【精品指南】良性阵发性位置性眩晕指南的要点解析

2017-05-11

2017年3月,美国耳鼻咽喉头颈外科学会(AAO-HNS)更新发布了良性阵发性位置性眩晕(BPPV)指南;新版指南是对2008年发布的早期指南的更新;根据新的临床研究和系统评价证据,新版指南对临床上的重要建议做了修改。梅斯小编整理新版指南内容要点,供大家参考! 一、新版指南与旧版指南的主要区别在于: 1.新证据源于2项临床实践指南,20项系统评价及27项随机对照研究; 2.向指南

中文标题:

【精品指南】良性阵发性位置性眩晕指南的要点解析

发布机构:

发布日期:

2017-05-11

简要介绍:

2017年3月,美国耳鼻咽喉头颈外科学会(AAO-HNS)更新发布了良性阵发性位置性眩晕(BPPV)指南;新版指南是对2008年发布的早期指南的更新;根据新的临床研究和系统评价证据,新版指南对临床上的重要建议做了修改。梅斯小编整理新版指南内容要点,供大家参考!
一、新版指南与旧版指南的主要区别在于:
1.新证据源于2项临床实践指南,20项系统评价及27项随机对照研究;
2.向指南更新小组新增一名患者权益保障人员;
3.对BPPV的诊断和管理建议进行了新增与扩展。
4.加强患者教育,重视共同决策;
5.用一种新的方法来阐明动作语句关系;
二、新版指南对临床医生提出了6项中肯的建议:
1.区分BPPV与其他原因的不平衡,如眩晕和头晕;
2.执行仰卧滚转测试,以评估水平半规管BPPV;
3初始观察或治疗1个月后重新评估患者,以记录症状的缓解或持续;
4.评估影响BPPV患者管理的因素,如运动障碍/平衡障碍,中枢神经系统疾病,家庭支持不足,跌倒风险增加等;
5.教育患者注意BPPV对其自身安全的影响,疾病复发的可能性和随访的重要性。
6.当BPPV未治愈时,医师应进行重新评估或考虑其他潜在外周前庭或中枢神经系统疾病;

总 之
新版指南指出:当眩晕与旋转相关时,临床医师应通过Dix-Hallpike试验诊断患者是否为后半规管BPPV;采用耳石复位法治疗后半规管BPPV。新版指南强烈反对,耳石复位法治疗BPPV后对患者进行体位限制。新版指南建议强调了BPPV诊断的准确性和效率,增加了恰当的治疗和定位策略,减少了不恰当前庭抑制药物与辅助测试的使用。
指南原文
2017 AAO-HNS临床实践指南:良性阵发性位置性眩晕(更新版)-全文
2017年3月,美国耳鼻咽喉头颈外科学会(AAO-HNS)更新发布了良性阵发性位置性眩晕指南。该指南的前一版于2008年发布,新版指南建议强调了诊断的准确性和效率,降低了前庭抑制药物的不当使用,同时减少不恰当的辅助测试增加了恰当的治疗和定位策略。

评论区 (3)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1219691, encodeId=9845121969167, content=学习, beContent=null, objectType=guider, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2b305254032, createdName=147ea070m50暂无昵称, createdTime=Sun May 15 01:29:02 CST 2022, time=2022-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=901657, encodeId=245b90165eba, content=<a href='/topic/show?id=23e3454e353' target=_blank style='color:#2F92EE;'>#学习#</a>, beContent=null, objectType=guider, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45473, encryptionId=23e3454e353, topicName=学习)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201016/3536357c07424f56b878266090ae9920/392e9c1e484c430daa2d0c82ef6df159.jpg, createdBy=52bf5424884, createdName=ms2000000956980985, createdTime=Tue Nov 24 09:12:15 CST 2020, time=2020-11-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=204124, encodeId=570f20412460, content=学习了, beContent=null, objectType=guider, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuCl4zaE0zq0kFsKQmg3vef7gFticiaFX50TWZibZibNHbk3YSJ5uSh1a0DcUiaVIHkoe2Om3eYg7oUTlf/0, createdBy=442c2063958, createdName=海棠胜雪, createdTime=Mon May 29 22:00:35 CST 2017, time=2017-05-29, status=1, ipAttribution=)]
    2022-05-15 147ea070m50暂无昵称

    学习

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1219691, encodeId=9845121969167, content=学习, beContent=null, objectType=guider, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2b305254032, createdName=147ea070m50暂无昵称, createdTime=Sun May 15 01:29:02 CST 2022, time=2022-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=901657, encodeId=245b90165eba, content=<a href='/topic/show?id=23e3454e353' target=_blank style='color:#2F92EE;'>#学习#</a>, beContent=null, objectType=guider, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45473, encryptionId=23e3454e353, topicName=学习)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201016/3536357c07424f56b878266090ae9920/392e9c1e484c430daa2d0c82ef6df159.jpg, createdBy=52bf5424884, createdName=ms2000000956980985, createdTime=Tue Nov 24 09:12:15 CST 2020, time=2020-11-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=204124, encodeId=570f20412460, content=学习了, beContent=null, objectType=guider, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuCl4zaE0zq0kFsKQmg3vef7gFticiaFX50TWZibZibNHbk3YSJ5uSh1a0DcUiaVIHkoe2Om3eYg7oUTlf/0, createdBy=442c2063958, createdName=海棠胜雪, createdTime=Mon May 29 22:00:35 CST 2017, time=2017-05-29, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=1219691, encodeId=9845121969167, content=学习, beContent=null, objectType=guider, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2b305254032, createdName=147ea070m50暂无昵称, createdTime=Sun May 15 01:29:02 CST 2022, time=2022-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=901657, encodeId=245b90165eba, content=<a href='/topic/show?id=23e3454e353' target=_blank style='color:#2F92EE;'>#学习#</a>, beContent=null, objectType=guider, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45473, encryptionId=23e3454e353, topicName=学习)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201016/3536357c07424f56b878266090ae9920/392e9c1e484c430daa2d0c82ef6df159.jpg, createdBy=52bf5424884, createdName=ms2000000956980985, createdTime=Tue Nov 24 09:12:15 CST 2020, time=2020-11-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=204124, encodeId=570f20412460, content=学习了, beContent=null, objectType=guider, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuCl4zaE0zq0kFsKQmg3vef7gFticiaFX50TWZibZibNHbk3YSJ5uSh1a0DcUiaVIHkoe2Om3eYg7oUTlf/0, createdBy=442c2063958, createdName=海棠胜雪, createdTime=Mon May 29 22:00:35 CST 2017, time=2017-05-29, status=1, ipAttribution=)]
    2017-05-29 海棠胜雪

    学习了

    0