护理干预对耳石复位治疗良性阵发性位置性眩晕患者焦虑抑郁的影响

目的探讨护理干预对耳石复位治疗良性阵发性位置性眩晕(BPPV)的临床疗效及对焦虑、抑郁的影响。方法对耳石复位治疗的46例BPPV患者进行护理干预,包括病情评估、手法复位的健康教育和心理疏导、复位中护理及复位后的体位、药物和宣传指导等。结果复位后1周、3个月进行随访,治疗总有效率分别为91.3%、97.8%;患者焦虑自评量表(SAS)和抑郁自评量表(SDS)评分与复位前比较,差异有统计学意义(均P0.05)。结论护理干预对耳石复位治疗BPPV能取得良好的临床疗效,改善患者焦虑、抑郁不良情绪。     

良性阵发性位置性眩晕诊疗分析

目的提高对良性阵发性位置性眩晕（BPPV）的认识并进行合理治疗。方法回顾性分析84例BPPV患者致病因素、治疗方法和疗效。全部病例经DK．Hallpike和滚转试验确诊。对后半规管BPPV（PC。BPPV）采用Semont摆动法或EpJey复位法,上半规管BPPV（SC—BPPV）采用Epley复位法,外半规管BPPv（Hc．BPPv）采用Lempert复位法,混合性BPPV（C-BPPV）分别行Epley复位法和Lempert复位法。完成治疗后2周复查评定疗效。结果PC-BPPv74例,其中痊愈56例,有效10例,无效8例;HC．BPPV6例,其中痊愈4例,无效2例;SC．BPPV3例和C—BPPV1例,均痊愈。发病10d内就诊者痊愈率89．3％（50／56）,11～29d就诊者痊愈率62．5％（5,8）,1～5个月就诊者痊愈率57．1％（8／14）,5个月以上就诊者痊愈率16．7％（1,6）,痊愈率比较差异有统计学意义（P〈0．05）。54例耳石复位1次痊愈,6例复位2次痊愈,4例复位3次痊愈。结论手法复位治疗BPPV有效率高,准确判断受累半规管是成功复位的关键,BPPv治疗效果与发病至就诊时间相关。     

良性阵发性位置性眩晕手法复位患者残余症状的前庭康复训练

目的探讨前庭康复训练对良性阵发性位置性眩晕(BPPV)手法复位患者残余症状的影响。方法将90例手法复位治疗后有残余症状的BPPV患者随机分为三组,分别接受前庭康复训练(前庭康复组,n=29)、口服甲磺酸倍他司汀(药物组,n=30)及联合前庭康复训练及药物治疗(联合组,n=31),干预6周。于入组时及干预2、4、6周末进行眩晕残障程度评定量表(DHI)评分。结果干预后前庭康复组与药物组DHI评分比较,差异无统计学意义(P0.05);联合组DHI评分与另外两组比较,差异有统计学意义(均P0.01)。结论前庭康复训练与甲磺酸倍他司汀对BPPV手法复位后伴残余症状患者治疗效果相当,两种方法联合可进一步提高治疗效果。     

Epley复位后体位对良性发作性位置性眩晕的疗效观察

良性发作性位置性眩晕（benign paroxysmal positional vertigo，BPPV）是眩晕最常见的类型之一，约占所有眩晕的25%^[1]。其特点为眩晕发作持续短暂，通常数秒至1min，与头部位置的改变密切相关。BPPV的年发病率为64/100000^[2]，男女比例为1：2，发病高峰期在40-50岁。国内外采用Epley复位法治疗BPPV取得很好的疗效，     

侧头训练联合手法复位治疗难治性良性阵发性位置性眩晕患者的护理

目的 探讨侧头训练联合手法复位对难治性良性阵发性位置性眩晕(BPPV)的治疗效果及护理方法.方法 对53例难治性后半规管BPPV患者在侧头训练后再行颗粒手法复位(PRM)治疗,并给予系统护理.结果 在侧头训练后,36例经1次、11例经2次、3例经3次、3例经4次PRM后眩晕症状均消失.结论 难治性BPPV可在侧头训练后...     

手法复位治疗良性阵发性体位性眩晕23例疗效观察

目的观察手法复位治疗良性阵发性体位性眩晕（BPPv）的疗效。方法对23例BPPV患者分别给予Epley复位法及Barbecue复位法治疗，观察疗效。结果手法复位治疗后明显好转15例（65．22％），好转5例（21．74％），无效3例（13．04％）。1周内复发3例（13．04％），重复手法复位治疗均明显好转。结论手法复位治疗BPPV疗效较好，复发病例重复手法复位治疗有效，操作简单，安全。     

良性阵发性位置性眩晕病人的护理

对37例良性阵发性位置性眩晕病人实施综合治疗及护理.结果10例完全恢复;17例发作次数减少,症状减轻;10例发作次数无改变但症状较治疗前减轻.提出应重点做好健康教育及药物、体位、前庭习服治疗的护理.     

