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目的观察和总结后半规管良性阵发性位置性眩晕(PSC-BPPV)急性发作时的临床特征,为临床诊断提供依据。方法回顾性分析115例PSC-BPPV患者急性发作时的临床表现,分析并总结患者的性别和年龄分布、发病时状态、头晕性质、眩晕发作与头部活动间的关系、眼震、伴随症状、辅助检查等临床特征。结果 PSC-BPPV急性发作时的临床表现具有以下特征:1女性多于男性;2易累及50岁以上人群;3在起床、躺卧、翻身或活动中头部主动或被动到某一位置时突然发病,特别是晨起发病居多;4剧烈的眩晕伴有恶心、呕吐;5部分患者在初次查体时表现出旋转性眼震;6不伴有耳蜗和神经系统症状和体征;7颅脑影像学检查无阳性相关发现。结论急诊时如患者在起床、躺下、翻身或头部活动到某一位置时突然出现剧烈的眩晕发作,不伴有耳蜗和神经系统症状体征,颅脑影像学检查无相关阳性发现,应当考虑PSC-BPPV的诊断,及早行Dix-Hallpke诱发试验能够确立诊断。
Objective To observe and summarize the clinical features of posterior semicircular canal in patients with benign paroxysmal positional vertigo (PSC-BPPV) during acute attack and provide the basis for clinical diagnosis. Methods A retrospective analysis of 115 cases of PSC-BPPV patients with acute attack of the clinical manifestations, analysis and summary of the patient’s gender and age distribution, the onset of state, dizziness, vertigo and head activity, the relationship between nystagmus, accompanying symptoms, Auxiliary examination and other clinical features. Results The clinical manifestations of PSC-BPPV with acute attack had the following characteristics: 1 more women than men; 2 easily affected people over 50 years of age; 3 in wake up, lie down, stand up or activities in the head active or passive to a position suddenly Onset, especially in the morning most of the onset; 4 severe vertigo associated with nausea and vomiting; 5 patients in the first examination showed rotational nystagmus; 6 without cochlear and nervous system symptoms and signs; 7 brain imaging No negative findings related to school tests. Conclusions A sudden onset of severe vertigo, sudden onset of vertigo, absence of cochlear and neurological symptoms and signs, and absence of positive findings in craniofacial imaging should be taken into account when patients emerge at a time when they wake up, lie down, stand up or move their head to a certain position PSC-BPPV diagnosis, early line Dix-Hallpke-induced test to establish the diagnosis.