907例典型良性阵发性位置性眩晕患者手法复位的疗效研究

Demographic characteristics and canalith repositioning efficacy in 907 patients with typical benign paroxysmal positional vertigo

目的:探讨手法复位治疗具有典型眼震的良性阵发性位置性眩晕(BPPV)患者的疗效。方法:统计分析907例具有典型眼震的BPPV患者的基本情况,并根据患者BPPV类型,应用相应的手法复位方法进行治疗,分析并总结手法复位治疗的临床效果。结果:907例具有典型眼震的BPPV患者的受累半规管分布:后半规管489例(53.9%),水平半规管312例(34.4%),前半规管63例(6.9%),多半规管受累为43例(4.8%)。根据生存分析曲线分析,后半规管BPPV中改良Semont复位法和Epley复位法的中位康复时间估计值均为3d,且2种复位法的生存曲线无明显差异;水平半规管BPPV中Barbecue复位法和李氏水平半规管复位法的中位康复时间估计值均为3d,而Gufoni复位法的中位康复时间估计值是1d,但3种复位法的生存曲线无明显差异。前半规管BPPV中李氏前半规管快速复位法于1d、3d、1周、1个月各治愈7例、31例、57例、58例,失访5例,根据生存曲线该方法的中位康复时间估计值为3d。结论:手法复位治疗方法安全,操作简单,治疗时间短,见效快,疗效确切,是治疗BPPV的首选方法。

Objective：To review the demographic characteristics and canalith repositioning efficacy in 907 patients with typical benign paroxysmal positional vertigo（BPPV）.Method：The demographic characteristics of 907 patients with typical BPPV were statistically analyzed.According to the type of BPPV,patients were treated with the appropriate repositioning maneuver,and the clinical efficacy of repositioning maneuver was analyzed and summarized.Result：Nine hundred and seven patients of BPPV with typical nystagmus were elected in this study.585 out of 907 were female and 322 out of were male,and the mean age was 53.10±14.25（13 to 89）years.The lesion located to the posterior semicircular canal was 489 patients（53.9%）,horizontal semicircular canal was 312 patients（34.4%）,anterior semicircular was 63 patients（6.9%）,and multiple semicircular was 43 patients（4.8%）.According to Kaplan-Meier survival analysis curve,the median cure time for the modified Semont and Epley repositioning maneuver in PC-BPPV groups was 3 days,and there was no significant difference in survival curves between the two repositioning maneuver.Meanwhile,the median cure time for Barbecue and Li horizontal canal quick repositioning maneuver groups was 3 days,and 1 day for Gufoni repositioning maneuver group in HCBPPV groups.And there was no significant difference in survival curves among the three repositioning maneuver.In the AC-BPPV,7 cases,31 cases,57 cases,58 cases were cured with the Li anterior canal quick repositioning maneuver in the 1 st day,the 3 rd day,1 week later,and 1 month later,and 5 cases lost to be follow-up.According to Kaplan-Meier survival analysis curve,the median cure time for the Li anterior canal quick repositioning maneuver in AC-BPPV groups was 3 days.Conclusion：Repositioning maneuver represents a simple,safe,rapid and effective approach to the treatment of BPPV.Therefore,repositioning maneuver should be choice for the BPPV treatment.