难治性良性阵发性位置性眩晕的临床分析

目的 探讨难治性良性阵发性位置性眩晕(BPPV)的临床特点及治疗。 方法 回顾分析2014年8月至2016年1月诊断为难治性BPPV的13例患者的临床资料,分析其病因相关因素、类型、临床特点及治疗效果。 结果 13例难治性BPPV中,头部外伤为最常见因素,离地性水平半规管BPPV为最常见类型。根据病因积极治疗伴随疾病,正确手法复位治疗,联合Brandt-Daroff康复训练,11例治愈,随访1年无复发;2例无效;1例后半规管、1例水平半规管BPPV,至他院行半规管堵塞术手术治疗,术后效果好。 结论 难治性BPPV可能与头部外伤及突发性聋等疾病相关,首先需根据病因积极治疗伴随疾病,同时采用正确的手法复位治疗,并联合康复训练。治疗后大部分患者疗效好,无效者行半规管堵塞术效果好。

Clinical analysis of intractable benign paroxysmal positional vertigo

Objective To investigate the clinical characteristics and treatment of intractable benign paroxysmal positional vertigo(BPPV). Methods A retrospective analysis was performed on 13 patients diagnosed as having intractable BPPV,and etiological factors, types, clinical features, and therapeutic effects were analyzed. Results Depending on the cause, concomitant illness was actively treated. Through correct manipulation and Brandt-Daroff treatment, 11 patients were cured, and none of the patients had any recurrence after 1 year of follow-up. The treatment was ineffective in 2 patients, one had a posterior semicircular canal, and one had horizontal semicircular canal BPPV and went to another hospital to undergo semicircular canal blockage surgery with good outcome. Conclusion Refractory BPPV may be associated with head trauma, sudden sensorineuraI hearing loss, and so on. First of all, we must actively treat the accompanying diseases according to the cause. Meanwhile, we should rehabilitate the patients with the correct method and combine Brandt-Daroff exercises. Most patients have good efficacy after treatment, and semicircular canal occlusion is effective for those with invalid refractory BPPV.