256例急诊头晕患者临床特点分析.docVIP

256例急诊头晕患者临床特点分析 　　【摘要】 目的：分析急诊头晕患者的病因，探讨其临床特点，提高临床诊断水平。方法：收集2014年1-12月于笔者所在医院急诊科就诊的256例头晕患者的临床资料，将患者分为老年组和非老年组，分析急诊头晕的病因与临床特点。结果：非老年组以良性位置性眩晕（BPPV）发病率最高，老年组以后循环缺血（PCI）等中枢神经系统病变常见。不同年龄组在经颅多普勒超声（TCD）检查中血流变化情况比较，差异均有统计学意义（P0.05）。结论：急诊头晕病因复杂，临床表现多样。青中年头晕患者首先考虑BPPV、精神因素及高血压病等。老年头晕患者主要以后循环缺血等中枢系统疾病为主，且在TCD检查中多伴有血流速度异常。 　　【关键词】 急诊头晕； 良性位置性眩晕； 后循环缺血 　　中图分类号 R741 文献标识码 B 文章编号 1674-6805（2016）16-0106-02 　　【Abstract】 Objective：To explore the causes of emergency dizziness，discuss the clinical characteristics and improve the diagnostic efficiency.Method：The clinical data of 256 dizziness patients in our emergency department from January 2014 to December 2014 were included，they were divided into the elder group and non-elder group，the etiology and clinical characteristics of emergency dizziness were analyzed.Result：The main causes in non-elder group was BPPV（52.7%），the main causes in elder group was PCI（41.7%）and other central nervous system diseases.Different age groups in transcranial doppler ultrasound（TCD） of the changes in the blood flow were compared，the differences were statistically significant（P0.05）.Conclusion：Emergency dizziness etiology is complex，clinical manifestations of a variety of young and middle-aged dizziness patients first consider BPPV，mental factors and hypertension and so on.Elderly patients with dizziness mainly after the circulation ischemia（PCI） and other central nervous system diseases，and in the TCD examination and more with abnormal blood flow. 　　【Key words】 Emergency dizziness； BPPV； PCI 　　First-author’s address：Fengtai Teaching Hospital of Capital Medical University，Beijing 100071，China 　　doi：10.14033/j.cnki.cfmr.2016.16.053 　　头晕是急诊科较为常见的主诉之一，其发病急，病因复杂，临床表现多种多样，令急诊医生感到非常棘手。许多基层的急诊医生对于头晕的病因及临床特点掌握不到位，容易出现误诊、误治，根据头晕的病因和临床特点进行快速识别及做出正确判断对于头晕的诊治至关重要。本文对不同年龄、性别的头晕患者的病因及临床特点进行了分析，以提高急诊医生对头晕的诊断水平。 　　1 资料与方法 　　1.1 一般资料 　　选择于2014年1-12月北京丰台医院急诊科就诊的256例头晕患者为研究对象，老年组144例（56.3%），年龄≥60岁，男53例，女91例；非老年组112例（43.7%），年龄21～59岁，男48例，女64例。两组患者一般资料比较差异无统计