经过手法复位的良性阵发性位置性眩晕再发的原因分析

Cause Analysis of Recurrence of Benign Paroxysmal Positional Vertigo after Manual Reduction

目的:分析经过手法复位的良性阵发性位置性眩晕(benign positional paroxysmal vertigo,BPPV)再发的原因。方法:收集2017年6月-2019年7月本院神经内科二病区收治的BPPV患者102例。所有患者均进行眼震电图检查,定位诊断后给予不同的复位。患者在出院后分别在第1、2、3个月以电话或微信方式进行随访,共随访3次。采用单因素及多因素分析复发的影响因素。结果:102例患者均随访3个月,第1个月失访3例,第2个月失访7例,第3个月失访9例,完成随访83例,脱落率18.6%。随访第1个月复发率为6.1%(6/99),第2个月复发率为10.5%(9/86),第3个月复发率为17.6%(12/68)。其中复发27例,未复发56例。两组的年龄、合并高血压、合并糖尿病、合并高脂血症、病程、发作次数、复位次数比较,差异均有统计学意义(P<0.05)。经多因素logistic回归分析,复位次数≥10次、病程为BPPV再发的独立危险因素(P<0.05)。结论:BPPV是中老年易发的外周性眩晕疾病,尽管治疗效果肯定,但有复发倾向,缩短发病时程,减少复位次数是降低BPPV复发的重要因素,可以对BPPV患者采取针对性的干预措施来减轻患者的症状,减少其复发。

Objective:To analyze the causes of recurrence of benign positional paroxysmal vertigo(BPPV)after manual reduction.Method:A total of 102 BPPV patients admitted to our hospital from June 2017 to July 2019 were collected.All patients were examined by electronystagmography,and different repositions were given after localization and diagnosis.Patients were followed up by telephone or WeChat at 1,2 and 3 months after discharge,with a total of 3 follow-up visits.The influencing factors of relapse were analyzed by univariate and multivariate methods.Result:All 102 patients were followed up for 3 months,3 cases were lost to follow up in the first month,7 cases were lost to follow up in the second month,and 9 cases were lost to follow up in the third month.83 cases were followed up,and the abscission rate was 18.6%.The recurrence rate was 6.1%(6/99)after the first month,10.5%(9/86)after the second month,and 17.6%(12/68)after the third month.Among them,27 cases relapsed and 56 cases did not.There were statistically significant differences in age,complicated hypertension,complicated diabetes,complicated hyperlipidemia,course of disease,frequency of attack and reduction between the two groups(P<0.05).Multivariate logistic regression analysis showed that the number of reduction≥10 times and course of disease were independent risk factors for BPPV recurrence(P<0.05).Conclusion:BPPV is a peripheral vertigo disease that is prone to occur in the middle-aged and elderly,although the treatment effect is certain,it has a tendency to relapse,shortening the duration of onset and reducing the number of reduction are important factors to reduce the recurrence of BPPV.