上半规管良性阵发性位置性眩晕41例

目的 探讨上半规管良性阵发性位置性眩晕(BPPV)诊断和治疗的最佳方案。方法 回顾性分析41例上半规管BPPV患者的病历资料，并对所有患者的诊断及复位进行评估分析。结果 SRM-Ⅳ模拟Dix-Hallpike试验诱发出典型垂直向下眼震28例(68.3%)，其中眼震伴有向地扭转的成分19例，不伴有扭转成分9例；SRM-Ⅳ上半规管BPPV诱发试验诱发出典型垂直向下眼震35例(84.6%)，其中眼震伴有向地扭转的成分30例，不伴有扭转成分5例。在所有41例患者中有38例能通过两种诱发试验对受累侧别做出判断，其中因诱发眼震伴有扭转成分而判断侧别30例，单侧诱发诱发出垂直向下眼震且不伴有扭转成分3例，双侧诱发出垂直向下眼震5例，且不伴有扭转成分，但因眩晕及眼震的强度有明显差别而判断出侧别，患者对受累侧别不能判断3例。在能判断出侧别的38例患者中有左侧上半规管受累25例，右侧上半规管受累13例。对41例采用SRM-Ⅳ上半规管BPPV复位法进行治疗，通过一次治疗痊愈28例，有效12例，无效1例。结论 上半规管BPPV 临床上被越来越重视，应用SRM-ⅣBPPV诊疗系统对上半规管BPPV进行诊治效果好，应该在临床得到推广。

Anterior semicircular canal benign paroxysmal positional vertigo in 41 patients

Objective To explore the diagnosis and the efficacy of canalith respositioning procedure(CRP) in patients with paroxysmal positional vertigo (BPPV) of anterior semicircular canal (ASC). Methods In this research, a retrospective study of 41 patients with ASC-BPPV was performed, then the positioning tests and the CRP were analyzed. Results In 28 individuals (68.3%) presented typical positional nystagmus during the positioning test for PSC-BPPV under the BPPV diagnosis and therapy system, 19 individuals had torsional nystagmus component and 9 individuals only had pure positional down beat nystagmus. In 35 individuals (84.6%) presented typical positional nystagmus during the positioning test for SSC-BPPV, 30 individuals had torsional nystagmus component and 5 individuals only had pure positional down beat nystagmus. In 38 patients had unilateral lesion, 30 were judged by torsional nystagmus component, 3 with pure positional down beat nystagmus but without torsional component were judged by the unilateral nystagmus and 5 with bilateral pure positional down beat nystagmus but without torsional component were judged by the obvious different strength of the vertigo and nystagmus, and 3 patients were difficult to judge the affected side. In 38 patients had unilateral lesion, 23 were with the left AC involvement and 15 were with the right AC involvement. By once treatment, 28 patients were cured, 12 were improved and 1 was invalid. Conclusion BPPV diagnosis and therapy system should be recommended for its exact curative effect in the process off diagnosis and treatment of BPPV.