外伤后良性阵发性位置性眩晕手法复位疗效欠佳原因分析

Causes for Poor Outcomes after Manual Reduction in Trauma-Related Benign Paroxysmal Positional Vertigo

目的探讨外伤后良性阵发性位置性眩晕手法复位疗效欠佳的原因。方法回顾性分析2016年12月—2018年12月南华大学附属第二医院眩晕门诊确诊的外伤后良性阵发性位置性眩晕患者186例,将其设为观察组,选取同期确诊的相同例数特发性良性阵发性位置性眩晕患者为对照组,两组患者经耳石复位后1月复查,比较两组疗效;此外对观察组中疗效欠佳者的年龄、既往疾病、睡眠状态、受伤部位等资料进行分析,寻找外伤后BPPV复位疗效欠佳的原因。结果观察组较对照组复发率明显增高(P<0.01);观察组中年龄≥60岁、高血压、糖尿病、冠心病、脑血管病、头部外伤及睡眠障碍患者耳石复位疗效欠佳(P<0.01)。结论外伤后良性阵发性位置性眩晕复发较特发性良性阵发性位置性眩晕明显增高,除外伤外,年龄≥60岁、既往心脑血管疾病、头部外伤及睡眠障碍等也是其高危因素。

Objective To report possible causes for poor outcomes after manipulative reduction in patients with benign paroxysmal positional vertigo associated with trauma.Methods The study retrospectively reviewed 186 cases of trauma-related BPPV seen between December 2016 and December 2018 at the Second Affiliated Hospital of South China University which were set as the study group,while randomly selected cases of idiopathic BPPV of the same period were used as the control group.Outcomes in the two groups at 1 month after otolith repositioning were compared.Age,existing diseases,injury site,sleep and other data of cases with poor outcomes in the study group were also analyzed to determine possible causes for poor treatment efficacy.Results The recurrence rate in the study group was significantly higher than that in the control group(P<0.01).Among patients in the study group,age≥60 years,hypertension,diabetes,coronary heart disease,cerebrovascular diseases,head trauma and sleep disorders were associated with poor outcomes(P<0.01).Conclusion Recurrence in trauma-related benign paroxysmal positional vertigo is significantly higher than in idiopathic benign paroxysmal positional vertigo.In addition to trauma,age≥60 years,previous cardiovascular and cerebrovascular diseases,head trauma and sleep disorders are also high risk factors.