BPPV的临床特点及手法复位复发率分析

Clinical features and recurrence rate on benign paroxysmal positional vertigo

目的:探讨BPPV的临床特点及手法复位复发率。方法:回顾性分析735例BPPV患者的临床资料。后半规管BPPV(PC-BPPV)采用Epley复位法;水平半规管BPPV(HC-BPPV)采用Barbecue复位法;上半规管BPPV(AC-BPPV)采用Yacovino复位法;混合型BPPV采用Epley加Barbecue联合疗法;双侧病变者先复位较严重的一侧,待较严重一侧眼震或眩晕完全消失后,再复位症状较轻的一侧。结果:①735例BPPV患者中,PC-BPPV 455例(61.90%),HC-BPPV 272例(37.01%),AC-BPPV 3例(0.41%),混合型BPPV 5例(0.68%)。②735例BPPV患者电话随访到455例,3年内复发51例,复发率11.21%;男性复发率25.68%(38/148),女性复发率28.66%(88/307)。51~60岁复发人数最多,复发率29.67%。③PC-BPPV患者电话随访到300例,其中复发81例(27.00%),1个月、6个月、1年、2年、3年的复发率分别为0.67%(2/300)、3.33%(10/300)、6.67%(20/300)、9.33%(28/300)和11.67%(35/300);HC-BPPV患者电话随访到155例,其中复发45例(29.03%),1个月、6个月、1年、2年、3年的复发率分别为0(0/155)、2.58%(4/155)、3.23%(5/155)、7.10%(11/155)和9.68%(15/155)。结论:BPPV患者发病以PC-BPPV多见,手法复位能有效治疗BPPV,BPPV复发率与年龄、性别无关,PC-BPPV与HC-BPPV的远期复发率一致。

Objective:To study the characteristics and the recurrence rate of manual reduction of BPPV.Method:The clinical characteristics of 735 patients with BPPV were analyzed retrospectively.The posterior semicircular canal BPPV(PC-BPPV)was treated with the Epley maneuver therapy;the horizontal semicircular canal BPPV(HC-BPPV)was treated with the Barbecue therapy;the anterior semicircular canal BPPV(AC-BPPV)was treated with the Yacovino therapy;the combined semicircular canal was treated with the Epley and the Barbecue therapy;and for the bilateral lesions,first treat the more severe side with manual reduction then the lighter side was treated with manual reduction after the more severe side nystagmus or vertigo completely disappears.Result:①Of the 735 patients with BPPV,455(61.90%)were PC-BPPV,272(37.01%)were HC-BPPV,3(0.41%)were AC-BPPV,and 5(0.68%)were combined BPPV.②A total of 455 patients with BPPV were followed up by telephone.51 patients recurred within 3 years,the recurrence rate was 11.21%;the male recurrence rate was 25.68%(38/148),and the female recurrence rate was 28.66%(88/307).The recurrence rate was the highest in 51-60 years old,and the recurrence rate was 29.67%.③300 patients with PC-BPPV were followed up by telephone,81 cases(27.00%)recurred,and the recurrence rates of one month,six months,one year,two years,and three years were 0.67%(2/300),3.33%(10/300),6.67%(20/300),9.33%(28/300)and 11.67%(35/300)respectively;155 patients with HC-BPPV were followed up by telephone,45 cases(29.03%)recurred,the recurrence rates of one months,six months,one year,two years,and three years were 0(0/155),2.58%(4/155),3.23%(5/155),7.10%(11/155)and 9.68%(15/155)respectively.Conclusion:PC-BPPV is the most common disease in BPPV patients.Manual recurrence can effectively treat the recurrence rate of BPPV,female patients is slightly higher than that of male patients.The long-term recurrence rate of PC-BPPV is consistent with that of HC-BPPV.The BPPV were most common in posterior semicircular canal.Manual reduction is effective to treat BPPV cases.BPPV recurrence was not correlated with age and gender.The long-term recurrence rate of PC-BPPV and HC-BPPV is consistent.