山东大学耳鼻喉眼学报 ›› 2017, Vol. 31 ›› Issue (5): 57-61.doi: 10.6040/j.issn.1673-3770.0.2017.066
鞠骏,李进让,邹世桢,贾曼玉
JU Jun, LI Jinrang, ZOU Shizhen, JIA Manyu
摘要: 目的 探究原发性(i-BPPV)与创伤性(t-BPPV)良性阵发性位置性眩晕的临床特点及近期疗效是否存在显著性差异。 方法 回顾性分析2014年7月至2016年9月在海军总医院全军耳鼻咽喉头颈外科中心确诊的307例i-BPPV及25例t-BPPV患者的临床资料,分析两组病例在性别、年龄、并发症(恶心、呕吐、耳鸣、听力减退)、患侧、受累半规管及近期疗效(3 d及1周)等方面是否存在显著性差异。 结果 i-BPPV组与t-BPPV组患者在性别、年龄、并发症、患侧等方面不存在显著差异(P>0.05);t-BPPV具有相对较差的短期疗效(P<0.001);t-BPPV患者更易出现前半规管受累(P=0.024)。 结论 相比i-BPPV,t-BPPV的预后较差,前半规管BPPV的正确治疗对t-BPPV预后更重要。
中图分类号:
[1] Bhattacharyya N, Baugh RF, Orvidas L, et al. Clinical practice guideline: benign paroxysmal positional vertigo [J]. Otolaryngol Head Neck Surg, 2008, 139(5 suppl 4):S47-S81. [2] Korres SG, Balatsouras DG, Kaberos A, et al. Occurrence of semicircular canal involvement in benign paroxysmal positional vertigo [J]. Otol Neurotol, 2002, 23(6):926-932. [3] Parnes LS,Agrawal K,Atlas J. Diagnosis and management of benign paroxysmal positional vertigo(BPPV)[J]. CAMJ, 2003, 169(7):681-693. [4] Balatsouras DG, Koukoutsis G, Aspris A, et al. Benign paroxysmal positional vertigo secondary to mild head trauma [J]. Ann Otol Rhinol Laryngol, 2017, 126(1):54-60. [5] Balatsouras DG, Koukoutsis G, Ganelis P, et al. Benign paroxysmal positional vertigo secondary to vestibular neuritis[J]. Eur Arch Otorhinolaryngol, 2014, 271(5):919-924. [6] Riga M, Bibas A, Xenellis J, et al. Inner ear disease and benign paroxysmal positional vertigo: a critical review of incidence, clinical characteristics, and management[J]. Int J Otolaryngol, 2011, 2011:709469-709469. [7] Karlberg M, Hall K, Quickert N, et al. What inner ear diseases cause benign paroxysmal positional vertigo[J]. Acta Otolaryngol, 2000, 120(3):380-385. [8] 邹世桢, 李进让, 王志斌, 等. 李氏复位法治疗水平离地性眼震BPPV的短期疗效[J]. 中华耳科学杂志, 2016, 14(4):481-485. ZOU Shizhen, LI Jinrang, WANG Zhibin, et al. Short-term outcomes of Lis repositioning maneuver for apogeotropic nystagmus horizontal semicircular benign paroxysmal positional vertigo[J]. Chin J Otol, 2016, 14(4):481-485. [9] Kim JS, Oh SY, Lee SH, et al. Randomized clinical trial for apogeo. tropic horizontal canal benign paroxysmal positional vertigo[J]. Neurology, 2012, 78(3):159-166. [10] 郭向东, 叶放蕾, 张治成, 等. 23例外伤后良性阵发性位置性眩晕临床分析[J]. 临床耳鼻咽喉头颈外科杂志, 2010, 24(16):738-742. GUO Xiangdong, YE Fanglei, ZHANG Zhicheng, et al. Posttraumatic benign paroxysmal positional vertigo: analysis of 23 cases[J]. J Clin Otorhinolaryngol Head Neck Surg, 2010, 24(16):738-742. [11] 庄建华, 黄坚, 赵忠新, 等. 外伤性良性发作性位置性眩晕的临床表现与预后[J]. 中华神经科杂志,2007,23(9):588-591. ZHUANG Jianhua, HUANG Jian, ZHAO Zhongxin, et al. Traumatic benign paroxysmal positional vertigo: clinical features and prognosis[J]. Chin J Neurol, 2007, 23(9):588-591. [12] Suarez H, Alonso R, Arocena M, et al. Clinical characteristics of positional vertigo after mild head trauma[J]. Acta Otolaryngol, 2011, 131(4):377-381. [13] Ahn SK, Jeon SY, Kim JP, et al. Clinical characteristics and treatment of benign paroxysmal positional vertigo after traumatic brain injury[J]. J Trauma, 2011, 70(2):442-446. [14] 中华耳鼻咽喉头颈外科杂志编委会,中华医学会耳鼻咽喉科学分会. 良性阵发性位置性眩晕的诊断依据和疗效评估[J]. 