ROSE规则在急诊晕厥患者的应用与临床分析  

Application of ROSE Rules for Syncope Patients in the Emergency Department and Clinical Analysis

作　　者：穆洪 刘杰昕 魏欣[2] 唐鹤飞[3] 刘中扬[4] 杨铁城[1] Mu Hong;Liu jie-xin;Wei xin;Tang He-fei;Liu Zhongyang;YANG Tie-cheng(Department of Emergency, Beijing Tiantan Hospital, Capital Medical University)

机构地区：[1]首都医科大学附属北京天坛医院急诊科,北京100070 [2]首都医科大学附属北京天坛医院心内科 [3]首都医科大学附属北京天坛医院神经内科 [4]北京蛋白质组研究中心

出　　处：《中国急救复苏与灾害医学杂志》2019年第10期957-960,共4页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：国家自然科学基金项目(31601064).

摘　　要：目的分析急诊晕厥患者的病因分类和ROSE规则评估危险分层。方法选择2016年6月-2019年1月在北京天坛医院就诊的晕厥患者135例,对临床资料进行回顾性分析,并应用英国ROSE规则评估患者短期内发生不良事件的危险层次。结果在135例急诊晕厥患者中,神经介导性晕厥患者81例(60.0%),心源性晕厥31例(23.0%),直立性低血压性晕厥13例(9.6%),其他原因晕厥10例(7.4%),其中,神经介导性晕厥的患者以中年人占较大比例,而心源性晕厥的患者以老年人占较大比例。高龄患者发生短期不良事件的比例更高(45.7%),心源性晕厥患者发生短期不良事件的比例更高(87.1%),ROSE规则具有筛查非高危患者的临床意义。结论急诊工作的医生可以结合患者临床表现和ROSE规则尽快理解晕厥原因和评判危险分层,为患者提供合理的对症治疗和有效的处理,对高龄、心源性晕厥患者要加强重视和短期随访,以改善预后,提高患者的生活质量。Objective To understand the common causes of syncope patients in the emergency department and analyze ROSE rule for patients' evaluation. Methods 135 patients with syncope who were admitted in Beijing Tiantan Hospital from June 2016 to January 2019 were selected. The clinical data were retrospectively analyzed and the patients were evaluated by ROSE rules. Results Among 135 patients with syncope, 81 cases (60.0%) were neuro-mediated syncope, 31 cases (23.0%) were cardiogenic syncope, 13 cases (9.6%) were orthostatic hypotensive syncope and 10 cases (7.4%) were other reasons. Among them, neuro-mediated syncope accounted for a larger proportion in the middle-aged group, while cardiogenic syncope accounted for a larger proportion in the old-aged group. The incidence of short-term adverse outcomes was higher in the old patients (45.7%) and higher in cardiogenic syncope (87.1%). The ROSE rule has the clinical significance of screening non-high-risk patients. Conclusions Doctors in the emergency department should comprehensively understand the causes of syncope and quickly evaluate risk stratification according to patients' clinical manifestations and ROSE rules, and then provide reasonable and effective treatments for patients, in addition, we should pay much more attention to the old patients and patients with cardiogenic syncope, in order to improve the patients' prognosis and quality of life.

关 键 词：晕厥 病因分析 ROSE规则 

分 类 号：R441.9[医药卫生—诊断学]