良性阵发性位置性眩晕患者100例临床分析

目的：探讨良性阵发性位置性眩晕（ BPPV）的诊断和治疗，观察复位后的有效率、并发症和复发率，以协助临床医生准确的诊治。方法对100例已确诊为BPPV的患者的病程、发作诱因、持续时间、发作频率、伴随症状进行详细的病史采集，观察不同类型的BPPV的潜伏期、眼震类型及持续时间，并给予相应的耳石复位法（ CRP ）治疗，对于3次复位效果不好的患者采用 Brandt-Daroff 习服法练习，随访3个月。结果100例BPPV的患者，其中男32例，女68例，年龄23～78岁，病程2 h至半年。后半规管BPPV占65％，其中右侧后半规管管结石占39％，左侧后半规管管结石占24％，右侧后半规管嵴帽结石1％，双侧后半规管结石1％。水平半规管BPPV占31％，其中右侧水平半规管管结石占13％，左侧水平半规管管结石占9％，右水平半规管嵴帽结石4％，左侧水平半规管嵴帽结石5％。混合半规管BPPV占4％，其中右后半规管结石合并右水平半规管结石2％，左水平半规管合并左后半规管1％，左水平半规管合并右后半规管1％。3个月后随访有效率96％，复发率5％。结论 BPPV的诊断和治疗依赖于病史和其临床特征，CRP是治疗BP-PV有效的方法。

Clinical features of 100 patients with benign paroxysmal positional vertigo

Objective To explore the diagnosis and treatment of benign paroxysmal positional vertigo （BPPV）.We assess the efficacy,complications and recurrence rate after canalith repositioning procedure （CRP）on the treatment of patients with BPPV , in order to improve the treatment .Methods 100 patients who had been diagnosis as BPPV were inquired and their clinical data included the course of BPPV , the onset of incentives , duration,seizure frequency,associated symptoms were collected .We observe their latency period ,nystagmus type and duration.Then give the different CRP .If patients failed after three continuous treatments ,we choose Brandt-Daroff.All the patients were followed up for 3 months.Results Of the 100 patients,32 were men and 68 were women,aged from 23 to 78 years.65% had unilateral posterior semicircular canal canalithiasis .39% had right unilateral posterior semicircular canal canalithiasis ,24%had left unilateral posterior semicircular canal canalithiasis ,1%had unilateral posterior semicircular canal cupulolithiasis , 1% had bilateral posterior semicircular canal canalithiasis .31% had unilateral horizontal semicircular canal canalithiasis .13% had right unilateral horizontal semicircular canal canalithiasis ,9% had left unilateral horizontal semicircular canal canalithiasis , 4% had right unilateral horizontal semicircular canal cupulolithiasis , 5% had left unilateral horizontal semicircular canal cupulolithiasis .combined multiple semicircular canal canalithiasis in 4%patients.2%right unilateral posterior semicircular canal canalithiasis combined with right unilateral horizontal semicircular canal canalithiasis ,1% left unilateral horizontal semicircular canal canalithiasis combined with left unilateral posterior semicircular canal canalithiasis , 1% left unilateral horizontal semicircular canal canalithiasis combined with right unilateral posterior semicircular canal canalithiasis . After 3 months the total improvement rate was 96%,and the recurrence rate was 5%.Conclusion CRP remains an efficient and long-lasting noninvasive treatment for BPPV ,we must be combined with the history and clinical features , giving an accurate diagnosis and treatment .