118例老年良性阵发性眩晕患者的亚型分布及复位效果分析

The subtype distribution and canalith reduction effect of 118 elderly patients with BPPV

目的分析118例老年良性阵发性位置性眩晕(BPPV)患者的BPPV亚型分布,并比较对不同BPPV亚型老年患者的复位次数,为治疗老年BPPV提供临床依据。方法收集2018年4月~2020年12月在我院确诊为BPPV的老年患者118例,回顾性分析BPPV的亚型及复位次数。结果118例老年BPPV患者中,诊断为后半规管BPPV(PSC-BPPV)86例(72.9%)、水平半规管BPPV(HSC-BPPV)管石症12例(10.2%)、HSC-BPPV嵴顶结石症(简称顶石症)19例(16.1%)、前半规管BPPV(ASC-BPPV)1例(0.8%)。一次复位治疗后,65%(56/86)的PSC-BPPV患者和58.3%(7/12)的HSC-BPPV管石症患者治愈,而仅21%(4/19)的HSC-BPPV顶石症患者治愈。一次复位后HSCBPPV顶石症治愈的比例小于PSC-BPPV或HSC-BPPV管石症患者(P<0.05)。结论PSC-BPPV是老年BPPV最常见的亚型,HSC-BPPV是仅次于PSC-BPPV的亚型。对PSC-BPPV和HSC-BPPV管石症的一次复位治疗效果显著,HSC顶石症次之。

Objective To investigate the subtype distribution of 118 elderly patients with BPPV,and compare the reduction times according to the subtype of BPPV,so as to provide clinical basis for the treatment of elderly BPPV.Meth⁃ods A total of 118 patients diagnosed with BPPV in Beijing Daxing District Hospital of Integrated Traditional Chinese and Western Medicine from April 2018 to December 2020 were retrospectively analyzed for the subtypes and reduction times of BPPV.Results Among 118 elderly patients with BPPV,86 cases(72.9%)were diagnosed as posterior semi⁃circular canal BPPV(PSC-BPPV),12 cases(10.2%)as horizontal semicircular canal BPPV(HSC-BPPV)canalolithia⁃sis,19 cases(16.1%)as HSC-BPPV cupulolithiasis,and 0.8%as anterior semicircular canal BPPV(ASC-BPPV).Af⁃ter a single CRM treatmen,65%of PSC-BPPV and 58.3%of HSC-BPPV canalolithiasis patients were cured,while only 21%of HSC-BPPV cupulolithiasis patients were cured.The cure rate of HSC-BPPV cupulolithiasis after one reduction was less than that of PSC-BPPV or HSC-BPPV canalolithiasis(P<0.05).Conclusion PSC-BPPV is the most common sub⁃type of BPPV in the elderly.HSC-BPPV is the most common subtype of BPPV after PSC-BPPV.The effect of one-time CRM treatment of PSC-BPPV and HSC-BPPV canalolithiasis is significant,followed by HSC cupulolithiasis.