相应侧Epley手法复位治疗可能的后半规管良性阵发性位置性眩晕疗效分析

Clinical Efficacy Analysis of Epley maneuver for Possible Posterior SemicanalBenign Paroxysmal Positional Vertigo

目的:探讨可能的后半规管良性阵发性位置性眩晕患者相应侧Epley手法复位后的治疗效果。方法:以2015年1月-2017年12月中山大学附属第六医院急诊及神经科门诊就诊的、可能的后半规管良性阵发性位置性眩晕患者为研究对象,应用Dix-hallpike及Roll-test动作行变位试验明确诊断,并行相应侧的Ep-ley手法复位,复位后2周及4周定期随诊。结果:符合纳入标准的107例患者在经过1-3次的Epley复位治疗后,有86例阵发性眩晕均完全缓解,眩晕缓解患者随访2周和4周,随访期内无复发。结论:可能的后半规管良性阵发性位置性眩晕缺少统一的诊疗方案,目前单纯药物治疗效果欠佳。相应侧的Epley手法复位可以有效缓解大部分此类患者的头晕症状,提高患者满意度,减轻急诊接诊医生的压力。

Objective： To evaluate the efficacy of Epley maneuver on possible posterior semicanal benign paroxysmal positional vertigo （PSC-BPPV）. Methods ： A study was carried out on 107 patients with possible PSC-BPPV from neurolog/cal clinic and emergency department from Jan. 2015 to Dec. 2017. After being diagnosed by Dix-Hallpike test and Roll test, the cases were treated by Epley maneuver on corresponding side and reexamined two weeks and four weeks later. Results： 107 cases who met the inclusion criteria were reseted by Epley maneuver. After being treated 1-3 times, out of 107 cases, ＂paroxysmal vertigo＂ symptom in 86 cases were completely vanished. During the four-week follow-up, no vertigo was seen in the remission cases. Conclusion ： There is no criterion for the treatment of possible PSC-BPPV.Medical therapy alone is ineffective. The study tells us that corresponding side Epley maneuver could relieve ＂vertigo＂ symptom in most possible PSC-BPPV cases. The treatment should contribute to enhancing degree of satisfaction of patients and reducing stress of emergency doctor.