發(fā)布時(shí)間：2018-08-03 08:23

【摘要】：目的 本文擬通過對(duì)112例特發(fā)性BPPV患者冷熱試驗(yàn)結(jié)果的分析,以期發(fā)現(xiàn)BPPV在前庭功能檢查方面的一些特點(diǎn),進(jìn)一步了解BPPV的可能發(fā)病機(jī)制。 方法 以2006年一2010年我科門診就診的眩暈患者中112例診斷為特發(fā)性BPPV者,其中后半規(guī)管性BPPV(PC-BPPV)91例,外半規(guī)管BPPV(HC-BPPV)19例,前半規(guī)管BPPV(AC-BPPV)2例,進(jìn)行雙耳交替冷熱試驗(yàn)(Calorictest,CT)檢測。以半規(guī)管輕癱值(CP)為評(píng)定參數(shù),分析PC-BPPV和HC-BPPV這兩種BPPV類型在溫度試驗(yàn)檢查中的差異,探討差異的可能原因及機(jī)制。 結(jié)果 91例PC-BPPV,患側(cè)CP 26例,健側(cè)CP 14例,患側(cè)CP發(fā)生率高于鍵側(cè),兩者差異有統(tǒng)計(jì)學(xué)意義;19例HC-BPPV,患側(cè)CP 10例,健側(cè)CP 1例,患側(cè)CP發(fā)生率高于健側(cè),兩者存在顯著差異,有統(tǒng)計(jì)學(xué)意義;PC-BPPV中患側(cè)CP 26例,HC-BPPV中患側(cè)CP 10例,HC-BPPV患側(cè)CP發(fā)生率高于PC-BPPV患側(cè)CP發(fā)生率,兩者差異有統(tǒng)計(jì)學(xué)意義。 結(jié)論 特發(fā)性PC-BPPV和HC-BPPV患者溫度試驗(yàn)中患側(cè)CP異常發(fā)生率明顯高于健側(cè);HC-BPPV患者患側(cè)CP異常發(fā)生率明顯高于PC-BPPV患者。半規(guī)管內(nèi)飄動(dòng)的耳石使內(nèi)淋巴液密度改變對(duì)內(nèi)淋巴產(chǎn)生重力加載可能是使溫度試驗(yàn)產(chǎn)生異常的原因之一。除了飄動(dòng)的耳石,前庭外周系統(tǒng)可能存在廣泛的病變。溫度試驗(yàn)、搖頭試驗(yàn)及前庭自旋轉(zhuǎn)試驗(yàn)聯(lián)合應(yīng)用有助于更全面評(píng)價(jià)BPPV患者的前庭功能。
[Abstract]:Objective to analyze the results of cold and hot tests in 112 patients with idiopathic BPPV in order to find out some characteristics of BPPV in vestibular function examination and to further understand the possible pathogenesis of BPPV. Methods from 2006 to 2010, 112 patients with idiopathic BPPV were diagnosed as idiopathic BPPV, including 91 cases of posterior semicircular canal BPPV (PC-BPPV), 19 cases of outer semicircular canal BPPV (HC-BPPV) and 2 cases of anterior semicircular canal BPPV (AC-BPPV). Using semicircular canal paresis value (CP) as the evaluation parameter, the differences between PC-BPPV and HC-BPPV in temperature test were analyzed, and the possible causes and mechanism of the differences were discussed. Results there were 91 cases of PC-BPPVs, 26 cases of affected side CP, 14 cases of healthy side CP. The incidence of CP in the affected side was higher than that in the key side. The difference between the two cases was statistically significant (P < 0.01). The incidence of CP in the affected side was higher than that in the healthy side, including 10 cases in the affected side and 1 case in the healthy side. There was a significant difference between the two groups. The incidence of CP in the affected side of 26 patients with HC-BPPV was significantly higher than that in the affected side of PC-BPPV, and the difference was statistically significant. Conclusion the incidence of CP abnormality in patients with idiopathic PC-BPPV and HC-BPPV is significantly higher than that in patients with HC-BPPV. The incidence of abnormal CP in patients with HC-BPPV is significantly higher than that in patients with PC-BPPV. The change in the density of endolymphatic fluid caused by the fluttering otoliths in the semicircular canal may be one of the reasons for the abnormal temperature test. In addition to fluttering otoliths, the vestibular peripheral system may have extensive lesions. Combined use of temperature test, shaking test and vestibular self-rotation test is helpful for more comprehensive evaluation of vestibular function in patients with BPPV.
【學(xué)位授予單位】：福建醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2011
【分類號(hào)】：R764.34

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