不同复位手法治疗良性阵发性位置性眩晕复位后残余症状的效果

Effects of different maneuvers on residual symptoms of benign paroxysmal positional vertigo after reduction

目的:比较不同复位手法治疗良性阵发性位置性眩晕(BPPV)复位后残余症状的效果。方法:选取117例BPPV复位后存在残余症状的患者,采用Epley耳石复位法治疗39例,采用Semont管石解脱法治疗38例,采用两种方法联合治疗40例,比较3组患者临床疗效、残余症状改善情况、复发率、情绪以及生活质量。结果:Epley治疗组、Semont治疗组、联合组治疗有效率分别为79.49%、84.21%、95.00%,差异无统计学意义(P=0.120)。3组患者治疗后眩晕症状评分量表评分及眩晕前庭指数(VSI)均下降,联合组VSI低于Epley治疗组、Semont治疗组(P<0.05)。治疗3个月后共11例患者复发,其中Epley治疗组4例(10.26%),Semont治疗组4例(10.53%),联合组3例(7.50%),3组复发率比较差异无统计学意义(P=0.878)。3组患者治疗后医院焦虑抑郁量表评分、眩晕障碍量表评分均下降,联合组低于Epley治疗组、Semont治疗组(P<0.05)。结论:Epley耳石复位法与Semont管石解脱法联合治疗BPPV复位后残余症状效果优于单一方法。

Aim:To compare the effects of different maneuvers on residual symptoms of benign paroxysmal positional vertigo(BPPV)after reduction.Methods:A total of 117 patients who had residual symptoms of BPPV after reduction were selected.The number of patients treated with Epley maneuver,Semont maneuver,or combination of the 2 methods was 39,38,and 40 cases.Clinical effect,improvement of residual symptoms,recurrence rate,emotion and quality of life were compared among the groups.Results:The treatment response rates in Epley maneuver group,Semont maneuver group and the combination group were 79.49%,84.21%and 95.00%,respectively(P=0.120).After treatment,the vertigo symptom score simplified scale scores and vestibular symptom index(VSI)of the 3 groups decreased,and the combination group had significantly lower VSI than Epley maneuver group and Semont maneuver group(P<0.05).The recurrence rates in Epley maneuver group,Semont maneuver group and the combination group were 10.26%(4 cases),10.53%(4 cases)and 7.50%(3 cases),respectively(P=0.878).After treatment,the hospital anxiety and depression scale scores and dizziness handicap inventory scores decreased,and the combination group had lower scores than Epley maneuver group and Semont maneuver group(P<0.05).Conclusion:Combination of Epley maneuver and Semont maneuver could improve the curative effects on residual symptoms of BPPV after reduction than single method.