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。
Abstract
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 randomly divided 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.
关键词
良性阵发性位置性眩晕 /
后半规管 /
360°旋转复位 /
Epley手法复位 /
残留症状
Key words
Benign paroxysmal positional vertigo /
Posterior semicircular canal /
360-Degree maneuver /
Epley maneuver /
Residual symptoms
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Lee NH, Ban JH, Lee KC, et al. Benign paroxysmal positional vertigo secondary to inner ear disease[J]. Otolaryngol Head Neck Surg, 2010, 143(3):413-417.
[2] Dispenza F, Kulamarva G, de Stefano A. Comparison of repositioning maneuvers for benign paroxysmal positional vertigo of posterior semicircular canal: advantages of hybrid maneuver[J]. Am J Otolaryngol, 2012, 33(5):528-532.
[3] 谭 俊, 于栋祯, 冯艳梅, 等. 复位治疗椅辅助治疗后半规管良性阵发性位置性眩晕的疗效观察[J]. 听力学及言语疾病杂志, 2013, 21(2):109-111.
[4] 张 颖, 张京秋, 赵锦成, 等. SRM-Ⅳ眩晕诊疗系统在良性阵发性位置性眩晕中的临床应用[J]. 临床耳鼻咽喉头颈外科杂志, 2015, 29(14):1248-1252.
[5] Seok JI, Lee HM, Yoo JH, et al. Residual dizziness after successful repositioning treatment in patients with benign paroxysmal positional vertigo[J]. J Clin Neurol, 2008, 4(3):107-110.
[6] 中华耳鼻咽喉头颈外科杂志编辑委员会. 良性阵发性位置性眩晕的诊断依据和疗效评估（2006，贵阳）[J]. 中华耳鼻咽喉头颈外科杂志, 2007, 42(3):163-164.
[7] 黄选兆, 汪吉宝, 孔维佳. 实用耳鼻咽喉头颈外科学[M]. 北京: 人民卫生出版社, 2008: 1046-1047.
[8] 章燕幸, 吴承龙, 肖桂荣, 等. 后半规管良性阵发性位置性眩晕三种自我治疗手法的疗效比较[J]. 中华耳鼻咽喉头颈外科杂志, 2012, 47(10):799-803.
[9] Horak FB. Postural compensation for vestibular loss and implications for rehabilitation[J]. Restor Neurol Neurosci, 2010, 28(1):57-68.
[10] 李亚楠. 良性阵发性位置性眩晕患者临床特点及手法复位疗效分析[J]. 中外医学研究, 2015, 13(10):47-49.
[11] Lee HK, Ahn SK, Jeon SY, et al. Clinical characteristics and natural course of recurrent vestibulopathy: a long-term follow-up study[J]. Larnygoscope, 2012, 122(4):883-886.
[12] Li JC, Epley J. The 360-degree maneuver for treatment of benign positional vertigo[J]. Otol Neurotol, 2006, 27(1):71-77.
[13] 孙 勍, 马丽涛, 李 娜, 等. 前庭功能诊治系统SRM-Ⅳ在良性阵发性位置性眩晕中的应用[J]. 中华耳科学杂志, 2010, 8(1):83-85.
基金
徐州市科技计划项目（编号：KC16SL143）
PDF(1658 KB)
