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目的分析单侧特发性后半规管良性阵发性位置性眩晕患者的病例特征。方法总结分析2013年11月至2015年2月在山西医科大学第一医院诊治的214例单侧特发性后半规管良性阵发性位置性眩晕患者的病例特点。结果单侧特发性后半规管良性阵发性位置性眩晕患者Dix-Hallpike试验时的眼震平均潜伏期为(2.02±1.19)s,平均持续时间为(21.3±14.5)s,其眼震平均潜伏期、平均持续时间均无性别、年龄差异。184例(86.0%)患者1~2次Dix-Hallpike试验即可诱发出典型眼震。162例(75.7%)患者在醒后起床时或夜间睡眠翻身时首次发病。51例(23.8%)患者出现反转相眼震。患者痊愈率为88.3%(189/214),有效率为98.1%(210/214)。14例(6.5%)患者复位后出现耳石转管现象,67例(31.9%)患者复位后残留头晕或走路不稳症状。210例治疗有效的患者中,1、3、6、12、18个月电话随访时复发率分别为0(0/210,0例失访)、5.7%(12/210,0例失访)、8.7%(18/208,2例失访)、11.8%(23/195,15例失访)、17.4%(31/178,32例失访)。结论单侧特发性后半规管良性阵发性位置性眩晕患者首次发病的高发时段为醒后起床时或夜间睡眠翻身时。大部分患者经过Epley法复位治疗后可痊愈,但长期疗效仍需继续随访观察。
Objective To analyze the case characteristics of patients with unilateral idiopathic posterior semicircular canal benign paroxysmal positional vertigo. Methods The clinical features of 214 patients with unilateral idiopathic posterior semicircular canal benign paroxysmal positional vertigo were analyzed from November 2013 to February 2015 in the First Hospital of Shanxi Medical University. Results The average nystagmus latency was (2.02 ± 1.19) s at Dix-Hallpike test in patients with unilateral idiopathic posterior semicircular canal with benign paroxysmal positional vertigo, with an average duration of (21.3 ± 14.5) s and mean nystagmus latency , The average duration of no gender, age differences. 184 cases (86.0%) of patients 1 to 2 times Dix-Hallpike test can induce typical nystagmus. 162 patients (75.7%) had their first onset when waking up or when they slept at night. In 51 patients (23.8%) patients with inverted phase nystagmus. The cure rate was 88.3% (189/214) and the effective rate was 98.1% (210/214). 14 cases (6.5%) had otolith transfer after reduction, and 67 patients (31.9%) had residual dizziness or walking instability after reduction. Among the 210 patients who were treated effectively, the recurrence rates were 0 (0/210, 0 lost) and 5.7% (12/210, 0 lost) in the 1, 3, 6, , 8.7% (18/208, 2 lost), 11.8% (23/195, 15 lost) and 17.4% (31/178, 32 lost). Conclusions The high incidence of unilateral idiopathic posterior semicircular canal benign paroxysmal positional vertigo is when waking up or when sleeping at night. Most patients after Epley reduction therapy can be cured, but the long-term efficacy still need to follow-up observation.