良性阵发性位置性眩晕的临床分析

目的探讨良性阵发性位置性眩晕的临床特征。方法回顾160例确诊BPPV患者，分析其临床资料。结果BPPV发病年龄为7-82岁，好发年龄段均为50—70岁，男女比例为0．68：1。发生于后半规管的BPPV为113例（70．6％），水平半规管为21例（13．1％），有26例（16．3％）为同时发生于后半规管和外侧半规管。47例水平半规管BPPV中，33例（70．2％）为半规管耳石，14例（29．8％）为壶腹嵴顶耳石。确诊患者中，有98例（61．3％）为首次发作，有49例（30．6％）为复发，或者有明确的类似发作病史。13例（8．1％）曾有眩晕发作，但具体发病特征不明确。对P—BPPV以Epley复位，1周后复查有效率为81．4％（92／113）。半规管型H—BPPV以Lempert法复位，有效率为72．7％（24／33）。壶腹嵴顶型H—BPPV采用强迫体位（健侧卧位）治疗，1周后复查有38．5％（5／13）转为半规管型，以Lempert法复位奏效。随访1月有12例复发（9例P—BPPV和3例H—BPPV）。结论BPPv在各年龄段均有发作，通过患者的发病特征和详细的神经耳科学检查可以做出诊断。根据不同类型进行复位治疗可以取得较好的疗效。

Clinical characteristics of benign paroxysmal positional vertigo

Objective to discuss the clinical characteristics of benign paroxysmal positional vertigo （BPPV）. Method retrospectively reviewed 247 cases of diagnosed and suspected BPPV, and analysis their data. Results BPPV could be recognized between 7-82 years old, with a peak age of 50~70, and a gender ratio of 0.68：1 （male：female）. In 160 cases of diagnosed BPPV, 113 （70.6%） were posterior, and 21 （13.1%） were horizontal, and 26 （16.3%） were simultaneously in both. In 47 cases of horizontal BPPV, 33 （70.2%） were Canalolithiasis while the other 14 （29.8%） were Cuplolithiasis. BPPV initially attacked in 98 cases （61.3%）, and recurred in 49 cases （30.6%）. Epley maneuver was sueeessed in 81.4%（92/113） cases, while Lempert maneuver was effective in 72.7% （24/33） cases. Conclusion BPPV could be recognized in all age, and a diagnosed should be based on a detailed interrogation and a careful check of nystagmus.