病程对水平半规管良性阵发性位置性眩晕复位后残余症状的影响

Disease Duration and Residual Symptoms after Successful Canalith Repositioning in Lateral Semicircular Canal BPPV

目的 探讨不同病程对水平半规管良性阵发性位置性眩晕(horizontal canal benign paroxysmal positional vertigo,HC-BPPV)患者成功复位后残余症状的影响。方法 选取2021年7月—2022年3月上海交通大学医学院附属新华医院耳鼻咽喉头颈外科收治的HC-BPPV患者49例,根据发病至复位时间分为短病程组33例和长病程组14例。所有患者均采用转椅辅助下的Barbecue或Gufoni耳石复位治疗,成功复位后7~10 d进行复诊,复位前后均采用眩晕障碍量表(dizziness handicap inventory,DHI)进行评估,比较两组复位前后DHI各维度评分及总分差异。结果 复位前后,长病程组DHI总分均高于短病程组,差异有统计学意义(P<0.05)。复位前,长病程组DHI-F评分高于短病程组,差异有统计学意义(P<0.05);复位后,长病程组DHI-F评分、DHI-P评分、DHI-E评分均高于短病程组,差异均有统计学意义(P<0.05)。复位前后,两组DHI各维度评分差值及总分差值比较,差异均无统计学意义(P>0.05)。结论HC-BPPV复位后,出现残余症状的风险与复位前病程有关,病程越长,复位后出现残余症状的风险越大,残余症状可表现在躯体功能、社会功能及心理障碍等方面。

Objective To report the effect of disease duration on residual symptoms after successful canalith repositioning procedure(CRP)in patients with horizontal canal benign paroxysmal positional vertigo(HC-BPPV).Methods A total of 49 patients with primary HC-BPPV diagnosed at Xinhua Hospital Hearing and Vertigo Center from July 2021 to March 2022 were selected and divided into a short duration group(n=33)and a long duration group(n=16).All patients were treated with Barbecue or Gufoni maneuver assisted by a swivel chair,and were reassessed 7-10 days after successful CRP.Patients were evaluated using the Dizziness Handicap Inventory(DHI)before and after CRP,and the total and sub-dimension scores were compared between the two groups.Results The total DHI score in long course group was higher than that in short course group both before and after CRP(P<0.05).The DHI-F dimension score in long course group was higher than that in short course group before and After CRP(P<0.05),as well as post-CRP DHI-P dimension and DHI-E dimension scores(P<0.05).Within each group,the pre-and post-CRP total or dimensions DHI scores showed no significant differences(P>0.05).Conclusion The risk for residual symptoms in HC-BPPV patients after CRP is related to the duration of disease,with longer course associated with greater risks.Residual symptoms may be manifested in the aspect of physical function,social function and psychology.