变位试验结合手法复位诊治良性发作性位置性眩晕

目的:探讨变位试验诊断良性发作性位置性眩晕(BPPV)及耳石手法复位的疗效。方法:回顾性分析50例BPPV患者的资料,对所有患者进行全面病史采集,行变位试验(Roll试验和Dix-hallpike试验)判定BPPV的类型及侧别,对后半规管BPPV(PC-BPPV)患者采用Epley手法复位,对水平半规管BPPV(HC-BPPV)管石症患者采用Barbecue翻滚法复位,对水平半规管嵴顶结石症患者采用Gufoni疗法、Casani解脱法和Barbecue翻滚法复位。结果:随访3周时治愈42例(84%),有效49例(98%),无效1例(2%),且无明显不良反应。结论:根据典型病史及变位试验可判断BPPV的类型及侧别。手法复位治疗BPPV效果显著、简便、安全,适于临床推广。

Treatment of Benign Paroxysmal Positional Vertigo with Positional Tests and Canalith Repositioning Procedures

Aim： To value the efficacy of positional tests in diagnosis of benign paroxysmal positional vertigo （BPPV） and canalith repositioning procedures（CRP）. Methods： 50 cases of BPPV patients were reviewed retrospectively. After comprehensive history-taking, Dix-Hallpike test and Roll test were performed to determine the type and the laterality of BPPV. Epley maneuver was used to posterior canal BPPV（PC-BPPV）, Barbecue maneuver to canalithiasis of horizontal semicircular canal BPPV（HC-BPPV）, Gufoni maneuver, Casani maneuver, and Barbecue maneuver to cupulolithiasis of HC-BPPV. Results： After 3 week following up, 84% of patients （42/50） were cured, 98%（49/50） effective, while 2% （1/50） ineffective. None of them had obvious side effect. Conclusion： The type and the laterality of BPPV were determined by typical case history and positional tests. Treatment of BPPV with CRP is thought to be effective, simple, safe and worth to popularize.