【摘要】 目的 了解原發性良性陣發性位置性眩暈（benign paroxysmal positional vertigo，BPPV）的雙溫試驗及純音測聽結果臨床特點。 方法 2009年6月—2010年6月診斷為原發性BPPV患者54例，于手法復位前行雙溫試驗及純音聽閾測試，分析原發性BPPV患者的雙溫試驗、純音測聽結果的臨床特點。 結果 40例患耳無半規管輕癱，其病程為（4.25±2.75）周，14例患耳半規管輕癱，其病程為（9.21±5.85）周，兩組間平均病程差異具有統計學意義（t=4.235，Plt;0.05）；39例后半規管BPPV中11例患耳半規管輕癱，15例水平半規管BPPV中3例患耳半規管輕癱，兩組患耳半規管輕癱發生率無統計學意義（χ2=2.679，Pgt;0.05）；39例后半規管BPPV中16例患耳聽力下降，15例水平半規管BPPV中7例患耳聽力下降，兩組患耳純音測聽異常率無明顯統計學差異（χ2=0.141，Pgt;0.05）。 結論 原發性后半規管BPPV與水平半規管BPPV半規管輕癱及純音聽閾異常發生率相近，病程長者更易出現半規管輕癱。【Abstract】 Objective To investigate the clinical features of results of bithermal test and pure tone test for patients with idiopathic benign paroxysmal positional vertigo (BPPV), and discuss strategies for prevention. Methods A total of 54 patients diagnosed to have BPPV during June 2009 to June 2010 underwent bithermal caloric test and pure tone test before particle repositioning maneuver. Then, we analyzed the clinical features of the test results. Results The course of 40 patients with canal paresis (CP) was (4.25±2.75) weeks, which had a significant difference from the course of 14 patients with CP in the abnormal side, which was (9.21±5.85) weeks (t=4.235, Plt;0.05). Among the 39 patients with posterior semicircular canal benign paroxysmal positional vertigo (PSC-BPPV), 11 cases of canal paresis were found in the abnormal ear, and of the 15 patients with horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV), 3 cases of canal paresis were found. There was no statistical difference in the rate of canal paresis between the two groups of patients mentioned above (χ2=2.679,Pgt;0.05). Sixteen out of the 39 PSC-BPPV patients and seven out of the 15 HSC-BPPV patients had hearing loss (HL) in the abnormal ear with no statistical difference between the two groups of patients in the incidence of hearing loss (χ2=0.141,Pgt;0.05). Conclusion The incidence of CP and HL in the abnormal ear of patients with HSC-BPPV and PSC-BPPV is similar, and patients with long course of disease are more likely to have CP.
目的 探討兒童氣道異物的診斷、治療及并發癥發生的原因，以減少誤診及降低并發癥的發生率。 方法 回顧分析2009年1月－2010年8月經病史、癥狀、體征及輔助檢查（胸部X線檢查或CT掃描）初診為氣道異物的317例患兒的臨床資料。所有患兒均行支氣管鏡檢查，明確有異物者行異物取出術，對術中、術后并發癥的原因和處理方法進行總結。 結果 本組患者中有105例（33.1%）患兒曾被誤診為支氣管肺炎或其他呼吸系統疾病，經支氣管鏡檢及異物取出術后，出現并發癥者共35例，包括：喉痙攣8例（22.8%），支氣管痙攣6例（17.1%），支氣管黏膜出血12 例（34.3%），皮下氣腫8例（22.8%），死亡1例（2.8%）。 結論 兒童氣道異物一經確診或高度懷疑，應盡快行支氣管鏡檢查，以保持呼吸道通暢。手術操作應輕柔準確，并注意觀察患兒全身狀況，是減少并發癥的關鍵。