Semont管石解脱法联合前列地尔治疗良性位置性眩晕的疗效及发生残余症状的影响因素分析

目的 探讨Semont管石解脱法联合前列地尔在良性位置性眩晕患者中的应用及发生残余症状的影响因素。方法 选取2018年1月—2019年12月在天津医院进行治疗的良性位置性眩晕患者120例为研究对象，随机分为观察组和对照组，每组60例。两组患者均采取Semont管石解脱法治疗。观察组患者在此基础上联合前列地尔治疗。比较两组患者的疗效、生活质量、复诊情况；多因素Logistic回归模型分析患者术后发生残余症状的影响因素。结果 与对照组相比，观察组患者的治疗总有效率升高（P <0.05）；经过治疗后，两组患者的DHI量表各项指标均下降，且观察组患者的功能、情感、躯体、总分差值高于对照组（P <0.05）；观察组的无残余症状患者数多于对照组，有残余症状、复发患者数少于对照组（P <0.05）；有残余症状与无残余症状患者的发病月份、睡眠障碍、DHI量表评分、高血压、糖尿病、冠心病比较，差异有统计学意义（P <0.05）；发病月份为12～2月［O^R=1.63（95% CI：1.33，2.32）］、睡眠障碍［O^R=1.06（95% CI：0.75，2.11）］、DHI量表评分［O^R=2.12（95% CI：1.36，2.62）］、高血压［O^R=1.12（95% CI：1.02，1.20）］、糖尿病［O^R=0.71（95% CI：0.52，0.94）］、冠心病［O^R=2.01（95% CI：1.56，2.30）］为患者治疗后发生残余症状的独立危险因素（P <0.05）。结论 Semont管石解脱法结合前列地尔对良性位置性眩晕患者的治疗效果显著，复发率较低；发病月份为12～2月、睡眠障碍、DHI评分较高、高血压、糖尿病、冠心病为患者治疗后发生残余症状的独立危险因素。

Application of Semont tube stone relief combined with alprostadil in otolith patients and the influencing factors of residual symptoms

Objective To study the application of Semont tube stone relief combined with alprostadil in otolith patients and the influencing factors of residual symptoms.Methods A total of 120 otolith patients who were treated in Tianjin Hospital from January 2018 to December 2019 were selected as the research objects. According to the principle of random grouping, the above patients were randomly divided into the observation group and the control group, with 60 cases in each group. Both groups were treated with Semont tube stone relief method, and the patients in the observation group were treated with alprostadil on this basis. The difference between the two groups in treatment effect, quality of life, and follow-up were compared, and the risk factors of postoperative residual symptoms were analyzed.Results Compared with the control group, the treatment of the observation group was better (P < 0.05), and the total effective rate (90.00%) was significantly increased (P < 0.05); after treatment, the DHI scale indexes of the two groups were significantly decreased, and the function, emotion, body, and total score were significantly decreased in the observation group (P < 0.05); the patients without residual symptoms in the observation group were significantly higher than those in the control group, and the patients with residual symptoms and recurrent otolith were significantly lower than those in the control group (P < 0.05); there were statistically significant differences in onset month, sleep disorder, DHI scale score, hypertension, diabetes mellitus, and coronary heart disease between patients with and without residual symptoms (P < 0.05); the onset month was from December to February [O^R= 1.63 (95% CI: 1.33, 2.32)], sleep disorder [O^R = 1.06 (95% CI: 0.75, 2.11)], DHI scale score [O^R = 2.12 (95% CI: 1.36, 2.62)], Hypertension [O^R = 1.12( 95% CI: 1.02, 1.20)], diabetes [O^R = 0.71 (95% CI: 0.52, 0.94)], coronary heart disease [O^R = 2.01 (95% CI: 1.56, 2.30)] were independent risk factors for residual symptoms after treatment.Conclusion The combination of Semont tube stone relief method and alprostadil has a significant therapeutic effect on otolith patients, with a low recurrence rate. At the same time, winter, sleep disorders, high DHI score, hypertension, diabetes and coronary heart disease will aggravate the residual symptoms of otolith.