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摘要


昏厥(syncope)係指因腦部整體的血液灌流不足而產生的暫時性意識喪失,依其成因可區分為三大類:(1)心因性(cardiogenic)昏厥;(2)姿態性低血壓或姿態不耐症候群(orthostatic hypotension or orthostatic intolerance syndrome)引起的昏厥;(3)神經反射性昏厥(neutrally mediated syncope or reflex syncope)。本文將針對第一線的醫師如何經由病史詢問,理學檢查,與初步檢查,做出分類的鑑別診斷,以區分出高風險的病患,將其轉診至相關專科,做進一步的診療。

參考文獻


1. Ganzeboom KS, Mairuhu G, Reitsma JB, et al. Lifetime cumulative incidence of syncope in the general population: a study of 549 Dutch subjects aged 35-60 years. J Cardiovasc Electrophysiol 2006;17:1172-6.
2. Hoefnagels WA, Padberg GW, Overweg J, et al. Transient loss of consciousness: the value of the history for distinguishing seizure from syncope. J Neurol 1991;238:39-43.
3. Bergfeldt L. Differential diagnosis of cardiogenic syncope and seizure disorders. Heart 2003;89:353-8.
5. Freeman R, Wieling W, Axelrod FB, et al. Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome. Clin Auton Res 2011;21:69-72.
6. Mosqueda-Garcia R, Furlan R, Tank J, et al. The elusive pathophysiology of neurally mediated syncope. Circulation 2000;102:2898-906.

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