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中华老年病研究电子杂志

中华老年病研究电子杂志 ›› 2019, Vol. 06 ›› Issue (04) : 18 -22. doi: 10.3877/cma.j.issn.2095-8757.2019.04.004

所属专题： 文献；

论著

眩晕诊疗系统在老年良性阵发性位置性眩晕诊治中的应用
楼跃1, 徐良国1, 蔡苗1, 王晏雯1, 张思然1, 刘小利1,†()   
  1. 1. 310013　杭州，浙江医院神经内科
  • 收稿日期:2019-10-05 出版日期:2019-11-28
  • 通信作者: 刘小利
  • 基金资助:
    浙江省自然科学基金项目(LQ19H090006); 浙江省医药卫生科技项目(2019KY260，2018KY195)

Application of vertigo diagnosis and treatment system for benign paroxysmal positional vertigo in the elderly

Yue Lou1, Liangguo Xu1, Miao Cai1, Yanwen Wang1, Siran Zhang1, Xiaoli Liu1,†()   

  1. 1. Department of Neurology, Zhejiang Hospital, Hangzhou 310013, China
  • Received:2019-10-05 Published:2019-11-28
  • Corresponding author: Xiaoli Liu
  • About author:
    Corresponding author: Liu Xiaoli, Email:
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引用本文：

楼跃, 徐良国, 蔡苗, 王晏雯, 张思然, 刘小利. 眩晕诊疗系统在老年良性阵发性位置性眩晕诊治中的应用[J]. 中华老年病研究电子杂志, 2019, 06(04): 18-22.

Yue Lou, Liangguo Xu, Miao Cai, Yanwen Wang, Siran Zhang, Xiaoli Liu. Application of vertigo diagnosis and treatment system for benign paroxysmal positional vertigo in the elderly[J]. Chinese Journal of Geriatrics Research(Electronic Edition), 2019, 06(04): 18-22.

目的

探讨眩晕诊疗系统对老年良性阵发性位置性眩晕（benign paroxysmal positional vertigo, BPPV）的诊治效果。

方法

选取2018年9月至2019年3月浙江医院眩晕门诊收治的360例BPPV患者为研究对象，183例老年患者（≥60岁）中98例（A组）采用眩晕诊疗系统进行复位治疗、85例（B组）采用手法复位治疗，177例中青年患者（C组）采用眩晕诊疗系统进行复位治疗。观察比较3组患者的复位疗效，并随访6个月后的复发情况。多组间计量资料的比较采用方差分析，计数资料的比较采用秩和检验及χ2检验。

结果

采用眩晕诊疗系统进行复位治疗时，老年与中青年BPPV患者总的一次、二次复位有效率以及不同亚型BPPV患者的一次、二次复位有效率的差异均无统计学意义（均P>0.05）。与采用手法复位的老年BPPV患者比较，采用眩晕诊疗系统复位的老年患者总的一次复位有效率以及pc-BPPV亚型的一次复位有效率明显更高，差异均有统计学意义（χ2=4.352、5.694，均P<0.05），总的二次复位有效率以及hc-BPPV、hc-BPPV-cu亚型一次、二次复位有效率的差异无统计学意义（均P>0.05）。6个月后的随访结果显示，A组与B、C组比较，差异均无统计学意义（χ2=1.225、1.262，P>0.05）；而且A、B组各亚型BPPV患者的复发率差异也无统计学意义（χ2=1.286、0.019、0.014，P>0.05）。

结论

眩晕诊疗系统对老年BPPV患者具有较好的短期疗效及稳定的长期疗效,成功率高，安全性好且易于操作。

关键词: 良性阵发性位置性眩晕, Dix-Hallpike试验, Roll test试验, 眩晕诊疗系统
Objective

To evaluate the efficacy of vertigo diagnosis and treatment system for benign paroxysmal positional vertigo (BPPV) in the elderly.

Methods

360 patients admitted from September 2018 to March 2019 in Zhejiang Hospital diagnosed as BPPV were included. There were 183 elder patients and 177 young patients. Among the elderly BPPV patients, 98 patients were treated with vertigo diagnosis and treatment system (group A) and 85 patients were treated with manual repositioning (group B).The young patients were treated with vertigo diagnosis and treatment system (group C). The reposition effects of the 3 groups were observed and compared, and the recurrences were followed up for 6 months. Analysis of variance was used for comparison of measurement data between groups, Kruskal-Wallis H test and chi-square test were used for comparison of count data.

