颗粒复位手法中的体位限制对治疗后半规管良性发作性位置性眩晕的作用

目的：评价颗粒复位手法(PRM)中的体位限制在治疗后半规管良性发作性位置性眩晕(BPPV)中的作用。方法：将后半规管 BPPV 患者随机分成2组，复位组33例给予 PRM 治疗加体位限制；对照组32例仅给予体位限制治疗。结果：治疗后第4天复位组和 对照组的成功率分别为75． 8%(25/33) 和15． 6%(5/32) ，两者差异显著(x~2=21． 28，P＜0． 005) ；治疗后第7天两者的成功率分别为 87． 9%(29/33) 和28． 1%(9/32) ，具有显著差异(x~2=21． 49，P＜0． 005) 。结论：PRM 治疗效果明显优于体位限制治疗，凡后半规管 BPPV 诊断明确者均应给予 PRM 治疗。     

颗粒复位法治疗后半规管良性发作性位置性眩晕的疗效观察

眩晕是患者常见的主诉,据统计在眩晕患者中约有56％为良性发作性位置性眩晕（benign paroxysmal positionalvertigo,BPPV）,后半规管发病率最高。以往BPPV的治疗主要通过抗组胺类药物、血管扩张剂和镇静剂等,但疗效欠佳,Epley基于管石理论（canalolithiasis）,     

Epley法治疗后半规管良性阵发性位置性眩晕的临床观察

目的探讨Epley耳石复位法治疗后半规管良性阵发性位置性眩晕的方法和效果。方法对诊断后半规管良性阵发性位置性眩晕的患者采用Epley耳石复位法进行治疗，观察并分析疗效。结果治疗有效率达98％。结论Epley耳石复位法治疗良性阵发性位置性眩晕操作简便，安全快速，经济实用。     

颗粒复位法治疗良性阵发性位置性眩晕的护理

良性阵发性位置性眩晕是临床最常见的眩晕病,但缺乏理想的治疗措施.为解除此类患者的痛苦,我们采用Epley颗粒复位手法进行治疗和护理,结果总有效率达93.2%,无明显不良反应,且安全、经济.护理体会严格掌握适应证,认真配合操作,做好心理护理、头位护理及出院指导.     

耳石复位法治疗后半规管良性阵发性位置性眩晕

目的：观察耳石复位治疗后半规管良性阵发性位置性眩晕（PC-BPPV）的疗效。方法：PC-BPPV患者26例,分为A、B2组,均采用Epley管石复位法治疗,B组加用Semont管石解脱法。结果：治疗1～3次后,B组有效率明显高于A组（93．8%与80．0％,P＜0．05）。结论：联合2种手法复位治疗PC-BPPV能提高疗效,降低复发率。     

两种手法复位治疗后半规管良性阵发性位置性眩晕

目的探讨管石复位法(Epley法)和嵴顶耳石解脱法(Semont法)两种手法复位治疗后半规管良性阵发性位置性眩晕(BPPV)患者的疗效。方法收集2009年9月-2011年1月就诊的后半规管BPPV患者60例,依据随机数字表法平均分配到两个治疗组,分别采用Epley法和Semont法进行治疗,观察患者眩晕改善情况,并随访3～12个月。结果两种方法的治愈有效率在治疗后1、2、3周,3个月时差异无统计学意义(P>0.05)。所有患者随访3～12个月,均无复发,治疗后均无不良反应。结论两种方法治愈有效率相近。治疗时可先选用Epley法,疗效不佳,再选择Semont法。     

Epley手法复位治疗垂直半规管性良性发作性位置性眩晕

良性发作性位置性眩晕(benign paroxysmal positional vertigo,BPPV)是眩晕最常见的病因之一.BPPV的年发病率为64／100000,在内科、神经内科和急诊室常可见到,占所有眩晕症的40％～50％,占周围性眩晕的60％。特点为眩晕发作持续短暂,通常数秒至1min,与头部位置的改变有关。大多数患者在坐起、躺下或前倾、后仰时出现,通过Dix—Hallpike试验可诱发出眩晕和眼震。目前BPPV的治疗主要通过抗组胺类药物、血管扩张剂和镇静剂等,     

Epley手法复位治疗良性发作性位置性眩晕的护理

良性发作性位置性眩晕(BPPV)是最常见的周围性眩晕,年发病率为64/100 000[1]。其特点为眩晕发作持续短暂,通常数秒至1 min,大多在坐起、躺下或前倾、后仰时出现,患者头常固定于某一位置,造成很大的痛苦。本科自2005年起采用Epley手法复位治疗BPPV 47例,其有效、方便,简单易行,并予以精心完善的宣教及护理,取得了良好的疗效,现将护理体会报告如下。1资料与方法1.1一般资料2005~2006年到本院住院治疗的BPPV患者共47例,其中男19例,女28例,年龄42~69岁,平均45岁,左耳15例,右耳19例,双侧13例,伴有供血不足者5例,伴脑梗塞者4例,所有病例符合…     

