Epley管石复位法联合Semont管石解脱法治疗难治性PC-BPPV效果研究-现代医学

Epley管石复位法联合Semont管石解脱法治疗难治性PC-BPPV效果研究

单位：1. 泰州市第二人民医院神经内科, 江苏泰州 225500;
2. 泰州市人民医院康复科, 江苏泰州 225500

关键词：Epley管石复位法 Semont管石解脱法难治性PC-BPPV 疗效预后

分类号：R764

出版年·卷·期（页码）：2018·46·第六期（682-686）

摘要：

目的：探讨Epley管石复位法联合Semont管石解脱法治疗难治性半规管良性阵发性位置性眩晕（PC-BPPV）的疗效，分析影响PC-BPPV预后的因素。方法：前瞻性纳入2016年6月至2017年6月于我院神经内科就诊的180例PC-BPPV患者，随机、双盲、平行分为Epley管石复位治疗组（A组）、Semont管石解脱法治疗组（B组）和Epley+Semont联合治疗组（C组），应用BPPV疗效评价、眩晕前庭指数（VSI）、眩晕症状评分（VSS-SF）评价治疗效果，Logistic回归分析影响PC-BPPV预后的因素。结果：C组一次痊愈率（68.33%）、1个月有效率（95%）显著高于A组、B组（P<0.05）；C组治疗1个月后VSI评分（25.13±4.38）、VSS-SF评分（31.25±4.82）低于A组、B组，差异有统计学意义（P<0.05）；Logistic回归分析显示复位次数≥ 3次、嵴顶结石、VSI ≥ 41分、半规管受损OR值分别为1.279（95% CI：1.024~2.138）、1.625（95% CI：1.146~4.162）、1.307（95% CI：1.034~3.241）、1.492（95% CI：1.221~3.034），是PC-BPPV复发的危险预测因子。结论：Epley管石复位法联合Semont管石解脱法治疗难治性PC-BPPV具有较高的一次痊愈率和有效率，可显著改善患者眩晕症状，多次复位、嵴顶结石、VSI ≥ 41分、半规管受损的患者复发几率较大。

Objective:To discuss the effect of Epley tube stone reduction method combined with Semont tube stone release method treatment on refractory semicircular canal benign paroxysmal positional vertigo(PC-BPPV),and to analyze the factors affecting the prognosis of PC-BPPV.Methods:We included 180 patients with PC-BPPV who were admitted to the Department of Neurology in Taizhou Second People's Hospital From June 2016 to June 2017. They were randomly divided into Epley tracheolithiasis reduction treatment group (group A), Semont stone release therapy group (group B), and combination of the Epley and Semont group(group C). Then evaluation of BPPV effect, vestibular index (VSI) and vertigo syndrom scale (VSS)-SF were used to evaluate the therapeutic effect. Finally, Logistic regression analysis was used to analyze the prognostic factors of PC-BPPV.Results:In group C the cure rate was 68.33%, the effective rate in one month was 95%,they were significantly higher than those in group A and group B (P<0.05).The scores of VSI and VSS-SF in group C were 25.13±4.38 and 31.25±4.82, respectively, which were significant lower than those in group A and group B after one month of treatment(P<0.05). Logistic analysis showed that the OR value of reduction times ≥ 3 times, crest stone, the VSI ≥ 41 points, semicircular canal damage were 1.279(95%CI:1.024-2.138),1.625(95%CI:1.146-4.162),1.307(95%CI:1.034-3.241),and 1.492(95%CI:1.221-3.034).They were risk factors for the recurrence of PC-BPPV. Conclusion:The treatment of refractory PC-BPPV by Epley reduction combined with Semont decompression has a higher recovery rate and effective rate. It can significantly improve the recurrence rate of patients with vertigo, multiple reduction, crest stone, the VSI ≥ 41 points, and semicircular canal damage.

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