改良Dix-Hallpike试验在后半规管良性阵发性位置性眩晕诊断中的应用
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摘要
目的:探讨改良Dix-Hallpike试验对后半规管良性阵发性位置性眩晕(BPPV)的临床意义。方法:对临床怀疑BPPV的患者,先后行改良Dix-Hallpike试验、水平滚转试验和经典Dix-Hallpike试验,比较改良和经典Dix-Hallpike试验诊断后半规管BPPV的敏感性和特异性。结果:后半规管BPPV患者55例,改良Dix-Hallpike和经典Dix-Hallpike均阳性,其中12例同侧水平滚转试验诱发旋转眼震。结论:改良Dix-Hallpike试验和经典Dix-Hallpike试验对于诊断后半规管BPPV具备同样的效能,但前者简化了操作和眼震观察及结果判断,有利于临床推广使用。
Objective: To investigate the application of modified Dix-Hallpike maneuver in the diagnosis of posterior semicircular canal benign paroxysmal positional vertigo. Method: The modified Dix-Hallpike maneuver, supine roll maneuver and classical Dix-Hallpike maneuver were performed respectively. The sensitivity and specificity of modified and classical Dix-Hallpike maneuver in the diagnosis of posterior semicircular canal BPPV was compared. Result: Fifty-five posterior semicircular canal BPPV patients showed both modified and classical Dix-Hallpike maneuver positive result, including 12 cases of rotational nystagmus induced by ipsilateral supine roll maneuver. Conclusion: Modified Dix-Hallpike maneuver and classical Dix-Hallpike maneuver have the same effect on the diagnosis of posterior semicircular canal BPPV, but the former is easy to the operation, nystagmus observation and result judgment, and is conducive to the promotion of use.
Objective: To investigate the application of modified Dix-Hallpike maneuver in the diagnosis of posterior semicircular canal benign paroxysmal positional vertigo. Method: The modified Dix-Hallpike maneuver, supine roll maneuver and classical Dix-Hallpike maneuver were performed respectively. The sensitivity and specificity of modified and classical Dix-Hallpike maneuver in the diagnosis of posterior semicircular canal BPPV was compared. Result: Fifty-five posterior semicircular canal BPPV patients showed both modified and classical Dix-Hallpike maneuver positive result, including 12 cases of rotational nystagmus induced by ipsilateral supine roll maneuver. Conclusion: Modified Dix-Hallpike maneuver and classical Dix-Hallpike maneuver have the same effect on the diagnosis of posterior semicircular canal BPPV, but the former is easy to the operation, nystagmus observation and result judgment, and is conducive to the promotion of use.
引文
[1] VON BREVERN M.Benign paroxysmal positional vertigo[J].Semin Neurol,2013,33:204-211.
[2] 中华耳鼻咽喉头颈外科杂志编辑委员会,中华医学会耳鼻咽喉科学分会.良性阵发性位置性眩晕诊断和治疗指南(2017)[J].中华耳鼻咽喉头颈外科杂志,2017,52(3):173-177.
[3] CAKIR B O,ERCAN I,CAKIR Z A,et al.What is the true incidence of horizontal semicircular canal benign paroxysmal positional vertigo[J]?Otolaryngol Head Neck Surg,2006,134:451-454.
[4] MICHAEL P,OLIVA C E,NU?EZ M,et al.An Abbreviated Diagnostic Maneuver for Posterior Benign Positional Paroxysmal Vertigo[J].Front Neurol,2016,7:115.
[5] COHEN H S.Side-lying as an alternative to the Dix-Hallpike test of the posterior canal[J].Otol Neurotol,2004,25:130-134.
[6] BHATTACHARYYA N,GUBBELS S P,SCHWARTZ S R,et al.Clinical practice guideline:benign paroxysmal positional vertigo(update)[J].Otolaryngol Head Neck Surg,2017,156(3_suppl):S1-S47.
[7] 杨晓凯,郑炎焱,杨晓国,等.外半规管良性阵发性位置性眩晕复位方法理论探讨[J].中国耳鼻咽喉头颈外科杂志,2016,23(12):681-685.
[2] 中华耳鼻咽喉头颈外科杂志编辑委员会,中华医学会耳鼻咽喉科学分会.良性阵发性位置性眩晕诊断和治疗指南(2017)[J].中华耳鼻咽喉头颈外科杂志,2017,52(3):173-177.
[3] CAKIR B O,ERCAN I,CAKIR Z A,et al.What is the true incidence of horizontal semicircular canal benign paroxysmal positional vertigo[J]?Otolaryngol Head Neck Surg,2006,134:451-454.
[4] MICHAEL P,OLIVA C E,NU?EZ M,et al.An Abbreviated Diagnostic Maneuver for Posterior Benign Positional Paroxysmal Vertigo[J].Front Neurol,2016,7:115.
[5] COHEN H S.Side-lying as an alternative to the Dix-Hallpike test of the posterior canal[J].Otol Neurotol,2004,25:130-134.
[6] BHATTACHARYYA N,GUBBELS S P,SCHWARTZ S R,et al.Clinical practice guideline:benign paroxysmal positional vertigo(update)[J].Otolaryngol Head Neck Surg,2017,156(3_suppl):S1-S47.
[7] 杨晓凯,郑炎焱,杨晓国,等.外半规管良性阵发性位置性眩晕复位方法理论探讨[J].中国耳鼻咽喉头颈外科杂志,2016,23(12):681-685.