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目的:通过手法复位与SRM-Ⅳ前庭功能检查及诊疗系统2种方法对后半规管及水平半规管良性阵发性位置性眩晕(BPPV)患者的诊断、疗效及复发率进行评估。方法:纳入采用Dix-Hallpike、滚转试验确诊的水平及后半规管BPPV患者,通过SRM-Ⅳ前庭功能检查及诊疗系统进行眼震评估,判断两者诊断(半规管类型)符合率。同时将患者分组,分别进行经典方法手法复位及SRM-Ⅳ仪器复位,从而评估2种复位方法的有效率。结果:采用经典方法与SRM-Ⅳ仪器进行半规管类型判断,两者符合率为100%。SRM-Ⅳ仪器复位组第1次复位痊愈率为73.8%,有效率为95.2%,第2次复位痊愈率为84.5%,有效率为97.6%。而手法复位组第1次复位分别为61.5%及80.8%,第2次为75.0%及82.7%。2组2次痊愈率及有效率均存在显著差异(均P<0.05)。其中后半规管BPPV患者中,手法复位组1次治愈率及总治愈率分别为65.8%和78.0%,SRM-Ⅳ仪器复位组1次治愈率及总治愈率分别为84.1%和92.1%,2组间差异均有统计学意义(均P<0.05)。而水平半规管BPPV患者中,手法复位组1次治愈率及总治愈率分别为45.4%和63.6%,SRM-Ⅳ仪器复位组1次治愈率及总治愈率分别为57.1%和85.7%,2组1次复位治愈率差异无统计学意义(P>0.05),总治愈率差异有统计学意义(P<0.05)。在疾病复发率上,各组均无统计学差异。结论:与经典方法相比,SRM-Ⅳ仪器对于不同类型BPPV治愈率及有效率更高。
OBJECTIVE: To assess the diagnosis, efficacy and recurrence rate of posterior semicircular canal and horizontal semicircular canal in patients with benign paroxysmal positional vertigo (BPPV) by manual reduction and SRM-Ⅳ vestibular function examination and diagnosis system. METHODS: Patients with Dix-Hallpike, clinically diagnosed levels of tumbling tests and BPPV in the posterior semicircular canal were enrolled in this study. The assessment of nystagmus by SRM-IV vestibular function test and treatment system was performed to determine the coincidence rate of the two methods (semicircular canal type). At the same time, the patients were divided into groups, respectively, the classic method of manual reduction and SRM-Ⅳ instrument reset to assess the effectiveness of the two kinds of reset method. Results: The classic method and SRM-Ⅳ instrument for semicircular canal type judgment, the two coincidence rate was 100%. The recovery rate of SRM-IV instrument in the first reduction group was 73.8%, the effective rate was 95.2%, the recovery rate of the second reduction was 84.5% and the effective rate was 97.6%. The first reduction of the manual reduction group was 61.5% and 80.8%, the second was 75.0% and 82.7%. There were significant differences between the two groups in the second cure rate and the effective rate (all P <0.05). Among the patients with BPPV in the posterior semicircular canal, the primary cure rate and the total cure rate in the manual reduction group were 65.8% and 78.0%, respectively. The primary cure rate and total cure rate in the SRM-IV instrument group were 84.1% and 92.1%, respectively There were significant differences between the two groups (all P <0.05). Among the patients with horizontal semicircular canal BPPV, the first-time cure rate and total cure rate were 45.4% and 63.6% in the reduction group and 57.1% and 85.7% in the SRM-IV instrument group, respectively There was no significant difference in the cure rate of one-time reduction (P> 0.05). The total cure rate had significant difference (P <0.05). The rate of disease recurrence, no significant difference between the groups. Conclusion: Compared with the classical method, SRM-IV instrument has higher cure rate and higher efficiency for different types of BPPV.