良性阵发性位置性眩晕复发的临床特征分析

Clinical features of recurrences in benign paroxysmal positional vertigo

目的:探讨良性阵发性位置性眩晕(BPPV)复发的临床特征及可能的相关因素。方法:将复位治疗后复发的80例BPPV患者分为青年组(21例)、中年组(25例)和老年组(34例),收集和总结3组年龄、性别、病理类型及半规管位置改变等临床资料,并对再次复位的疗效进行分析。结果:本研究中原发性BPPV患者62例(77.5%),继发性BPPV 18例(22.5%)。原诊与复发半规管均以外半规管和后半规管多见,二者差异无统计学意义(P>0.05)。复发位置为同一半规管的患者占48.75%,同耳侧不同管占21.25%、不同耳侧占30.00%。复发后治疗随访1个月,总治愈率高达96.25%,一次性复位成功率为56.25%。结论:BPPV复发患者的年龄、性别、类型以及发生半规管的位置等存在一定的临床特征,较长的复发病程及变化率较高的半规管位置均支持来源于新耳石的观点。

Objective：To study the clinical features of patients with recurrent benign paroxysmal positional vertigo（BPPV）and to analyze potential related factors of recurrences.Method：Eighty patients who suffered recurrent BPPV were enrolled in this study.Patients were divided into three groups：young group（21 cases）,middleaged group（25 cases）and old-aged group（34 cases）.The clinical data including age,gender,pathological pattern and canal type of BPPV were collected.We further analyzed the efficacy of repositioning treatment for recurrent BPPV.Result：In this study,there are 62 cases of primary BPPV（77.50%）and 18 cases of secondary BPPV（22.50%）.In patients with recurrent BPPV,the laterior semicircular canal BPPV and posterior semicircular canals BPPV were the most common,and there was no differences on the aspects of age and gender in the two groups of patients with recurrent HSC BPPV and PSC BPPV（P〉0.05）.Compared with the primary diagnosis,we found that 48.75%cases relapsed in the same semicircular canals,21.25%cases relapsed in other canals of the same ear,and 30.00%cases relapsed in a different ear.In this study,96.25% patients with recurrent BPPV were cured in a month and one-time reset success rate was 56.25%.Conclusion：The age,gender,pathological pattern and canal type show certain clinical features of recurrent BPPV.The evidence of long term of recurrence course and high variability of problematic location support the approval opinion based on new otolith.