以晕厥为首发症状的锁骨下动脉盗血综合征20例临床分析  

The misdiagnosis analysis of subclavian steal syndrome with syncope as first symptom 20 cases report

作　　者：李俊枝 杜芳[2] 蔡斌 李燕 许涵 

机构地区：[1]西安市第九医院急诊科,西安710054 [2]第四军医大学西京医院

出　　处：《陕西医学杂志》2011年第10期1331-1333,共3页Shaanxi Medical Journal

摘　　要：目的:探讨以晕厥为首发症状的锁骨下动脉盗血综合征(SSS)的临床特征及急诊诊断方法。方法:分析急诊20例以晕厥为首发症状的SSS患者的临床特征、误诊原因、TCD和颈动脉彩色多普勒超声检查的结果。结果:最常见的误诊诊断:脑血管性晕厥6例,癫痫3例,反射性晕厥4例,心源性晕厥5例,代谢性晕厥2例。6例经皮腔内血管成形术(PTA)治愈,12例病因治疗症状改善,2例放弃治疗。椎动脉(VA)反向血流是SSS的重要诊断依据。结论:以晕厥为首发症状的SSS极易误诊。主要的病因是动脉粥样硬化。急诊确诊SSS主要靠颈动脉彩色多普勒超声、TCD。Objective：To investigate the clinical characteristics,methods of emergency diagnosis in patients with subclavian steal syndrome（SSS）presenting with syncope.Methods：Analyze clinical manifestations,reasons of misdiagnosis,cervical vascular ultrasound and TCD were collected among 20 SSS cases with syncope as first symptom.Results：The most common misdiagnosed diseases were cerebrovascular syncope（6 cases）.The other misdiagnosed diseases included epilepsy（3 cases）,reflex syncope（4 cases）,cardiogenic syncope（5 cases）,metabolic causes of syncope（2 cases）.6 patients were cured successfully by using Percutaneous Transluminal Angioplasty（PTA）,and symptoms were improved in 12 patients,and 2 patients abandoned threrapy.Backward blood of VA was of great importance in diagnosis SSS.Conclusion：SSS with syncope as first symptom is easily misdiagnosed.The chief cause of SSS are atherosclerosis.Cervical vascular ultrasound and TCD are the primary means of diagnosis in the emergency.

关 键 词：晕厥 锁骨下动脉窃血综合征 超声检查 多普勒 彩色 误诊 

分 类 号：R742[医药卫生—神经病学与精神病学]