80岁以上老人良性阵发性位置性眩晕的诊治分析

Diagnosis and Treatment of Benign Paroxysmal Positional Vertigo in Elderly People over 80 Years Old

目的探讨回顾2014年-2018年期间收治的442例80岁以上有多种慢病的眩晕老人确诊BPPV患者,变位试验的诱发、复位的方法及疗效观察。方法应用Dix-Hallpike和Roll-test诱发试验明确诊断,对于身体受限制的老人根据个体情况进行优化检查步骤,行Epley和Barbecue翻滚法进行治疗。结果规范的变位试验与优化检查的方法阳性结果相同,复位后442例患者中420例眩晕症状完全消失,22例混合半规管和脊顶耳石治愈慢且易反复发作,多次复位治疗仍有效。结论80岁以上老人BPPV发作期诱发方法的选择根据个体化原则,规范的手法耳石复位治疗各型良性阵发性位置性眩晕效果好,治愈率达95%。

Objective To review 442 cases of vertigo patients over 80 years old with multiple chronic diseases diagnosed as BPPV who were admitted from 2014 to 2018, and to observe the methods and effects of induction and reduction of displacement test. Methods Dix-Hallpike and Roll-test induction tests were used to make a definite diagnosis. Epley and Barbecue rolling methods were used to treat the elderly with physical limitation according to their individual conditions. Results The positive results of standard displacement test were the same as those of optimized examination. After the reduction, 420 cases of vertigo symptoms disappeared completely in 442 patients, and 22 cases of mixed semicircular canals and vertebral otoliths were cured slowly and easily recurred. Multiple reduction treatments were still effective. Conclusion According to the principle of individualization and the methods for inducing during the onset of BPPV, standard manual otolith reduction is effective in the treatment of benign paroxysmal positional vertigo in the elderly over 80 years old. The cure rate is 95%.