良性阵发性位置性眩晕诊治分析

摘要

Objective To report results of a retrospective analysis of risk factors and treatment outcomes in a group of patients with BPPV in the hope to improve diagnosis and treatment.Methods A total of 1,200 patients diag-nosed with BPPV between June 2010 and November 2016 were enrolled in the study by vertigo questionnaires.All were treated with either Epley,Barbecue,Semont or Brandt-Daroff maneuvers,supplemented with drug or psychological ther-apies as needed.Results The male to female ratio was 1:2.2,with onset ages ranging from 60 to 70 years.Vertigo symp-toms were associated with postures only,and no underlying diseases or comorbidities were observed.The lesion was lo-cated to the posterior semicircular canal in 1,012 patients (84.33%),to horizontal semicircular canal in 162 patients (13.50%)and to multiple semicircular canals in 26 patients(2.17%).There was no involvement of the anterior semicir-cular canal.The most effective treatment for this roup of patients was otolith repositioning maneuvers with an effective rate of 88%.Conclusion Detailed history and typical clinical characteristics through comprehensive evaluation are the key to correct diagnosis.The key to successful management in BPPV is personalized treatment.%目的 回顾性分析我科诊治的良性阵发性位置性眩晕(BPPV)患者,分析发病因素及治疗方式,旨在协助临床医生提高精准诊治.方法 以眩晕问卷形式收集2010年6月-2016年11月接诊1200例BPPV患者,分别采用Epley复位法、Barbecue复位法、Semont复位法及Brandt-Daroff习服法,药物与心理辅助治疗.分析发病原因、临床特征、治疗方式.结果 1200例BPPV患者中,女性多见,男女比例为1:2.2;60-70岁年龄段发病多;症状仅表现为体位发作性眩晕,无基础病和合并症者多;诊断分型后半规管BPPV1012例(84.33%)、水平半规管BPPV162(13.50%)、上半规管BPPV0例(0.00%)、多个半规管BPPV26例(2.17%);耳石复位是首选治疗方法,首次复位有效率为88%.结论 详细收集病史及临床特征,综合评估做出正确诊断,给予个性化治疗是有效治疗BPPV的关键.