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目的分析单侧特发性水平半规管良性阵发性位置性眩晕的病例特征。方法回顾性分析2014-01~2015-03门诊诊治的137例单侧特发性水平半规管良性阵发性位置性眩晕患者的临床资料,总结记录发病诱因、发病至就诊间隔时间、变位试验特点、眼震形式、复位有效率及随访期间复发率。结果 (1)86例(62.8%)在床上翻身时首次发作,24例(17.5%)在睡前躺下或清晨起床时首次发作,15例(10.9%)在弯腰低头或转头时首次发作。(2)发病3 d及3 d以内就诊者63例,4 d至1周者46例,1-2周者15例,2周以上者13例,发病至就诊平均持续时间6.7 d。(3)首诊当日经过一次变位试验即诱发出典型眼震者96例,经过2次roll test出现典型眼震者22例。(4)左侧患病者67例,右侧患病者70例;行roll test出现向地性眼震者85例,背地性眼震52例。(5)首诊当日复位总有效率82.5%(113/137),3-7 d复诊时有效率为91.2%(125/137),治疗有效的125例患者,就诊后1,3,6,12,18个月随访,复发率分别为0.8%(1/125,0例失访)、4%(5/125,0例失访)、7.3%(9/124,1例失访)、12.1%(14/116,9例失访)、15.9%(17/107,18例失访)。结论水平半规管良性阵发性位置性眩晕通过病史和变位试验可以明确诊断,Barbecue法复位有效率高,但有一些复杂病例需要结合多种检查判定患侧,其长期有效率和复发率需继续随访观察。
Objective To analyze the case characteristics of benign paroxysmal positional vertigo in unilateral idiopathic semicircular canal. Methods The clinical data of 137 patients with unilateral idiopathic horizontal semicircular canal benign paroxysmal positional vertigo diagnosed from January 2014 to March 2015 were analyzed retrospectively. The incidence of the disease, the interval from onset to treatment, the characteristics of the displacement test , Nystagmus form, effective rate of reduction and recurrence rate during follow-up. Results (1) 86 patients (62.8%) first attacked while turning up in bed, 24 patients (17.5%) first attacked before going to bed or getting up early in the morning, and 15 patients (10.9% attack. (2) There were 63 patients within 3 days and 3 days of onset, 46 cases from 4 days to 1 week, 15 cases from 1 to 2 weeks and 13 cases from 2 weeks to over. The average duration of onset from treatment to treatment was 6.7 days. (3) 96 cases of typical nystagmus were induced by a displacement test on the first diagnosis day, and 22 cases of typical nystagmus occurred after 2 roll tests. (4) 67 patients on the left side and 70 patients on the right side; 85 cases were found to have nocturnal nystagmus and 52 cases were nocturnal nystagmus. (5) The total effective rate of the first visit was 82.5% (113/137) on the first visit, 91.2% (125/137) at the 3-7 day follow-up, 125 patients were treated effectively, The recurrence rates at 12 and 18 months were 0.8% (1 / 125,0 and 0%), 4% (5/125 and 0%, respectively), 7.3% (9/124 and 1 patient lost) 12.1% (14/116, 9 lost), 15.9% (17/107, 18 lost). Conclusions The level of semicircular canal benign paroxysmal positional vertigo can be clearly diagnosed by the history and the displacement test. Barbecue method has the advantages of high efficiency, but complicated cases need to be combined with multiple tests to determine the affected side, and its long-term efficiency and recurrence rate should continue Follow-up observation.