本文選題：前庭 + 代償��； 參考：《臨床耳鼻咽喉頭頸外科雜志》2017年09期

【摘要】：目的:探討前庭外周損傷患者自發(fā)眼震(SN)的特點(diǎn)及其臨床價(jià)值。方法:以60例急性單側(cè)前庭外周損傷眩暈患者為研究對象,均為前庭神經(jīng)炎(VN),分別完成自發(fā)眼震、冷熱試驗(yàn)測評。以SN強(qiáng)度和方向、冷熱試驗(yàn)的優(yōu)勢偏向(DP)值及單側(cè)半規(guī)管反應(yīng)減退(UW)值為評定指標(biāo)(異常者分別稱為DP、UW),結(jié)合病程,分析SN的特點(diǎn)及其與病程、DP及UW間的關(guān)系。結(jié)果:60例中有SN者49例(81.7%),無SN者11例(18.3%)。SN強(qiáng)度范圍0.5°/s~20.4°/s,與病程呈負(fù)相關(guān)(r=-0.478,P0.01)。將SN強(qiáng)度按輕、中、重分組,病程中位數(shù)分別為6.5、5.0、3.0d,差異有統(tǒng)計(jì)學(xué)意義(χ~2=9.071,P0.01)。有SN者中冷熱試驗(yàn)DP 44例(89.8%),DP值正常5例(10.2%),SN強(qiáng)度與DP值呈正相關(guān)(r=0.513,P0.01);存在UW者35例(71.4%)(UW側(cè)別與SN方向不同者31例、相同者4例),雙側(cè)半規(guī)管反應(yīng)減退者7例(14.3%),雙側(cè)半規(guī)管反應(yīng)正常者7例(14.3%),SN強(qiáng)度與冷熱試驗(yàn)UW值無相關(guān)關(guān)系(r=-0.321,P0.05)。有SN和無SN者UW值分別為(40.9±26.3)%和(29.9±18.2)%,差異有統(tǒng)計(jì)學(xué)意義(F=4.497,P0.05)。結(jié)論:急性前庭外周損傷者的SN強(qiáng)度多為中重度,強(qiáng)度隨病程延長逐漸減弱或改變方向,且較無SN者的前庭損傷程度重。SN對前庭外周損傷側(cè)別及代償狀態(tài)評估具有臨床指導(dǎo)價(jià)值。
[Abstract]:Objective: to investigate the characteristics and clinical value of spontaneous nystagmus in patients with vestibular peripheral injury. Methods: 60 patients with acute unilateral vestibular peripheral injury vertigo were studied. The strength and direction of SN, the dominant bias of the cold and hot test and the UW value of unilateral semicircular canal reaction were taken as the evaluation index (abnormal cases were called DPUWN respectively). The characteristics of SN and its relationship with the course of disease and the course of disease were analyzed. Results among 60 cases, 49 cases had SN (81.7%), 11 cases without SN had intensity range of 0.5 擄/ s (20.4 擄/ s), which was negatively correlated with the course of disease (P 0.01). SN intensity was divided into light, medium and heavy groups, the median course of disease was 6.5V 5.0 / 3.0d, and the difference was statistically significant (蠂 ~ (2 / 2) 9.071g / (P0.01). Among the patients with SN, 44 cases with DP-89.8 and 5 cases with normal DP value (10.2%) had a positive correlation between SN strength and DP value (P 0.01), 35 cases with UW and 31 cases with different direction between UW and SN. There was no correlation between the intensity of SN and the UW value of the cold and hot test in 7 patients with normal bilateral semicircular canal reaction and the UW value of the cold and hot test. There was no correlation between the intensity of SN and the UW value of the cold and hot test. The values of UW in patients with SN and without SN were 40.9 鹵26.3% and 29.9 鹵18.2, respectively. The difference was statistically significant (P 0.05). Conclusion: the SN intensity of patients with acute vestibular peripheral injury is moderate and severe, and the intensity decreases or changes with the course of disease. Moreover, the degree of vestibular injury in patients without SN was more severe than that in patients without SN, and had clinical guiding value for the evaluation of vestibular peripheral injury side and compensatory state.
【作者單位】： 天津醫(yī)科大學(xué)一中心臨床學(xué)院;天津市第一中心醫(yī)院耳鼻咽喉頭頸外科天津市耳鼻咽喉科研究所;
【分類號】：R764

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