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埃普利手法:后半规管良性阵发性位置性眩晕的单一治疗方法

Epley's Manoeuvre: A Single Line Treatment for Posterior Semicircular Canal Benign Paroxysmal Positional Vertigo.

作者信息

Gupta Diksha, Solanki Bharti

机构信息

Department of ENT, Dr. S.N. Medical college, Hostel no: 9, shastri nagar, Jodhpur, Rajasthan India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2022 Dec;74(Suppl 3):3877-3882. doi: 10.1007/s12070-021-02695-6. Epub 2021 Jun 26.

Abstract

Benign Paroxysmal Positional Vertigo (BPPV) is the commonest cause of peripheral vertigo. Displaced free floating otoconia in the semicircular canals are responsible for brief attacks of vertigo and nystagmus. Epley's manoeuvre relocates these particles into the utricle. Here we studied the efficacy of Epley's manoeuvre in posterior semicircular canal BPPV without labyrinthine sedatives. 120 patients presented with positional vertigo were included in the study based on positive Dix- hallpike test from August 2018 to July 2019. These patients were treated with only the Epley's manoeuvre and followed up for 6 months. Patients who were previously on labyrinthine sedatives were advised to stop them and treated with only the Epley's manoeuvre. In our study of 120 patients, mean age was 43.5 yrs. Females (52.5%) were commonly affected. Left side posterior semicircular involvement was more than the right side. Epley's manoeuvre had 90% efficacy at 1 week and 100% efficacy at 4 week. Duration of vertigo had significant association ( < 0.01) with the number of sessions required. There was significant improvement in the duration of vertigo attack ( < 0.0001) and frequency of attack ( < 0.0001) before and after the manoeuvre. Epley's manoeuvre lead to significant ( < 0.001) improvement in the quality of life of affected patients measured by DHI scoring. In our 6 months follow up, 10 recurrences occurred having significant ( < 0.01) association with the duration of vertigo attack. Only Epley's manoeuvre without any labyrinthine sedatives is an effective treatment for posterior semicircular canal BPPV patients. It also improves the quality of life of affected patients.

摘要

良性阵发性位置性眩晕(BPPV)是周围性眩晕最常见的病因。半规管内移位的游离耳石会导致短暂的眩晕和眼球震颤发作。Epley手法可将这些颗粒重新定位到椭圆囊。在此,我们研究了在不使用迷路镇静剂的情况下,Epley手法治疗后半规管BPPV的疗效。基于2018年8月至2019年7月期间Dix-Hallpike试验阳性,120例出现位置性眩晕的患者被纳入研究。这些患者仅接受Epley手法治疗,并随访6个月。之前使用过迷路镇静剂的患者被建议停药,仅接受Epley手法治疗。在我们对120例患者的研究中,平均年龄为43.5岁。女性(52.5%)更易受累。左侧后半规管受累多于右侧。Epley手法在1周时有效率为90%,在4周时有效率为100%。眩晕持续时间与所需治疗次数有显著关联(P<0.01)。手法治疗前后,眩晕发作持续时间(P<0.0001)和发作频率(P<0.0001)均有显著改善。通过DHI评分测量,Epley手法使受影响患者的生活质量得到显著改善(P<0.001)。在我们6个月的随访中,出现了10例复发,与眩晕发作持续时间有显著关联(P<0.01)。仅采用Epley手法而不使用任何迷路镇静剂是治疗后半规管BPPV患者的有效方法。它还能改善受影响患者的生活质量。

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Lateral canal paroxysmal positional vertigo revisited.再探半规管良性阵发性位置性眩晕
Ann N Y Acad Sci. 2009 May;1164:316-23. doi: 10.1111/j.1749-6632.2008.03720.x.

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