良性阵发性位置性眩晕患者的心理护理体会

目的探讨良性阵发性位置性眩晕患者心理护理的效果。方法随机将40例良性阵发性位置性眩晕的患者分为2组,各20例。对照组实施常规护理,观察组在常规护理的基础上实施心理护理。在治疗前及治疗后2周采用汉密尔顿焦虑量表(HAMA)对患者焦虑评分进行测评。结果 2组首次治疗治愈率比较,差异无统计学意义(P0.05),治疗前2组的HAMA分值比较,差异无统计学意义(P0.05)。治疗后2组的HAMA分值与治疗前均有所降低,其中观察组显著低于对照组,差异均有统计学意义(P0.05)。结论心理护理是改善良性阵发性位置性眩晕患者焦虑状态的有效措施。     

颈性眩晕150例临床分析

１９９４年２月～１９９６年１月,我们接诊了由颈椎病引起颈性眩晕患者１５０例,现报告如下。临床资料１．一般资料：本组１５０例中男５５例,女９５例;年龄１４～７４岁,以３０～５０岁者最多（８６例）。有颈部扭伤史者２例,无明显诱因者１４８例。病程２时～１０...     

三维牵引复位与两桌法复位治疗胸腰段脊柱骨折的临床应用对比研究

目的探讨两种非手术方法治疗胸腰段脊柱骨折的临床效果。方法对38例及36例外伤性胸腰段脊柱骨折病人分别进行三维牵引复位,两桌法复位治疗,并对骨折复位程度及疗效进行观测及对比分析。结果治疗组,对照组均住院1月,均于随访六月后进行临床疗效评定。结果显示:无论三维牵引,两桌复位法,治疗前后相比病情均有明显改善(P<0.05),而三维牵引复位和两桌复位法疗效比较也存在差异(P<0.05),前者疗效更显著;(2)从椎体形态治疗前后比较,三维牵引复位椎体前缘高度增加17%左右,而两桌法复位增加11%左右;三维牵引复位突入椎管下降0.19cm,两桌复位法下降0.12cm左右。治疗前后各项指标比较有显著差异性,前者明显优于后者。结论三维牵引复位较两桌法复位能明显恢复椎体形态,为一种治疗有效率更高,更安全的非手术治疗方法。     

Short- and long-term outcomes of canalith repositioning for benign paroxysmal positional vertigo.

This is a prospective, nonrandomized study of the canalith repositioning procedure (CRP) for treatment of benign paroxysmal positional vertigo (BPPV). CRP was used to treat 168 patients with BPPV. Patient data were gathered by yearly telephone interviews to determine whether symptoms of position-induced vertigo had returned. After 1 or 2 treatment sessions 91.3% of patients reported complete symptom resolution. Average follow-up for the study population after the initial treatment was 26 months. A recurrence rate of 26.8% was found among those patients who initially reported resolution of symptoms after CRP. Application of recurrence data to a Kaplan-Meier estimation suggests a 15% recurrence rate per year of BPPV, with a 50% recurrence rate of BPPV at 40 months after treatment. There was no significant association between cure or recurrence rate and sex, age, duration of symptoms, presumed cause, or treating physician.     

The canalith repositioning procedure: for treatment of benign paroxysmal positional vertigo.

The Canalith Repositioning Procedure (CRP) is designed to treat benign paroxysmal positional vertigo (BPPV) through induced out-migration of free-moving pathological densities in the endolymph of a semicircular canal, using timed head maneuvers and applied vibration. This article describes the procedure and its rationale, and reports the results in 30 patients who exhibited the classic nystagmus of BPPV with Hallpike maneuvers. CRP obtained timely resolution of the nystagmus and positional vertigo in 100%. Of these, 10% continued to have atypical symptoms, suggesting concomitant pathology; 30% experienced one or more recurrences, but responded well to retreatment with CRP. These results also support an alternative theory that the densities that impart gravity-sensitivity to a semicircular canal in BPPV are free in the canal, rather than attached to the cupula. CRP offers significant advantages over invasive and other noninvasive treatment modalities in current use.     

