目的 观察SRM-Ⅳ全自动前庭功能诊疗系统对无眼震性良性阵发性位置性眩晕的治疗效果。方法 选取64例可能为后半规管或水平半规管受累而位置试验无眼震的BPPV患者,按治疗方法分为3组:机器组(24例)、手法组(24例)和药物组(16例),分别通过诊疗系统行耳石复位、手法行耳石复位、口服甲磺酸倍他司汀及银杏叶提取物片,治疗7 d后比较各组间耳石复位效果,观察眼震和症状变化。结果 机器组痊愈率为70.83%,总有效率达91.6%;手法组痊愈率为50%,总有效率达66.67%;药物组痊愈率为18.75%,总有效率达50%。机器组与手法组比较,痊愈率和总有效率差异有统计学意义(P<0.05);与药物组比较,机器组痊愈率和总有效率明显高于药物组(P<0.05)。结论 SRM-Ⅳ前庭功能诊疗系统可有效地治疗无眼震BPPV,提高阴性眼震的检出率,有利于BPPV治疗的精准性和有效性。
Abstract
Objective To evaluate the therapeutic efficacy of SRM-Ⅳ vestibular function diagnosis and treatment system against benign paroxysmal positional vertigo(BPPV)without nystagmus.Methods Sixty-four patients were diagnosed with the posterior and horizontal semicircular BPPV without nystagmus according to clinical symptoms and positional test. They were randomly divided into three groups and treated for one week. Twenty-four of these patients underwent automatic positional maneuver by the SRM-Ⅳ vestibular function diagnosis system, another 24 patients underwent traditional positional maneuver, and 16 patients received medication.Results After one week, the difference of the recovery rate and total effective rate was statistically significant (P<0.05) between the machine group and the traditional group. The recovery rate and total effective rate of the machine group were significantly higher than those of the drug group (P<0.05).Conclusions The positional therapy by the automatic SRM-Ⅳ system can be an effective and reliable approach to BPPV without nystagmus.
关键词
良性阵发性位置性眩晕 /
SRM-Ⅳ前庭功能诊疗系统 /
眼震
Key words
benign paroxysmal positional vertigo /
SRM-Ⅳ vestibular diagnosis and treatment system /
nystagmus
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参考文献
[1] 闫亚平, 薄建华. SRM-IV型前庭功能治疗系统治疗耳石症68例[J]. 武警医学, 2015, 26(12): 1267-1272.
[2] Brevern M, Bertholon P, Brandt T, et al. Benign paroxysmal positional vertigo: Diagnostic criteria[J]. J Vestib Res, 2015, 25(3-4): 105-117.
[3] 中华耳鼻咽喉头颈外科杂志编辑委员会, 中华医学会耳鼻咽喉头颈外科学分会. 良性阵发性位置性眩晕诊断和治疗指南(2017)[J]. 中华耳鼻咽喉头颈外科杂志, 2017, 52(3): 173-177.
[4] 王暖, 耿德勤, 周昊,等. SRM-Ⅳ前庭功能诊疗系统治疗良性阵发性位置性眩晕疗效分析[J]. 中国临床神经科学, 2016, 24(6):635-640.
[5] Parnes L S, Agrawal S K, Atlas J.Diagnosis and management of benign paroxysmal positional vertigo (BPPV)[J]. CMAJ, 2003, 169(7): 681-693.
[6] Hall S F, Ruby R R, Mcclure J A.The mechanics of benign paroxysmal vertigo[J]. J Otolaryngol, 1979, 8(2): 151-158.
[7] Schuknecht H F.Positional vertigo: clinical and experimental observations[J]. Trans Am Acad Ophthalmol Otolaryngol, 1962, 66:319-332.
[8] 马鑫, 司峰志, 刘燕, 等. 良性阵发性位置性眩晕变位试验假阴性原因分析[J]. 临床耳鼻咽喉头颈外科杂志, 2016, 30(1):19-20.
[9] Tan J, Yu D, Feng Y, et al. First-referral presentations of patients with benign paroxysmal positional vertigo who were negative on positional testing and who lacked nystagmus[J]. Eur Arch Otorhinolaryngol, 2015, 272(11): 3247-3251.
[10] Balatsouras D G, Korres S G.Subjective benign paroxysmal positional vertigo[J]. Otolaryngol Head Neck Surg, 2012, 146(1): 98-103.
[11] 庄建华, 黄坚, 赵忠新, 等. 主观性良性阵发性位置性眩晕的临床表现和治疗[J]. 中华耳鼻咽喉头颈外科杂志, 2007, 42(3): 177-179.
[12] Alvarenga G A, Barbosa M A, Porto C C.Benign Paroxysmal Positional Vertigo without nystagmus: diagnosis and treatment[J]. Braz J Otorhinolaryngol, 2011, 77(6):799-804.
[13] 于立民, 刘鸣, 金德钧, 等. 无明显眼震的良性阵发性位置性眩晕患者手法复位疗效分析[J]. 听力学及言语病学杂志, 2013, 21(3):289-290.
[14] Bhattacharyya N, Baugh R F, Orvidas L, et al. Clinical practice guideline: benign paroxysmal positional vertigo[J]. Otolaryngol Head Neck Surg, 2008, 139(5 Suppl 4): S47-81.
