良性阵发性位置性眩晕手法复位短期疗效不佳患者临床特征分析.docVIP

良性阵发性位置性眩晕手法复位短期疗效不佳患者临床特征分析 　　[摘要] 目的 分析良性阵发性位置性眩晕手法复位短期疗效不佳患者的临床特征。 方法 选取2013年1月～2016年1月50例在我院确诊的BPPV患者，经过2周内3次以上的手法复位仍疗效不佳，记录各患者临床表现及随诊结果，探讨此类患者的临床特征。 结果 BPPV患者中，60岁以上的36例，占70.2%。纯音测听双耳正常19例，31例有不同程度的耳?@症状。冷热试验异常中同侧19例，对侧12例；高刺激速率ABR异常中同侧22例，对侧17例。单侧后半规管受累10例，单侧后半规管嵴顶受累11例，单侧水平半规管受累11例，上半规管受累者8例，混合型BPPV 12例。2周～1个月内痊愈23例，1个月后31例，2个月后35例，3个月后39例，1年内手法复位完全无效的9例，有效的41例中1年内复发的25例，占61.0%。 结论 短期疗效欠佳的BPPV患者多为60岁以上的老年人，嵴顶结石、多管受累可能是其复位效果不佳的影响因素。此类患者一次手法复位难以成功，多数需要联合多种复位方法，结合体位训练和药物辅助治疗 [关键词] 良性阵发性位置性眩晕；临床特征；短期疗效；手法复位 [中图分类号] R741 [文献标识码] A [文章编号] 2095-0616（2017）06-135-03 [Abstract] Objective To analyze the clinical characteristics of benign paroxysmal positional vertigo patients with poor short-term efficacy of manipulative reduction. Methods 50 cases of BPPV patients cured in our hospital from January 2013 to January 2016 were selected. After 2 weeks， more than 3 times， the reduction was still not effective. Clinical manifestations and follow-up results of the two groups were recorded. Clinical characteristics of the patients were expored. Results Among the BPPV patients， there were 36 cases of more than 60 years old， accounting for 70.2%，19 cases of pure tone audiometry normal ears， and31 cases with different degrees of hearing loss. Among the cold and hot test abnormal patients， there were 19 cases with ipsilateral and contralateral to the other 12 cases. Among the High stimulation rate ABR abnormal patients， there were 22 cases with ipsilateral and contralateral to the other 17 cases. There were10 cases of unilateral posterior semicircular canal involvement， 11 cases of unilateral posterior semicircular canal involvement， 11 cases of unilateral horizontal semicircular canal involvement， 8 cases of the upper semicircular canal involvement， and 12 cases ofmixed BPPV. There were 23 cases of 2 weeks to 1 months to cure， 31 cases of after the 1 month， 35 cases of after the 2 month， 39 cases of f after the 3 month， 9 cases of 1 years of manual reset completely ineffe