360°旋转复位与Epley手法复位治疗后半规管良性阵发性位置性眩晕的比较

360-Degree maneuver vs Epley maneuver for repositioning treatment in patients with posterior semicircular canal benign paroxysmal positional vertigo

目的:比较360°旋转复位与Epley手法复位治疗后半规管良性阵发性位置性眩晕的临床疗效。方法:69例后半规管良性阵发性位置性眩晕患者被随机分入研究组(35例,接受360°旋转复位治疗)和对照组(34例,接受Epley手法复位治疗)。比较2组患者的疗效以及痊愈后的残留症状。结果:研究组和对照组患者在接受1次治疗后即可获得治愈的患者所占比例分别为91.4%(32/35)和88.2%(30/34),需要接受2次治疗才能达到治愈的患者所占比例分别为8.6%(3/35)和11.8%(4/34),但2组之间的差异均无统计学意义(P值均>0.05)。研究组治愈后有残留症状(包括头晕、行走不稳、颈部不适)的患者所占比例为17.1%(6/34),显著低于对照组患者[29.4%(10/35)](P<0.05)。结论:360°旋转复位与Epley手法复位治疗后半规管良性阵发性位置性眩晕的疗效相似,但前者的残留症状更少,有助于提高患者的生活质量,且操作更加简便、舒适度更优,显示出较高的临床应用价值。

Objective: To compare the clinical efficacy between 360-degree maneuver and Epley maneuver repositioning treatment in patients with posterior semicircular canal benign paroxysmal positional vertigo(BPPV).Methods: There were 69 patients with posterior semicircular canal BPPV were randomlydivided into study group(n = 35, treated with 360-degree maneuver) and the control group(n = 34, treated with Epley maneuver). The efficacy and the residual symptoms after recovery between the two groups were compared.Results: There were 91.4%(32/35) of the patients in the study group and 88.2%(30/34) of the patients in the control group achieved recovery after single treatment, and the difference was not significant(P > 0.05). The proportions of patients who achieved recovery after two treatments were 8.6%(3/35) in the study group and 11.8%(4/34) in the control group, and the difference was also not significant(P > 0.05). The proportion of patients who had been cured but still had residual symptoms(including dizziness, walking instability and neck discomfort) in the study group was 17.1%(6/34), which was significantly lower than that of the control group [29.4%(10/35)](P < 0.05).Conclusion: 360-Degree maneuver and Epley maneuver in the treatment of posterior semicircular canal BPPV can achieve similar effectiveness, but less residual symptoms are observed in patients treated with 360-Degree maneuver, which can improve the quality of life of the patients, and has the advantages of simpler operation, better comfort, and higher clinical application value.