Results

While using vertigo diagnosis and treatment system for reposition treatment, there was no statistically significant difference in the total first-time and second-time reposition effective rates between the elderly and the young and middle-aged patients with BPPV, as well as patients with different subtypes of BPPV (allP > 0.05). Compared with the elderly BPPV patients with manual treatment, the total first-time reposition effective rates of elderly patients with vertigo diagnosis and treatment system and the first-time reposition effective rates of pc-BPPV subtype were significantly higher, and the differences were statistically significant (χ2=4.352、5.694, allP< 0.05). There was no significant difference between the total sencond-time reposition effective rates and the first-time and sencond-time reposition effective rates of hc-BPPV, hc-BPPV-cu subtypes (allP > 0.05). After 6 months of follow-up, there were no significant differences in the reposition effective rates among group A and groups B, group C (χ2=1.225, 1.262,P> 0.05); and there was no significant differences in the reposition effective rates of BPPV patients in each subtype of groups A and B (χ2=1.286, 0.019, 0.014,P> 0.05).

Conclusion

Vertigo diagnosis and treatment system has good short-term curative effect and stable long-term curative effect for elder BBPV patients. It has a high probability of success, and is safe and easy to perform.

Key words: Benign paroxysmal positional vertigo, Dix-Hallpike test, Roll test, Vertigo diagnosis and treatment system
表1 3组患者一般资料的比较
组别 例数 年龄（岁） 性别（男/女，例） 患病侧（左/右，例） 发病类型（pc-BPPV/ hc-BPPV/ hc-BPPV-cu，例）
A组 98 60～87（69±7） 41/57 40/58 74/16/8
B组 85 61～84（67±6） 36/49 41/44 59/18/8
C组 177 23～59（44±10） 62/115 85/92 119/30/28
检验值 ? F=36.250 χ2=1.248 χ2=2.546 χ2=3.455
P值 ? <0.05 >0.05 >0.05 >0.05
表2 老年与中青年BPPV患者眩晕诊疗系统的复位疗效比较[例（%）]
组别 例数 一次复位 二次复位 pc-BPPV hc-BPPV hc-BPPV-cu
一次复位 二次复位 一次复位 二次复位 一次复位 二次复位
A组 98 75（76.5） 84（85.7） 63（85.1） 68（91.9） 11（68.8） 14（87.5） 1（12.5） 4（14.3）
C组 177 131（74.0） 145（81.9） 103（86.6） 111（93.3） 24（80.0） 27（90.0） 2（25.0） 7（25.0）
χ2值 ? 0.226 0.231 0.076 0.130 0.726 0.067 0.605 2.057
P值 ? >0.05 >0.05 >0.05 >0.05 >0.05 >0.05 >0.05 >0.05
表3 老年BPPV患者眩晕诊疗系统与手法复位效果比较[例（%）]
组别 例数 一次复位 二次复位 pc-BPPV hc-BPPV hc-BPPV-cu
一次复位 二次复位 一次复位 二次复位 一次复位 二次复位
A组 98 75（76.5） 84（85.7） 63（85.1） 68（91.9） 11（68.8） 14（87.5） 1（12.5） 4（14.3）
B组 85 53（62.4） 67（78.8） 40（67.8） 51（86.4） 13（72.2） 15（83.3） 0（0.0） 1（12.5）
χ2值 ? 4.352 1.498 5.694 1.036 0.049 0.117 1.067 0.410
P值 ? <0.05 >0.05 <0.05 >0.05 >0.05 >0.05 >0.05 >0.05
表4 3组患者复发情况的比较[例（%）]
组别 例数 pc-BPPV hc-BPPV hc-BPPV-cu 合计
A组 92 10（14.1%） 3（21.4%） 1（14.2%） 14（15.2%）
B组 78 12（21.8%） 4（23.5%） 1（16.6%） 17（21.8%）
C组 163 11（9.8%） 3（12%） 3（11.5%） 17（10.4%）
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