97例儿童心源性晕厥临床分析  

Clinical features and diagnosis of cardiogenic syncope in children

作　　者：王凯 王东伟 孙漾丽 WANG Kai;WANG Dongwei;SUN Yangli(Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450007,China)

机构地区：[1]郑州大学附属郑州中心医院,河南郑州450007

出　　处：《中国实用神经疾病杂志》2020年第11期986-990,共5页Chinese Journal of Practical Nervous Diseases

基　　金：河南省科技攻关计划项目(编号:2018020771)。

摘　　要：目的回顾性分析儿童心源性晕厥的临床特征,以更有效的指导临床。方法选取2016-06—2019-06于郑州中心医院儿科就诊并住院治疗的心源性晕厥患儿97例为研究对象,依据病因将患儿分为心律失常性晕厥组、器质性心血管疾病性晕厥组、混合性晕厥组。详细记录每组患儿心源性晕厥的诱因、先兆、先兆类型、发作次数、意识丧失时长、伴发症状及检查结果。结果69例(71.1%)患儿无明显先兆,28例(28.9%)患儿有先兆,差异有统计学意义(χ^2=7.614,P<0.05),而诱因之间的差异无统计学意义(χ^2=2.871,P>0.05)。先兆类型以头晕和黑蒙的发生率最高。46例(47.4%)患儿晕厥次数少于5次,76例(78.3%)患儿意识丧失时间<5 min。主要伴发症状为抽搐,发生率为43.3%。79例(81.4%)患儿可见心脏阳性体征,18例(18.6%)患儿可见肝肿大,11例(11.3%)患儿可见面色发绀。结论儿童心源性晕厥有其独特的临床特征,患儿入院后详细的心脏检查可作为初步诊断的依据。Objective To retrospectively analyze the clinical characteristics of cardiogenic syncope in children,so as to guide the clinical practice more effectively.Methods A total of 97 children with cardiogenic syncope who were admitted to the department of pediatrics from June 2016 to June 2019 and hospitalized in our hospital were selected as the study objects.According to the causes,the children were divided into arrhythmia syncope group,organic cardiovascular disease syncope group and mixed syncope group.The causes,precursors,types,frequency,duration of loss of consciousness,accompanying symptoms and physical examination results of cardiogenic syncope in each group were recorded in detail.Results Sixty-nine cases(71.1%)of the patients had no significant aura,28 cases(28.9%)had aura,the difference was significant(χ^2=7.614,P<0.05),but the difference between causes was not significant(χ^2=2.871,P>0.05).Precursor types with dizziness and black Meng highest incidence.Forty-six cases(47.4%)had less than 5 syncope episodes and 76 cases(78.3%)had less than 5 minutes of loss of consciousness.The main concomitant symptom was convulsion,with an incidence of 43.3%.Heart-positive signs were observed in 79 cases(81.4%)of the children,hepatomegaly in 18 cases(18.6%)and cyanosis in 11 cases(11.3%).Conclusion Cardiogenic syncope in children has its unique clinical characteristics.After admission,detailed cardiac examination can be used as the basis for preliminary diagnosis.

关 键 词：心源性晕厥 儿童 临床特征 心脏检查 

分 类 号：R748[医药卫生—神经病学与精神病学]