山东大学耳鼻喉眼学报 ›› 2013, Vol. 27 ›› Issue (5): 24-27.doi: 10.6040/j.issn.1673-3770.0.2013.070

• 论著 • 上一篇    下一篇

位置性眩晕的临床诊疗分析

王宁宁,李永团   

  1. 青岛大学医学院附属青岛市立医院耳鼻咽喉头颈外科, 山东  青岛 266011
  • 收稿日期:2013-03-11 出版日期:2013-10-16 发布日期:2013-10-16
  • 通讯作者: 李永团。 Email:liyongtuan@yahoo.com.cn
  • 作者简介:王宁宁。 Email:wangningning100911@126.com
  • 基金资助:

    山东省医药卫生科研项目2005-HW033

Clinical analysis of positional vertigo

WANG Ning-ning, LI Yong-tuan   

  1. Department of Otolaryngology & Head and Neck Surgery, Affiliated Qingdao Municipal Hospital of Qingdao University Medical College, Qingdao 266011, Shandong, China
  • Received:2013-03-11 Online:2013-10-16 Published:2013-10-16

摘要:

目的    探讨位置性眩晕的临床诊断、治疗的更佳方案。方法    回顾性研究分析233例表现为位置性眩晕患者的临床特点及治疗效果。结果    233例中226例良性阵发性位置性眩晕(BPPV),中枢性眩晕6例(Arnold-Chiari 畸形1例、多发性硬化2例、小脑腔隙性梗塞2例、小脑出血1例),颈部寰枢椎脱位1例。后半规管BPPV 182例经复位法治疗,治愈129例(70.88%),改善39例(21.43%),无效14例(7.70%)。其他类型半规管BPPV 44例,治愈24例(54.54%),改善13例(29.55%),无效7例(15.91%)。Arnold-Chiari 畸形采用神经外科手术治疗治愈,寰枢椎脱位采用颈部牵引、多发性硬化和小脑腔隙性梗塞及小脑出血神经科保守治疗,症状缓解。结论    准确诊断和系统治疗是治疗位置性眩晕的关键。

关键词: 良性阵发性位置性眩晕, 治疗, 眩晕

Abstract:

Objective    To investigate the better schema of diagnosis and treatment for positional vertigo. Methods    The clinical features and treatment effectiveness of 233 positional vertigo patients were reviewed. Results    In 233 cases, there were 226 benign paroxysmal positional vertigo, 1 atlantoaxial dislocation, and 6 central vertigo, including 1  Arnold-Chiari malformation, 2 multiple-sclerosis lesions, 2 cerebellar lacunar infarction, and 1 cerebellar hemorrhage. Within 182 cases of posterior semicircular canal BPPV, 129 cases were cured (70.88%), 39 cases improved (21.43%), and 14 cases ineffective (7.70%) after the manipulative treatment. In 44 cases of other types of semicircular canal BPPV, there were 24 cured cases  (54.54%), 13 improved cases (29.55%), and 7 ineffective cases(15.91%). The patient of Arnold-Chiari malformation was cured by neurosurgery. The atlantoaxial dislocation case was treated with neck traction and the patients with multiple-sclerosis lesions and cerebellar lacunar infarct or haemorrhage were improved by neurological treatment. Conclusions    Proper diagnosis and treatment is the key to treat positional vertigo.

Key words: Vertigo, Benign paroxysmal positional vertigo, Therapy

中图分类号: 

  • R764.3
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