Management of benign paroxysmal positional vertigo with the canalith repositioning maneuver in the emergency department setting

Vertigo is a common clinical manifestation in the emergency department (ED). It is important for physicians to determine if the peripheral cause of vertigo is benign paroxysmal positional vertigo (BPPV), a disorder accounting for 20% of all vertigo cases. However, the Dix-Hallpike test--the standard for BPPV diagnosis--is not common in the ED setting. If no central origin of the vertigo is determined, patients in the ED are typically treated with benzodiazepine, antihistamine, or anticholinergic agents. Studies have shown that these pharmaceutical treatment options may not be the best for patients with BPPV. The authors describe a case of a 38-year-old woman who presented to the ED with complaints of severe, sudden-onset vertigo. The patient's BPPV was diagnosed by means of a Dix-Hallpike test and the patient was acutely treated in the ED with physical therapy using the canalith repositioning maneuver.     

Benign paroxysmal positional vertigo as the cause of dizziness in patients after severe traumatic brain injury: diagnosis and treatment

Objectives: To identify patients with benign paroxysmal positional vertigo (BPPV) among patients with severe traumatic brain injury (TBI) and to evaluate the effectiveness of the Particle Repositioning Maneouvre (PRM).

Design and methods: Eighteen months prospective study of 150 consecutive patients with severe TBI referred to an in-patients rehabilitation department.

Interventions: A structured interview emphasizing the possible presence of vertigo followed by a detailed neuro-otological examination. Patients diagnosed with BPPV were immediately treated with the PRM.

Main outcomes and results: BPPV diagnosis was based on a positive Dix-Hallpike positional test. PRM efficacy was determined by repeating the positional test 1 or 2 weeks after treatment. Twenty out of 150 (13.3%) patients complained about positional vertigo. The diagnosis of BPPV was confirmed in 10 patients. Signs and symptoms were completely relieved in six patients after a single PRM, while the other four patients needed repeated treatment for complete resolution of BPPV.

Conclusions: About half of the patients with severe TBI who complain about positional vertigo suffer from BPPV. These patients can be efficiently treated by physical maneouvres improving the rehabilitation outcome.     

良性胃十二指肠溃疡急性穿孔不同手术方法的疗效比较

目的探讨良性胃十二指肠溃疡急性穿孔不同手术方式治疗的临床价值。方法对我院1993年1月～2007年6月收治的128例胃十二指肠溃疡急性穿孔分为单纯穿孔修补术加抑酸、根除幽门螺杆菌（第一组）、穿孔修补加扩大壁细胞迷走神经切断术（第二组）、胃大部切除（第三组）进行疗效比较。结果所有病例治愈出院，随访6～120个月。三组的疗效按改良Visick分级评分标准Ⅰ、Ⅱ级分别为84．4％、88．1％、74％，溃疡复发率分别为6．7％、4．8％、7．4％，术后再次穿孔率均为零。χ^2均〈χ^2 0.05（1）），P〉0．05，三组差异无显著性。结论消化性溃疡穿孔修补加抑酸、根除幽门螺杆菌治疗，操作简单、创伤小、并发症少、远期疗效好，可以作为胃十二指肠溃疡穿孔治疗的首选方式。     

STARR术与Bresler术治疗出口梗阻型便秘的短期疗效比较

目的 比较STARR术与Bresler术治疗出口梗阻型便秘（ODS）的短期疗效.方法 回顾性分析并比较由直肠前突和/或直肠内脱垂引起的女性出口梗阻型便秘患者行STARR手术或者Bresler手术的临床资料各30例.结果 STARR术平均手术时间14～31 min,平均（23±4）min,术中出血量5～15 ml,平均（10±3）ml.术后住院时间4～7d,平均5d.术后2例直肠肛门疼痛,其中l例持续至术后6个月;5例轻度大便失禁（肛门失禁评分小于3）,均自行恢复;1例吻合口轻度出血.术后均随访6个月,临床疗效评估满意度为76％.Bresler术平均手术时间15～30 min,平均（22±5）min,术中出血量5～15 ml,平均（10 ±2） ml.术后住院时间4～6d,平均5d.术后3例直肠肛门疼痛,其中1例持续至术后6个月;4例轻度大便失禁（肛门失禁评分小于3）,均自行恢复;2例直肠切割线轻度出血.术后均随访6个月,临床疗效评估满意度为73％.两种手术方式在平均手术时间、术中出血量、术后平均住院时间以及短期临床效果评估上差异均无统计学意义（P＞0.05）.结论 对经严格筛选的ODS患者,两种手术方式短期治疗效果相当,但二者长期疗效比较尚需进一步论证.