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单次 Epley 手法治疗良性阵发性位置性眩晕吗?

Do single-session Epley maneuvers treat benign paroxysmal positional vertigo?

机构信息

From the Otorhinolaryngology Head and Neck Surgery Department, Tokat Gaziosmanpasa Universitesi, Tokat, Turkey.

From the Department of Otorhinolaryngology, Kastamonu University, Kastamonu, Turkey.

出版信息

Ann Saudi Med. 2024 May-Jun;44(3):161-166. doi: 10.5144/0256-4947.2024.161. Epub 2024 Jun 6.

Abstract

BACKGROUND

Benign paroxysmal positional vertigo (BPPV) is the most common peripheral vestibular condition characterized by short-term vertigo attacks that significantly affect quality of life.

OBJECTIVES

Examine how well a single Epley maneuver worked in an outpatient setting for people with posterior canal benign paroxysmal positional vertigo (PC-BPPV) and whether they needed a second Dix-Hallpike maneuver.

DESIGN

Prospective.

SETTINGS

Otorhinolaryngology department of a tertiary care center.

PATIENTS AND METHODS

Sociodemographic data, body mass index (BMI), and systemic disease history of 75 patients diagnosed with PC-BPPV were recorded, and their relationship with success rates after the modified Epley maneuver was analyzed.

MAIN OUTCOME MEASURES

Detect cases that could not be repositioned with the diagnostic control Dix-Hallpike test performed 20 minutes after the modified Epley reposition maneuver in the same session in PC-BPPV patients.

SAMPLE SIZE

RESULTS

Of the 75 patients, 31 were male (41.3%), 44 female (58.6%) with a mean (standard deviation) age of 58.6 (15.9) years age, 54.6% had one or more chronic diseases. BMI was 30 mg/kg and above in 31 patients (41.3%). The modified Epley maneuver was successful in 77.3%. No significant relationship was found between additional diseases or BMI in the patient group in whom the maneuver was unsuccessful.

CONCLUSION

The success rates of repositioning maneuvers in treating patients diagnosed with PC-BPPV are high. However, more than a single maneuver is required in some resistant patients. Second diagnostic and repositioning maneuvers performed in the same session will reduce multiple hospital admissions. While it is helpful to repeat the maneuver in the patient group where it was unsuccessful, other factors causing the failure should be investigated.

LIMITATIONS

Lack of follow-up results of patients after 7-10 days.

摘要

背景

良性阵发性位置性眩晕(BPPV)是最常见的外周前庭疾病,其特征为短期眩晕发作,严重影响生活质量。

目的

检查单次 Epley 手法在外周性后半规管良性阵发性位置性眩晕(PC-BPPV)患者中的治疗效果,以及他们是否需要进行第二次 Dix-Hallpike 手法。

设计

前瞻性。

设置

三级保健中心的耳鼻喉科。

患者和方法

记录 75 例被诊断为 PC-BPPV 的患者的社会人口统计学数据、体重指数(BMI)和全身疾病史,并分析其与改良 Epley 手法后的成功率之间的关系。

主要观察指标

检测在同一时段的改良 Epley 复位后 20 分钟,诊断性控制性 Dix-Hallpike 试验无法重新定位的病例。

样本量

75。

结果

75 例患者中,男性 31 例(41.3%),女性 44 例(58.6%),平均(标准差)年龄为 58.6(15.9)岁,54.6%有 1 种或多种慢性病。BMI 为 30 mg/kg 及以上的患者有 31 例(41.3%)。改良 Epley 手法的成功率为 77.3%。在手法不成功的患者组中,未发现额外疾病或 BMI 与患者之间存在显著关系。

结论

对诊断为 PC-BPPV 的患者进行体位复位治疗的成功率较高。然而,一些耐药患者需要进行多次手法复位。在同一时段进行第二次诊断和复位操作,将减少多次住院。对于手法复位不成功的患者,重复操作是有帮助的,但应调查导致失败的其他因素。

局限性

缺乏患者在 7-10 天后的随访结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8a4/11268478/16e74e59384c/0256-4947.2024.161-fig01.jpg

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