儿童晕厥的病因及临床特征分析  

Analysis of etiology and clinical characteristics of syncope in children

作　　者：于侠[1] 孙立双[1] 韩立志[1] 张德磊[1] 王倩倩[1] 孙景辉[1] 

机构地区：[1]吉林大学白求恩第一医院,吉林长春130021

出　　处：《临床儿科杂志》2013年第7期605-608,共4页Journal of Clinical Pediatrics

基　　金：国家"十二五"科技支撑计划课题(No.2012BA103B03)

摘　　要：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。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%） ofneurally 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 cardiogenic syncope by precordial discomfort, pain and chest pain. Conclusions The VVS is one of the most common cause of syn- cone in children. The onsets of the various tvves of svncove often have incentives and are vreceded bv some symptoms. Most ofthem have the feature of recurrent attacks.

关 键 词：晕厥 病因 临床特征 儿童 

分 类 号：R725.4[医药卫生—儿科]