42例轻嵴帽患者的眼震特点及临床疗效分析

Characteristics and clinical efficacy analysis of nystagmus in 42 patients with light cupula

目的 对轻嵴帽患者的眼震特点及临床疗效进行分析。方法 收集2018年1月—至2021年1月就诊于晋中市第一人民医院耳鼻咽喉科眩晕门诊并确诊为轻嵴帽患者42例为研究对象,通过视频眼震电图记录并分析其眼震数据,全部患者均给予Barbecue法复位治疗及复位后予口服药物治疗,评价即时、1周后及1个月后疗效。结果 42例患者中继发于突发性耳聋2例(4.8%),出现直立位自发性眼震10例(23.8%),仰卧位眼震24例(57.1%),眼震均朝向健侧,并出现眼震消失平面即第二零平面,且位于患侧。所有患者双侧转头位均出现持续性向地性位置性眼震,平均持续时间>1 min,平均慢相角速度(SPV)>20°/s,且无明显潜伏期,治疗后即时痊愈0例,改善5例(11.9%),无效37例(88.1%)。1周后痊愈2例(4.8%),改善18例(42.9%),无效22例(52.4%);1个月后痊愈39例(92.9%),改善3例(7.1%),无效0例。即时疗效、1周后疗效及1个月后疗效比较差异具有统计学意义(P<0.05);年龄与即时疗效相关(P<0.05);患侧眼震强度与1周后疗效相关(P<0.05),患侧眼震强度及持续时间与1个月后疗效相关(P<0.05)。结论 轻嵴帽眼震特点表现为持续性向地性位置性,持续时间长,且无潜伏期,部分可出现零平面,并伴随仰卧位眼震发生。该疾病具有一定自愈性,预后良好。年龄、患侧眼震强度、时长对患者的预后有影响,年龄小、眼震强度弱且眼震持续时间短的患者疗效相对较好。

Objective To analyze the characteristics of nystagmus and the clinical efficacy in patients diagnosed with light cupula.Methods A total of 42 patients diagnosed with light cupula were selected as the research subjects, who were enrolled in the vertigo clinic of the Department of Otolaryngology-Head and Neck surgery, the First People’s Hospital of JinZhong from January 2018 to January 2021. The characteristics of nystagmus were recorded and analyzed by video electronystagmus. All patients were treated with Barbecue roll maneuver and oral drug after reduction, and the efficacy was evaluated immediately, one week and one month later.Results There were 42 patients with light cupula, of which two cases(4.8%) were secondary to sudden deafness. All of the patients, spontaneous nystagmus was appeared in upright position at 10 case(23.8%) and in supine position at 24 cases(57.1%), which were oriented to the healthy side and appeared in the second zero plane of nystagmus disappearance located on the affected side. All patients presented persistent geostatic positional nystagmus in bilateral head turning position, with an average duration of > 1 min and an average slow phase velocity(SPV) of > 20°/s, and no obvious incubation period. After treatment, 0 cases were cured immediately, 5 cases(11.9%) were improved and 37 cases(88.1%) were invalid. After one week, 2 cases(4.8%) were cured, 18 cases(42.9%) were improved, and 22 cases(52.4%) were invalid. After 1 month, 39 cases(92.9%) were cured, 3 cases(7.1%) were improved, and 0 cases were invalid. There was statistically significant difference in the effectafter treatment immediately, one week later and one month later(P<0.05). Age was correlated with immediate curative effect(P<0.05). The intensity of nystagmus on the affected side may be correlated with the curative effect one week later(P<0.05).The intensity and duration of nystagmus on the affected side were correlated with the curative effect after 1 month(P<0.05).Conclusions Nystagmus with light cupula is characterized by persistent geotropism, long duration and no incubation period. In some cases, zero plane may occur in partial patient accompanied by supine nystagmus. The disease has a certain self-healing and good prognosis. Age, intensity and duration of nystagmus on affected side have influence on the prognosis of patients. There were relatively better efficacy of treatment in young patients with weak intensity of nystagmus and short duration of nystagmus.