CAJ | 학술논문

目的观察发作频率不同的血管迷走性晕厥患者的预后.方法对因晕厥就诊的门诊患者进行体检,筛查出159例15 ～59岁的患者,根据在首诊之前5年内晕厥发作次数分为低频组(95例)和高频组(64例),同时根据治疗方法的不同将患者划分为3类治疗级别:未治疗亚组、物理治疗亚组和综合治疗亚组,并对人群进行为期24个月的随访,观察患者发作晕厥的情况.结果高频组晕厥前兆的发生率明显高于低频组[40.6％ (26/64)比11.6％ (11/95),P＜O.01]；低频组晕厥总体好转率明显高于高频组(P＜0.01),低频组患者物理治疗亚组及综合治疗亚组晕厥好转率[分别为81.8％ (27/33)和82.2％ (37/45)]均明显高于未治疗亚组[47.1％ (8/17),P均＜0.05]；高频组综合治疗亚组好转率明显高于物理治疗亚组[62.2％ (28/45)比31.6％ (6/19),P＜0.05].结论针对晕厥发作次数较少的患者,物理治疗可以明显降低晕厥的复发率.针对晕厥发作次数多的患者,应该采用物理联合药物的治疗方案.
목적 관찰발작빈솔불동적혈관미주성훈궐환자적예후.방법 대인훈궐취진적문진환자진행체검,사사출159례15 ～59세적환자,근거재수진지전5년내훈궐발작차수분위저빈조(95례)화고빈조(64례),동시근거치료방법적불동장환자화분위3류치료급별:미치료아조、물리치료아조화종합치료아조,병대인군진행위기24개월적수방,관찰환자발작훈궐적정황.결과 고빈조훈궐전조적발생솔명현고우저빈조[40.6％ (26/64)비11.6％ (11/95),P＜O.01]；저빈조훈궐총체호전솔명현고우고빈조(P＜0.01),저빈조환자물리치료아조급종합치료아조훈궐호전솔[분별위81.8％ (27/33)화82.2％ (37/45)]균명현고우미치료아조[47.1％ (8/17),P균＜0.05]；고빈조종합치료아조호전솔명현고우물리치료아조[62.2％ (28/45)비31.6％ (6/19),P＜0.05].결론 침대훈궐발작차수교소적환자,물리치료가이명현강저훈궐적복발솔.침대훈궐발작차수다적환자,응해채용물리연합약물적치료방안.
Objective To analyze the impact of attack frequency as well as therapy strategies on outcome of patients with vasovagal syncope (VVS).Methods A total of 159 patients (aged from 15-59 years old) with VVS were included in this study.Patients were divided into low frequency (＜ 3) group (n =95) and high (≥3) frequency group (n =64) according to the attack frequency in the past 5 years at the primary survey.Patients received one of the three therapies:no treatment,physical therapy,and comprehensive treatment.All cases were followed up with telephone or outpatient visit for 24 months.Results Incidence of syncope was significantly higher in the high frequency group and in the low frequency group [40.6％ (26/64) vs.11.6％ (11/95),P ＜0.01].The overall improvement rate was significantly higher in the low frequency group than that of high frequency group (P ＜ 0.01).Improvement rate was significantly higher in the physical therapy subgroup and the comprehensive treatment subgroup than no treatment subgroup for patients with low attack frequency [81.8％ (27/33) vs.47.1％ (8/17),P ＜ 0.05 ; 82.2％ (37/45) vs.47.1％ (8/17),P ＜ 0.05],and in comprehensive treatment subgroup than in physical therapy subgroups observed between and [62.2％ (28/45) vs.31.6％ (6/19),P ＜ 0.05] for patients with high attack frequency.Conclusion Outcome is related to previous attack frequency for patients with VVS,physical therapy is effective for reducing the recurrence rate of syncope in VVS patients with low attack frequency while physical therapy combined with pharmacotherapy should be applied for VVS patients with high attack frequency to improve outcome.