中华耳鼻咽喉头颈外科杂志, 2007, 42(3):163-164. [15] Balatsouras DG, Koukoutsis G, Ganelis P, et al. Diagnosis of single- or multiple-canal benign paroxysmal positional vertigo according to the type of nystagmus[J]. Int J Otolaryngol, 2011, 2011:483965. [16] Chang TP, Lin YW, Sung PY, et al. Benign paroxysmal positional vertigo after dental procedures: a population-based case-control study[J]. PLoS One, 2016, 11(4):e0153092. [17] Liu H. Presentation and outcome of post-traumatic benign paroxysmal positional vertigo[J]. Acta Otolaryngol, 2012, 132(8):803-806. [18] Motin M, Keren O, Groswasser Z, et al. Benign paroxysmal positional vertigo as the cause of dizziness in patients after severe traumatic brain injury: diagnosis and treatment[J]. Brain Inj, 2005, 19(9):693-697 [19] 李进让, 李厚恩. 良性阵发性位置性眩晕的手法复位治疗[J]. 中国耳鼻咽喉头颈外科,2007,14(10):619-620. [20] Gordon CR, Levite R, Joffe V, et al. Is posttraumatic benign paroxysmal positional vertigo different from the idiopathic form[J]. Arch Neurol, 2004, 61(10):1590-1593. [21] Choi SJ, Lee JB, Lim HJ, et al. Clinical features of recurrent or persistent benign paroxysmal positional vertigo[J]. Otolaryngol Head Neck Surg, 2012, 147(5):919-924. [22] Dlugaiczyk J, Siebert S, Hecker DJ, et al. Involvement of the anterior semicircular canal in posttraumatic benign paroxysmal positioning vertigo[J]. Otol Neurotol, 2011, 32(8):1285-1290. [23] Baloh RW, Honrubia V, Jacobson K. Benign positional vertigo: clinical and oculographic features in 240 cases[J]. Neurol, 1987, 37(3):371-378. [24] Cohen HS, Kimball KT, Stewart MG. Benign paroxysmal positional vertigo and comorbid conditions[J]. ORL J Otorhinolaryngol Relat Spec, 2004, 66(1):11-15. [25] Sato G, Sekine K, Matsuda K, et al. Risk factors for poor outcome of a single Epley maneuver and residual positional vertigo in patients with benign paroxysmal positional vertigo[J]. Acta Otolaryngol, 2013, 133(11):1124-1127. [26] Katsarkas A. Benign paroxysmal positional vertigo(BPPV): idiopathic versus post-traumatic[J]. Acta Otolaryngol, 1999, 119(7):745-749. [27] Aron M, Lea J, Nakku D, et al. Symptom resolution rates of posttraumatic versus nontraumatic benign paroxysmal positional vertigo: a systematic review[J]. Otolaryngol Head Neck Surg, 2015, 153(5):721-730. [28] Schuknecht HF. Mechanism of inner ear injuries from blows to the head[J]. Ann Otol Rhinol Laryngol, 1969, 78(2):253-262. |
[1] | 鄢慧琴,王豪. 难治性良性阵发性位置性眩晕的临床分析[J]. 山东大学耳鼻喉眼学报, 2018, 32(3): 86-88. |
[2] | 李桂芳,王春华,张淑贞. 体位限制对手法复位后良性阵发性位置性眩晕的疗效观察[J]. 山东大学耳鼻喉眼学报, 2017, 31(6): 42-45. |
[3] | 张颖,陈红梅,吴欣怡. 糖尿病大鼠角膜上皮创伤愈合中IGF-1的表达[J]. 山东大学耳鼻喉眼学报, 2017, 31(6): 74-78. |
[4] | 刘学升,李筱瑜,邓玮. DHM阴性的非典型PSC-BPPV诊断策略探讨[J]. 山东大学耳鼻喉眼学报, 2017, 31(1): 88-90. |
[5] | 王学海,张建新,孟昭进,刘秀玲. 上半规管良性阵发性位置性眩晕41例[J]. 山东大学耳鼻喉眼学报, 2014, 28(3): 47-50. |
[6] | 郑立友1,李学军2. 耳鼻喉颌面伤合并颅脑损伤500例[J]. 山东大学耳鼻喉眼学报, 2014, 28(1): 59-61. |
[7] | 孙祥1,于亚峰2 . 继发性后半规管良性阵发性位置性眩晕的诊治[J]. 山东大学耳鼻喉眼学报, 2013, 27(5): 22-23. |
[8] | 王宁宁,李永团. 位置性眩晕的临床诊疗分析[J]. 山东大学耳鼻喉眼学报, 2013, 27(5): 24-27. |
[9] | 全世明1,彭本刚1,高志强2. T细胞免疫缺陷小鼠创伤性面瘫模型的建立及其形态学评价[J]. 山东大学耳鼻喉眼学报, 2010, 24(6): 5-9. |
[10] | 刘静波,刘建治,黄建民. 手法复位治疗良性阵发性位置性眩晕36例[J]. 山东大学耳鼻喉眼学报, 2010, 24(6): 17-19. |
[11] | 曹效平 王天生 顾东胜 吴春平. 耳石复位法治疗良性阵发性位置性眩晕32例[J]. 山东大学耳鼻喉眼学报, 2009, 23(5): 10-12. |
[12] | 吴柳青,刘红琪,唐向荣,梁志成 . 外伤性鼓膜穿孔265例[J]. 山东大学耳鼻喉眼学报, 2007, 21(4): 362-363 . |
|