临床儿科杂志
臨床兒科雜誌
림상인과잡지
2013年
7期
605-608
,共4页
于侠%孙立双%韩立志%张德磊%王倩倩%孙景辉
于俠%孫立雙%韓立誌%張德磊%王倩倩%孫景輝
우협%손립쌍%한립지%장덕뢰%왕천천%손경휘
晕厥%病因%临床特征%儿童
暈厥%病因%臨床特徵%兒童
훈궐%병인%림상특정%인동
syncope%etiology%clinical characteristics%child
目的分析儿童晕厥的病因及临床特征。方法回顾性分析以晕厥为主诉的128例住院患儿的临床资料。结果根据晕厥的定义及临床检查结果，排除其中非晕厥性疾病20例，108例患儿确诊为晕厥；其中自主神经介导性晕厥(NMS)70例(64.81%)，心源性晕厥8例（7.41%)，不明原因晕厥24例（22.22%)。发作前有诱因者85例（78.71%)，有晕厥家族史者21例（19.44%)，有猝死家族史者1例（0.93%)。NMS及心源性晕厥常有反复发作的特征。NMS中，血管迷走性晕厥（VVS）前兆常为四肢无力、面色苍白、眼前发黑、听力下降、恶心、胸闷等表现；体位性心动过速综合征（POTS）表现为心慌、胸闷、乏力等；直立性低血压（OH）表现为眼前发黑，面色苍白、听力下降等；心源性晕厥表现为心前区不适、疼痛、胸闷。结论VVS是儿童晕厥最常见原因之一，各类型晕厥的发作常有诱因及前兆，有反复发作的特征。
目的分析兒童暈厥的病因及臨床特徵。方法迴顧性分析以暈厥為主訴的128例住院患兒的臨床資料。結果根據暈厥的定義及臨床檢查結果，排除其中非暈厥性疾病20例，108例患兒確診為暈厥；其中自主神經介導性暈厥(NMS)70例(64.81%)，心源性暈厥8例（7.41%)，不明原因暈厥24例（22.22%)。髮作前有誘因者85例（78.71%)，有暈厥傢族史者21例（19.44%)，有猝死傢族史者1例（0.93%)。NMS及心源性暈厥常有反複髮作的特徵。NMS中，血管迷走性暈厥（VVS）前兆常為四肢無力、麵色蒼白、眼前髮黑、聽力下降、噁心、胸悶等錶現；體位性心動過速綜閤徵（POTS）錶現為心慌、胸悶、乏力等；直立性低血壓（OH）錶現為眼前髮黑，麵色蒼白、聽力下降等；心源性暈厥錶現為心前區不適、疼痛、胸悶。結論VVS是兒童暈厥最常見原因之一，各類型暈厥的髮作常有誘因及前兆，有反複髮作的特徵。
목적분석인동훈궐적병인급림상특정。방법회고성분석이훈궐위주소적128례주원환인적림상자료。결과근거훈궐적정의급림상검사결과，배제기중비훈궐성질병20례，108례환인학진위훈궐；기중자주신경개도성훈궐(NMS)70례(64.81%)，심원성훈궐8례（7.41%)，불명원인훈궐24례（22.22%)。발작전유유인자85례（78.71%)，유훈궐가족사자21례（19.44%)，유졸사가족사자1례（0.93%)。NMS급심원성훈궐상유반복발작적특정。NMS중，혈관미주성훈궐（VVS）전조상위사지무력、면색창백、안전발흑、은력하강、악심、흉민등표현；체위성심동과속종합정（POTS）표현위심황、흉민、핍력등；직립성저혈압（OH）표현위안전발흑，면색창백、은력하강등；심원성훈궐표현위심전구불괄、동통、흉민。결론VVS시인동훈궐최상견원인지일，각류형훈궐적발작상유유인급전조，유반복발작적특정。
Objectives To analyse the etiology and clinical characteristics of syncope in children. Methods The clinical data of 128 children with syncope were retrospectively analyzed. Results According to the definition of syncope and supporting test results, 20 cases of non-syncopal conditions were excluded. In 108 cases of syncope, there were 70 cases (64.81%) of neurally mediated syncope, 8 cases (7.41%) of cardiogenic syncope, and 24 cases (22.22%) of unexplained syncope. Eighty-five cases (78.71%) had incentives before the onsets. Twenty-one cases (19.44%) had the family histories of syncope. One case (0.93%) had the family history of sudden death. The neurally mediated syncope and cardiogenic syncope had the feature of recurrent attacks. The VVS were preceded by limbs weakness, pale complexion, darkness in front of eyes, hearing loss, nausea and chest pain, the POTS by palpitation, chest pain and weakness, the OH by darkness in front of eyes, pale complexion and hearing loss, and the car-diogenic syncope by precordial discomfort, pain and chest pain. Conclusions The VVS is one of the most common cause of syn-cope in children. The onsets of the various types of syncope often have incentives and are preceded by some symptoms. Most of them have the feature of recurrent attacks.
