体位限制对手法复位后良性阵发性位置性眩晕的疗效观察

Curative effect of postural restriction on benign paroxysmal positional vertigo after manual reduction

目的探讨手法复位后体位限制对良性阵发性位置性眩晕(BPPV)患者的疗效。方法 2015年12月至2016年6月共收治BPPV患者210例,随机分为手法复位后联合体位限制组(观察组)105例和单纯手法复位组(对照组)105例,其中后半规管BPPV(PSC-BPPV)患者两组各70例,向地性水平半规管BPPV(HSC-BPPV)患者两组各25例,背地性HSC-BPPV患者两组各10例。结果 PSC-BPPV两组短期7 d和3个月疗效差异均无统计学意义(P=0.515,P=0.967);向地性HSC-BPPV和背地性HSC-BPPV患者两组短期7 d疗效差异均有统计学意义(P=0.030,P=0.040),长期疗效评价无统计学意义(P=0.972)。结论 PSC-BPPV患者行手法复位后可不予体位限制,HSC-BPPV患者手法复位后需要行体位限制,待患者无任何症状后可以自由体位。

Objective To examine the effect of postural restriction on patients with benign paroxysmal positional vertigo （ BPPV） after manual reduction. Methods A total of 210 cases of BPPV including 140 with posterior semicircular ca-nal （ PSC）-BPPV and 70 with horizontal semicircular canal （ HSC）-BPPV （ 50 HSC-BPPV and 20 apogeotropic HSC-BPPV） were randomly divided into a combined position restriction group （ observation group） and a control group. Results In patients with PSC-BPPV, there was no significant short-term （ 7 days） or long-term （ 3 months） difference in curative effect between the two groups （ P=0.515, P=0.967） . There was a statistically significant difference during short-term evaluation （P=0.030, P=0.040） but no significant difference （P=0.972） in the long-term curative effect between the HSC-BPPV and apogeotropic HSC-BPPV groups. Conclusion Postural restriction therapy is not needed in PSC-BPPV but should be used in HSC-BPPV until symptoms remit.