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目的:探讨水平半规管良性阵发性位置性眩晕(HSC-BPPV)的眼震特点和治疗方法。方法:对43例HSC-BPPV患者应用红外线视频眼动记录仪分析其变位试验诱发的眼震特点,进行分型、定侧,并采用相应的耳石复位法治疗。结果:43例患者中:①水平向地性眼震患者27例,其中19例接受Barbecue翻滚疗法,或结合强迫侧卧体位疗法,8例不适于翻滚或体位维持困难者接受Asprella法治疗;②水平背地性眼震16例,其中自行或采用Gufoni疗法后转变为水平向地性眼震12例,方向不能转换4例,采用Barbecue翻滚和(或)强迫侧卧体位疗法。1周后随访总有效率为72.1%,3个月后总有效率为81.4%。结论:HSC-BPPV的诊断和治疗应根据不同变位试验诱发的眼震特征判别耳石位于半规管的不同部位及不同发病机制类型,并选择合适的耳石复位技术治疗。
Objective: To investigate the characteristics and treatment of nystagmus of horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV). Methods: 43 cases of HSC-BPPV patients were analyzed by infrared video ocular movement recorder of its displacement test induced nystagmus characteristics, type, side, and the corresponding treatment of otolith reduction. Results: In 43 patients, ① 27 cases of horizontal nystagmus were involved. Among them, 19 patients underwent Barbecue tumbling therapy combined with forced lateral position therapy and 8 were unsuitable for tumbling or asymptomatic maintenance patients receiving Asprella therapy. 16 cases of nocturnal nystagmus, of which Gufoni or Gufoni converted to horizontal geotropic nystagmus in 12 cases, the direction can not be converted in 4 cases, the use of Barbecue rolling and (or) forced lateral position therapy. The follow-up total effective rate was 72.1% after 1 week and 81.4% after 3 months. Conclusions: The diagnosis and treatment of HSC-BPPV should be based on the different nocturnal findings induced by nystagmus test to identify the different parts of the otolith and different types of pathogenesis, and select the appropriate otolith reduction technique.