改良Epley手法复位治疗后半规管性良性发作性位置性眩晕的护理

良性发作性位置性眩晕（BPPV）是体位改变时以短暂眩晕发作为主要表现的前庭半规管疾病,是眩晕最常见的病因之一。BPPV的年发病率约为64／100000,占所有眩晕症的20％,也是约半数耳源性眩晕症的原因。     

Epley复位法治疗良性发作性位置性眩晕的疗效观察

良性发作性位置性眩晕(benign paroxysmal positional vertigo,BPPV)是周围性眩晕的最常见类型,可占周围性眩晕的50%,主要表现为体位改变时激发的短暂的、发作性眩晕,并伴有眼震[1],以后半规管BPPV发病率最高,可达90%,病因多于椭圆囊中耳石脱落至半规管有关。Epley基于管石理论提出了手法复位治疗BPPV,本次研究通过Epley复位法和常规抗眩晕药物治疗的比较,了解Epley复位法治疗BPPV的临床疗效。现报道如下。     

Risk factors for residual dizziness in patients successfully treated for unilateral benign posterior semicircular canal paroxysmal positional vertigo

ObjectiveThe risk factors for residual dizziness (RD) after successful treatment of benign paroxysmal positional vertigo (BPPV) are poorly characterized. We determined the risk factors for RD in patients with benign unilateral posterior semicircular canal paroxysmal positional vertigo (pc-BPPV) after successful treatment.MethodsWe conducted a prospective study of patients diagnosed with unilateral pc-BPPV between March 2015 and January 2017. Bone mineral density (BMD) was measured by dual-energy X-ray bone mineral densitometry. Participants underwent bithermal caloric testing (C-test) using videonystagmography and a canalith repositioning procedure (CRP). The occurrence of RD was the primary outcome. The participants underwent follow-up 1 week, 1 month, and 1 year after successful CRP, consisting of outpatient visits, questionnaires, and telephone interviews.ResultsWe assessed 115 participants with unilateral pc-BPPV (31 men and 84 women) who were 53.2 ± 8.8 years old. RD occurred in 60 (52.2%) participants. The participants who experienced RD were older, had vertigo for longer before treatment, and were more likely to show a positive C-test and significant BMD loss.ConclusionsWe found that a significant reduction in BMD (T-score  < −1 standard deviation), a positive C-test, and older age are independently associated with RD in patients with pc-BPPV after successful CRP.     

Identification of the affected ear in lateral canal benign paroxysmal positional vertigo

Background:

The effective management of lateral canal benign paroxysmal positional vertigo (LC-BPPV) is dependent upon the accurate identification of the affected ear. The supine roll test is the gold standard for diagnosing LC-BPPV. However, in some cases, the elicited nystagmus has a similar intensity when the head is rolled to the right or to the left.

Objectives:

The purpose of this systematic review was to determine the effectiveness of accessory diagnostic procedures, used in conjunction with the supine roll test, at accurately identifying the affected ear in individuals with LC-BPPV.

Methods:

The following databases were searched: (1) CINAHL Plus with Full Text, (2) ProQuest Medical Library, and (3) MEDLINE. The following search terms were used: (1) ‘lateral canal’ OR ‘horizontal canal’ AND (2) ‘positional vertigo’ OR ‘positioning vertigo’ OR ‘positional nystagmus’ OR ‘positioning nystagmus’. Evidence level was examined with the Oxford Centre for Evidence-Based Medicine 2011 levels of evidence method, and methodological rigour was examined with the QUADAS method.

Results:

A database search originally identified 1348 records, and nine studies were ultimately included in the qualitative synthesis. This systematic review revealed four index tests that, when used in conjunction with the supine roll test, were able to accurately identify the affected ear in a majority of individuals with LC-BPPV.

Conclusions:

The pseudo-spontaneous test was found to be slightly superior to the other three index tests in terms of eliciting nystagmus during its administration and identifying the same affected ear as the supine roll test.     

后半规管阻塞术治疗难治性阵发性位置性眩晕的围手术期护理

目的探讨后半规管阻塞术治疗难治性阵发性位置性眩晕的围手术期护理方法。方法回顾性分析和总结18例行后半规管阻塞术患者的围手术期护理经验。结果术后发生眩晕2例,经处理眩晕症状缓解。术后随访1年,17例眩晕症状消失,1例仍有阵发性位置性眩晕发作。结论术前做好患者的心理护理,术后加强病情观察和指导对提高治疗效果具有重要意义。     

