论文部分内容阅读
目的:探讨不同变位试验在诊断良性阵发性位置性眩晕(BPPV)中的价值。方法:对我科2000年2月~2004年4月诊断的后半规管(PC)源性良性眩晕72例,采用交叉设计,随机将其中36例先行Dix-Hallpike试验,再行侧卧试验;男36例试验排序与其相反。此后再行仰卧侧头位试验。结果:Dix-Hallpike试验和侧卧试验在诊断PC-BPPV中所得结果具有关联性(P<0.01),诊断阳性率差异无统计学意义(P>0.05);两者裸眼观察到眼震的典型阳性反应分别为77.9%及77.1%,差异亦无统计学意义(P>0.05)。2种试验诱发眩晕和(或)眼震具有的潜伏期、持续期及性质、方向等特征无差异。1例患者同时仰卧侧头位试验阳性,诊断同时存在PC-BPPV。结论:在诊断PC-BPPV中,侧卧试验与Dix-Hallpike具有相同的客观诊断价值。在活动受限的情形下,侧卧试验更易于操作及更具安全性,可完全取代Dix-Hallpike试验。在前2种试验出现水平眼震时应同时行仰卧头位试验,以确定是否同时伴有或为水平半规管源性病变。
Objective: To investigate the value of different displacement tests in the diagnosis of benign paroxysmal positional vertigo (BPPV). Methods: 72 cases of posterior semicircular canal (PC) -based benign vertigo were diagnosed in our department from February 2000 to April 2004. Twenty-six patients were randomized to Dix-Hallpike test by cross design. The 36 trials ranked the opposite. After supine side head position test again. Results: There was no significant difference between the Dix-Hallpike test and the side-by-side test in diagnosing PC-BPPV (P <0.01), and the positive rate of diagnosis was not statistically significant (P> 0.05) The positive reactions were 77.9% and 77.1% respectively, with no significant difference (P> 0.05). There was no difference in latency, duration, nature, direction and other characteristics of vertigo and / or nystagmus induced by the two kinds of tests. One patient was positive in the supine position at the same time, diagnosing PC-BPPV at the same time. CONCLUSIONS: Lateral tests have the same objective diagnostic value as Dix-Hallpike in the diagnosis of PC-BPPV. Side-by-side tests are easier and safer to handle and can completely replace the Dix-Hallpike test when activity is limited. In the first two trials, there should be horizontal nystagmus at the same time when the head position test to determine whether at the same time or with horizontal semicircular canal-derived lesions.