| Objective: By observing the treatment effect of otolithic manipulation on the dizziness patients whose initial onset was related to the changes in head position,the diagnostic value of head position changes for benign paroxysmal positional vertigo was explored.Methods: A total of 144 patients were admitted to our department from November 2018 to January 2019 due to dizziness,92 of whom were enrolled.The 92 patients were divided into BPPV group,probable BPPV group and suspectable BPPV group.BPPV group: dizziness at the time of onset and visit were related to changes in head position,duration not exceeding 1 min and positional tests were positive.pBPPV group: dizziness at the time of onset and visit were related to changes in head position,duration not exceeding 1 min,with negative positional tests.sBPPV group: dizziness was related to changes in head position at the time of onset,and the duration was no more than 1 min,but not related to changes in head position at the time of visit,with negative positional tests.According to the medical histories and/or the positional tests to determine the affected semicircular canal,the corresponding repositioning method is given,and the therapeutic effect is observed half an hour and one day after repositioning.If there is no cure one day after repositioning,the treatment is continued,and the effect is evaluated again on the third day after the first repositioning.The data was analyzed using SPSS21.0 software.The count data is expressed as a percentage,and the difference in the rate is compared using a chi-square test.The measurement data is expressed by the mean plus or minus standard deviation of the normal distribution,and the variance analysis of multiple sets of sample mean is used.The measurement data that did not obey the normal distribution were expressed by the median and upper and lower quartiles.The logistic regression model was used to analyze the multivariate effect.P < 0.05 indicates that the difference is statistically significant.Results:1.There were no differences in age,gender,BMI,the nature of dizziness at onset,the time from onset to visit,and the combined disease(hypertension,diabetes,hyperlipidemia)among BPPV group,pBPPV group and sBPPV group(P>0.05).The dizziness in the sBPPV group was mainly lightheadedness and unclearness.2.The treatment efficiency of BPPV group,pBPPV group and sBPPV group was 84%,90.9%,84.5% within half an hour after repositioning,and the treatment efficiency one day after repositioning was 84%,72.7%,88.9%,respectively.The effective rate of treatment on the third day was 96%,100%,and 97.8%,respectively.There was no statistical difference in the treatment effect among the three groups(P>0.05).3.Age and time from onset to visit were the influencing factors of the reduction of treatment(P<0.05).Within half an hour after repositioning,the effective rate of reposition decreased by 6.6% for each additional year of age(OR=0.934),and the rate decreased by 19.4% for each additional day of the time from onset to visit(OR=0.806).One day after repositioning,the effective rate of reposition was reduced by 5.9% for each additional year of age(OR=0.941),and the rate decreased by 18.3% for each additional day of the time from onset to visit(OR=0.817).Conclusions:1.For patients with dizziness,if the onset is related to the change of head position and the duration does not exceed 1 min,even if no relation to changes in head position at the time of visit and negative positional tests,BPPV can also be diagnosed and treated with otolithic reposition after excluding other diseases.The onset of dizziness related to the changes in head position is the main basis for the diagnosis of BPPV.The positive position test should not be used as a necessary condition for the diagnosis.2.Age and time from onset to visit are the main influencing factors of otolithic reposition.The older the age,the longer the onset to treatment,the worse the effect of repositioning therapy. |
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