良性阵发性位置性眩晕中眩晕分级治疗的临床分析

The clinical analyse of vertigo classification in benign paroxysmal positional vertigo

目的探讨根据眩晕分级选择不同的方法治疗良性阵发性位置性眩晕BPPV患者的临床应用价值。方法收集2016年1月-2017年5月苏州市立医院北区的137例BPPV患者,根据眩晕分级分为四组,门诊组(第1组:0～Ⅰ级,药物治疗;第2组:Ⅱ～Ⅲ级,门诊复位CRP+药物治疗)和住院组:Ⅳ～Ⅴ级(第3组:药物治疗;第4组:复位+药物治疗),观察不同治疗方法的临床效果。结果 4组1w的治愈率分别为25%、96.3%、20.8%和47.7%;1个月治愈率分别为83.3%、96.3%、87.5%和95.5%。第1组和2、4组1w治愈率有差异性,P<0.05;第3、4组间1w治愈率差异有统计学意义。结论本研究表明,0～Ⅲ级的BPPV患者,门诊治疗疗效肯定;分级较轻的患者即使单纯药物治疗,也可以恢复;对于Ⅳ～Ⅴ级的BPPV患者,通过住院治疗可以取得良好的治疗效果;手法复位疗效肯定。通过眩晕分级选择合适的治疗方案,能够节省医疗资源,达到相似的治疗效果。

Objective To explore the clinical value of different treatment methods according to vertigo classification to cure the patients with benign paroxysmal position vertigo（BPPV）. Method137 patients with BPPV were included in this study who were confirmed by the Northern Area of Suzhou Municipal Hospital from January 2016 to May 2017. The patients were divided into the outpatient group （the first group0-Ⅰlevel, with drug therapy;the second group：Ⅱ-Ⅲ level , CRP and drug therapy） and the inpatient group（the third group： Ⅳ-Ⅴlevel,with drug therapy;the four group：Ⅳ-Ⅴlevel,with CRP and drug therapy）according to vertigo classification, and observed the clinical effect of different treatment methods. Results The one week cure rate of the four groups were 25%, 96.3%, 20.8% and 47.7%. The one month cure rate were 83.3%, 96.3%, 87.5% and 95.5%. There was statistically significant difference between the first group and the second group, the fourth group about one week cure rate, P〈0.05. There was statistically significant difference between the third group and the fourth group about one week cure rate, P〈0.05. Conclusion The patients of 0-Ⅲ level BPPV can be given the outpatient treatment and gain the affirmative curative effects. The patients with lighter level can recover even if they are treated with medication alone. The Ⅳ-Ⅴlevel BPPV patients can achieve good therapeutic effects through hospitalization. The results of our research showed that CRP can be effective. Selecting the appropriate treatment according to vertigo classification can save medical resources and achieve similar therapeutic effects.