题名

昏厥的鑑別診斷

DOI

10.6666/ClinMed.201810_82(4).0112

作者

黃至誠

关键词

心因性昏厥(cardiogenic syncope) ; 姿態性低血壓(orthostatic hypotension) ; 姿態不耐症候群(orthostatic intolerance syndrome) ; 神經反射性昏厥(neutrally mediated syncope)

期刊名称

臨床醫學月刊

卷期/出版年月

82卷4期(2018 / 10 / 26)

页次

608 - 612

内容语文

繁體中文

中文摘要

昏厥(syncope)係指因腦部整體的血液灌流不足而產生的暫時性意識喪失,依其成因可區分為三大類:(1)心因性(cardiogenic)昏厥;(2)姿態性低血壓或姿態不耐症候群(orthostatic hypotension or orthostatic intolerance syndrome)引起的昏厥;(3)神經反射性昏厥(neutrally mediated syncope or reflex syncope)。本文將針對第一線的醫師如何經由病史詢問,理學檢查,與初步檢查,做出分類的鑑別診斷,以區分出高風險的病患,將其轉診至相關專科,做進一步的診療。

主题分类 醫藥衛生 > 基礎醫學
醫藥衛生 > 社會醫學
参考文献
  1. (2009).The European Society of Cardiology Guidelines for the diagnosis and management of syncope reviewed by Angel Moya, MD, FESC, Chair of the Guideline Taskforce with J. Taylor, MPhil.Eur Heart J,30,2539-2540.
  2. Bergfeldt, L(2003).Differential diagnosis of cardiogenic syncope and seizure disorders.Heart,89,353-358.
  3. Brignole, M,Moya, A,de Lange, FJ(2018).ESC Guidelines for the diagnosis and management of syncope.Eur Heart J,39,e43-e80.
  4. Colivicchi, F,Ammirati, F,Melina, D(2003).Development and prospective validation of a risk stratification system for patients with syncope in the emergency department: the OESIL risk score.Eur Heart J,2,811-819.
  5. Freeman, R,Wieling, W,Axelrod, FB(2011).Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome.Clin Auton Res,21,69-72.
  6. Ganzeboom, KS,Mairuhu, G,Reitsma, JB(2006).Lifetime cumulative incidence of syncope in the general population: a study of 549 Dutch subjects aged 35-60 years.J Cardiovasc Electrophysiol,17,1172-1176.
  7. Hoefnagels, WA,Padberg, GW,Overweg, J(1991).Transient loss of consciousness: the value of the history for distinguishing seizure from syncope.J Neurol,238,39-43.
  8. Mosqueda-Garcia, R,Furlan, R,Tank, J(2000).The elusive pathophysiology of neurally mediated syncope.Circulation,102,2898-2906.
  9. Naschitz, JE,Rosner, I(2007).Orthostatic hypotension: framework of the syndrome.Postgraduate Med J,83,568-574.
  10. Reed, MJ,Newby, DE,Coull, AJ(2010).The ROSE (risk stratification of syncope in the emergency department) study.J AmColl Cardiol,55,713-721.