目的 探讨良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)复位即时疗效不佳的影响因素。方法 选择2016-01至2017-12在医院经SRM-Ⅳ前庭功能治疗系统单次复位后即时疗效评估效果不佳的BPPV患者95例作为复位不良组,选择285例即时复位有效的患者作为复位有效组,通过比较两组临床特征,探讨引起即时疗效不佳的影响因素。结果 经Logistic回归多因素分析,头部外伤、前庭神经炎、突发性耳聋为BPPV即时疗效不佳的危险因素(OR分别为2.650、5.997、9.561;均有P<0.05)。多半规管BPPV较后半规管及水平半规管BPPV更易发生即时疗效不佳(P<0.05)。结论 完善基础检查及早期发现BPPV复位不良的危险因素,制定有针对性的复位和治疗方法,可减少患者的复位次数并缩短病程。

Objective To investigate the factors that lead to the poor immediate effect of reposition for benign paroxysmal positional vertigo.Methods Ninety-five cases of BPPV patients with poor immediate effect after the automatic vestibular function diagnosis and therapy system(SRM-Ⅳ) treatment at our hospital between January 2016 and December 2017 were selected as the ineffective group, while 285 cases with immediate effect served as the effective group. Clinical features were compared between the two groups to identify the causes of poor immediate effect.Results Multivariate analysis of logistic regression showed that head injury, vestibular neuritis and sudden deafness were risk factors for poor immediate effect for benign paroxysmal positional vertigo (OR was 3.444, 10.009 and 5.934, respectively, P<0.05). Poor immediate effect was more likely to occur in the multiple semicircular canal (BPPV) than in the posterior semicircular canal or the horizontal semicircular canal BPPV (P<0.05).Conclusions The effect of basic examination ought to be improved to detect risk factors for poor immediate effect for BPPV earlier, and targeted approaches have to be devised to reduce the times of reposition and shorten the course of treatment.