不会影响患者的预后,但应注意避免高龄患者由于自身身体状况或系统疾病可能给诊断和治疗带来的风险。

Objective：To provide evidence and strategy for treatment of very old patients with benign paroxysmal positional vertigo（v-BPPV）by retrospective analysis of v-BPPV patients.Method：According to the criteria,19 v-BPPV patients were collected,aging from 80 to 91 years old,including 10 horizontal semicircular canal BPPV（HC-BPPV）,4 posterior semicircular canal（PC-BPPV）and 5 mutiple semicircular canal BPPV patients.PC-BPPV patients were treated by Epley or Li maneuver,and HC-BPPV patients were treated by Barbecue or Li maneuver.Each patient was treated twice,with an interval of 5 to 10 minutes.Result：Rates of 3-day cure and efficacy were 63.16% and 94.74%,respectively.Rates of 1-week cure and efficacy were 89.47% and 100.00%,respectively.Conclusion：v-BPPV can have good outcomes via proper treatment.Age should not influence BPPV outcomes,while we should pay more attention to v-BPPV patientsphysiclal status and systematic diseases which may increase risk to diagnosis and treatment.