Li Fei, Xu Jin, Liu Dan, Wang Jun, Lu Lingmei, Gao Rui, Zhou Xiaowen, Zhuang Jianhua, Zhang Sulin
Department of Neurology, Second Affiliated Hospital of Naval Medical University, Shanghai, China.
Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Front Neurol. 2023 Sep 14;14:1243034. doi: 10.3389/fneur.2023.1243034. eCollection 2023.
This study proposes a "modular management" approach for vestibular neuritis (VN) to reduce chronicization and improve patient prognosis. The approach involves multi-factor grading and hierarchical intervention and was found to be more effective than traditional treatment strategies.
This retrospective analysis compared two groups of VN patients from two medical institutions. The intervention group of 52 patients received "modular management," while the control group of 51 patients did not receive this kind of management. Analyzed the early treatment strategies, 6-month prognosis, and other indicators of the two groups of patients, compared and analyzed their overall prognosis, and identified the risk factors affecting the chronicization.
The modular management group had lower dizziness severity, better balance, lower anxiety, and higher video head impulse testing (v-HIT) gain after 6 months of onset. Analysis of factors related to persistent postural-perceptual dizziness (PPPD) in patients with VN showed positive correlations between the time from onset to diagnosis and PPPD, and Vertigo Symptom Scale (VSS), Dizziness Handicap Inventory (DHI), anxiety, and depression. Normalized vestibular rehabilitation was negatively correlated with PPPD, while gender, age, and early steroid use had no significant correlation. The multi-factor logistic regression model correctly classified 93.20% of the study subjects with a sensitivity of 87.50% and specificity of 94.90%.
The proposed "modular management" scheme for VN is a comprehensive and dynamic approach that includes health education, assessment, rehabilitation, therapy, evaluation, and prevention. It can significantly improve patient prognosis and reduce chronicization by shifting from simple acute treatment to continuous management.
本研究提出一种用于前庭神经炎（VN）的“模块化管理”方法，以减少疾病慢性化并改善患者预后。该方法涉及多因素分级和分层干预，且被发现比传统治疗策略更有效。
本回顾性分析比较了来自两家医疗机构的两组VN患者。干预组的52例患者接受了“模块化管理”，而对照组的51例患者未接受此类管理。分析两组患者的早期治疗策略、6个月预后及其他指标，比较并分析其总体预后，确定影响慢性化的危险因素。
模块化管理组在发病6个月后头晕严重程度较低、平衡能力较好、焦虑程度较低且视频头脉冲测试（v-HIT）增益较高。对VN患者持续性姿势性感知性头晕（PPPD）相关因素的分析显示，从发病到诊断的时间与PPPD、眩晕症状量表（VSS）、头晕残障量表（DHI）、焦虑和抑郁之间呈正相关。标准化前庭康复与PPPD呈负相关，而性别、年龄和早期使用类固醇无显著相关性。多因素逻辑回归模型对93.20%的研究对象分类正确，灵敏度为87.50%，特异度为94.90%。
所提出的VN“模块化管理”方案是一种全面且动态的方法，包括健康教育、评估、康复、治疗、评价和预防。它可以从单纯的急性治疗转向持续管理，从而显著改善患者预后并减少慢性化。
