摘要
目的探讨不同病程时段联合简易床旁检查法对老年血管源性眩晕的检出情况及临床意义。方法选取2017年1月至2020年1月解放军第305医院神经内科收治的67例老年血管源性眩晕患者,分别于3个时段(发病6 h内、6~24 h、48~72 h)进行联合简易床旁检查法查体。结果除自发眼震外,其他查体项目均随着时间延长,阳性检出率呈上升趋势。发病48~72 h,对中枢性眩晕检出率较高的前3位检查项目分别是联合床旁检查法(+)、头脉冲(HIT,甩头试验)(-)、FUKUDA(原地踏步)试验(+)。发病6 h内、6~24 h、48~72 h,联合简易床旁检查法对中枢性眩晕阳性检出率逐渐增高,分别为82.1%(55/67)、91.0%(61/67)、94.0%(63/67)。3组阳性检出率两两比较差异有统计学意义(P<0.05)。结论老年血管源性眩晕患者发病72 h之内应反复多次进行眩晕床旁查体,其临床价值在于中枢性眩晕的早期发现,而不是完全排除中枢性眩晕。
Objective To explore the positive detection rate and clinical significance of combined simple bedside vertigo examination in elderly patients with vascular vertigo.Methods Sixty-seven elderly patients with vascular vertigo from January 2017 to January 2020 were enrolled in the study.The patients were underwent combined simple bedside vertigo examination in three time periods(<6 h,6-24 h,48-72 h).Results Except for spontaneous nystagmus,other physical examination items showed an increasing positive detection rate with the extension of time.The first three test items with high detection rate of central vertigo within 48-72 h were combined bedside test(+),head pulse test(-),and FUKUDA test(+).The positive detection rate of combined simple vertigo examination increased gradually,which was 82.1%(55/67),91.0%(61/67)and94.0%(63/67)respectively in three time periods(<6 h,6-24 h,48-72 h).There were statistically differences(P<0.05)of the positive detection rates among the three time periods.Conclusions The vertigo physical examination should be repeated within 72 h after the onset of vascular vertigo in the elderly patients.Its clinical value lies in the early detection of central vertigo rather than the complete exclusion of central vertigo.
作者
赵津京
王凯
严小艳
须瑞
陈丰
杨志丽
Zhao Jinjing;Wang Kai;Yan Xiaoyan;Xu Rui;Chen Feng;Yang Zhili(Department of Neurology,The 305th Hospital of PLA,Beijing 100017,China)
出处
《北京医学》
CAS
2020年第9期844-846,共3页
Beijing Medical Journal
基金
首都特色应用研究与成果推广项目(Z171100001017175)。
关键词
联合简易床旁检查法
血管源性眩晕
老年
combined simple bedside vertigo examination
vascular vertigo
elderly