良性阵发性位置性眩晕成功手法复位后短期残余头晕的影响因素分析

目的:探讨良性阵发性位置性眩晕(benign paroxysmal positional vertigo, BPPV)患者成功手法复位后1周残余头晕(residual dizziness, RD)的发生情况及相关危险因素。方法:对2018年6月至2019年6月在上海交通大学医学院附属第九人民医院首次就诊成功手法复位的223例BPPV患者进行为期1周的随访,在首诊(W0)及手法复位后1周(W1)时进行眩晕/头晕视觉模拟量表(VAS)、头晕残障量表(DHI)评估,并在W0行GAD-7、PHQ-9、HAMA及HAMD-17等神经心理学量表评估。W1时头晕VAS评分大于1分判定为存在RD。比较伴有及不伴有RD组之间人口学及临床指标的差异,调查成功手法复位后患者短期生活质量的影响因素。结果:成功手法复位的BPPV患者1周时RD的发生率为50.67%(113/223)。伴有RD组首诊时头晕残障量表(DHI)评分明显高于不伴有RD组(P=0.009),差异主要体现在功能性分值(DHI-F)[(17.38±8.67)vs(14.91±9.39),P=0.044]和情绪性分值(DHI-E)[4(2,11.5)vs 4(0,8),P=0.013],而年龄、性别、眩晕持续时间,焦虑抑郁评分在2组间差异无统计学意义。多因素logistic回归分析发现,首诊时DHI评分30分(OR=2.149,95%CI 1.257～3.673,P=0.005)是RD的独立预测因素。线性回归发现,RD是BPPV患者成功手法复位后1周时生活质量的主要影响因素(95%CI 10.346～16.661,P0.001)。结论:近一半的BPPV患者成功手法复位后1周存在RD,首诊时DHI总分大于30分可作为手法复位后短期RD的预测因子。     

与良性阵发性位置性眩晕相关的影响因素分析

目的 探讨良性阵发性位置性眩晕(BPPV)相关的影响因素.方法 选取2018年9月至2020年9月于该院神经内科就诊的BPPV患者126例作为BPPV组,选取同期年龄、性别相匹配的70例体检健康者作为对照组.记录两组人群的性别、年龄、饮酒史、吸烟史、糖尿病、高血压、家族冠心病史、偏头痛病史.检测白细胞计数(WBC)、血...     

良性阵发性位置性眩晕的影响因素分析

目的探讨良性阵发性位置性眩晕(BPPV)临床诱因以及合并疾病的影响。方法对137例BPPV患者病历进行分析,并对其采用自制问卷进行调查。结果本组中患者合并有循环缺血、高血压、突发性耳聋以及迷路炎的较多;过度劳累、精神以及心理因素、全身疾病、体力以及脑力劳动、合并中耳疾病是导致BPPV的独立因素。结论过度劳累、精神以及心理因素、全身疾病、体力以及脑力劳动、合并中耳疾病史是导致患者发生BPPV的独立影响因素,在BPPV治疗中应当注意对原发疾病的治疗。     

特发性良性阵发性位置性眩晕复位后残余头晕与脑血管反应性的关系

目的 探讨特发性良性阵发性位置性眩晕（BPPV）患者在复位成功后残余头晕（RD）的发生与脑血管反应性（CVR）的关系。方法 记录117例特发性BPPV患者的眩晕残障评定量表（DHI）评分,复位成功后应用经颅多普勒血流分析仪通过屏气试验（BHI）测定CVR,观察1周内患者RD的发生情况,根据是否存在RD将117例患者分为...     

Anterior canal benign paroxysmal positional vertigo treatment techniques

Background: Being able to resolve the symptoms associated with benign paroxysmal positional vertigo (BPPV) is imperative because of its adverse effect upon an individual's ability to perform normal activities of daily living. Although there are several effective treatments for posterior canal BPPV (PC-BPPV) and for horizontal canal BPPV (HC-BPPV), interventions for anterior canal BPPV (AC-BPPV) are less understood.

Objective: The purpose of this systematic review was to evaluate the effectiveness of interventions that have been specifically designed for the treatment of AC-BPPV.

Methods: A literature search in the CINAHL Plus with Full Text, ProQuest Medical Library, and MEDLINE databases was conducted using the search terms ‘positional vertigo’ OR ‘positional nystagmus’ OR ‘positioning vertigo’ OR ‘positioning nystagmus’ AND ‘anterior canal’ OR ‘superior canal’. The evidence level (EL) of each included study was evaluated using the 2011 Oxford Centre for Evidence-Based Medicine scale, and the methodological rigor (MR) of each included study was evaluated using a scale adapted from Medlicott and Harris.

Results: Through an electronic database search, 342 records were identified. Of these 342 records, four articles met the inclusion criteria and were included in the qualitative synthesis. Although the Yacovino et al. study demonstrated the best one-treatment resolution rate, the other three studies possessed different distinct advantages.

Conclusions: This systematic review revealed four particle repositioning maneuvers that had been specifically developed for the treatment of AC-BPPV. In addition to their relatively high resolution rates, each maneuver was easy to administer and could be safely applied to individuals of various ages and physical abilities.