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目的:探讨良性阵发性位置性眩晕(BPPV)患者的发病特点及临床特征,观察并分析手法复位的疗效。方法:回顾分析384例BPPV患者的发病特点及临床特征,并根据受累半规管的情况行手法复位治疗,观察并分析其疗效。结果:(1)384例患者中,后半规管BPPV(PC-BPPV)331例(86.20%),水平半规管BPPV(HC-BPPV)47例(12.24%),上半规管BPPV(AC-BPPV)3例(0.78%),混合半规管BPPV 3例(0.78%)。(2)384例BPPV患者均行手法复位治疗,PC-BPPV首次有效率为93.66%,远期(半年)有效率96.68%;HC-BPPV首次有效率91.49%,远期(半年)有效率95.74%;AC-BPPV首次和远期(半年)有效率均为66.67%;混合型半规管BPPV首次和远期(半年)有效率均为66.67%。(3)PC-BPPV 331例中,管结石症319例(96.37%),嵴帽结石症12例(3.63%)。HC-BPPV 47例中,管结石症37例(78.72%),嵴帽结石症10例(21.28%)。(4)在半年随访期间,复发49例,复发率12.76%。结论:(1)广西BPPV患者在发病年龄、男女占比、各半规管发病率与文献报道相近或相符,地域和民族因素并未影响上述结果。(2)手法复位治疗BPPV疗效好、见效快、方法简单,是治疗BPPV的最佳方法。(3)BPPV患者复位治疗后复发率较高。
Objective: To investigate the onset and clinical features of patients with benign paroxysmal positional vertigo (BPPV) and to observe and analyze the curative effect of manual reduction. Methods: A retrospective analysis of 384 cases of BPPV in patients with onset characteristics and clinical features, and according to the condition of the affected semicircular canal line reduction therapy, observation and analysis of its efficacy. RESULTS: Among the 384 patients, 331 (86.20%) were BPPV (PC-BPPV) in the posterior semicircular canal, 47 (12.24%) were BPPV (HCBPPV) (0.78%), and three cases of semicircular canalization BPPV (0.78%) were mixed. (2) 384 cases of BPPV patients were treated by manual reduction. The effective rate of PC-BPPV was 93.66% for the first time and 96.68% for the long-term (six months). The effective rate of HC-BPPV was 91.49% for the first time and 95.74 for the long- %. The first and long-term (half-year) AC-BPPV rates were 66.67%. The first and long-term (six months) efficiency of mixed semicircular canal BPPV were 66.67%. (3) Among the 331 PC-BPPV cases, 319 (96.37%) had tubolithosis and 12 (3.63%) had crest-cap stone disease. Among 47 cases of HC-BPPV, 37 cases (78.72%) had lithiasis and 10 cases (21.28%) had crest-cap stone disease. (4) During the follow-up period of six months, 49 cases were relapsed, the recurrence rate was 12.76%. Conclusion: (1) Guangxi BPPV patients age at onset, the proportion of men and women, the incidence of semicircular canal and reported in the literature similar or consistent, regional and ethnic factors did not affect the above results. (2) Manual reduction and treatment of BPPV has the advantages of good curative effect, quick response, simple method and is the best method to treat BPPV. (3) BPPV patients with high recurrence rate after treatment.