老年人晕厥的临床特征分析.pdfVIP

!生! 筮 !鲞箜!!塑 |n J Crit Care Med，Nnv．2007，V01．27．N0．11 ·961· 老年人晕厥的临床特征分析 张新超，王 琚， 冷 斌， 李金龙 作者单位：100730 北京，卫生部北京医院急诊科(张新超，冷 斌，李金龙)；清华大学华信医院急诊科(王 瑁) 作者简介：张新超(1962一)，男，博士，主任医师，教授，硕士生导师，急诊科副主任，主要从事急诊与危重病医学尤其是心血管急症的临床 与基础研究，E—mail：xinchaoz@public3．6ta．net．ell。 [摘要] 目的 分析老年人晕厥的临床特征。方法 整理、归纳老年晕厥106例的临床资 料。结果 老年人晕厥以男性居多，心源性为主(51．9％)，脑源性次之(29．2％)；晕厥发作大多在 运动时(70．7％)；绝大多数病例(89．6％)存在2种或2种以上基础疾病和(或)合并症；发作时伴 发心律(率)和血压或心电图的异常，或发作后伴发心绞痛或胸闷或呼吸困难，高度提示心脏或血 管原因；本组死亡10例，心源性者7／10，其中4例有心力衰竭。结论 晕厥在老年人群中常见，其 中心源性居多，自限性差，是疾病预后不良的危险因素；复杂的基础疾病和(或)合并症等多个因素 共同参与晕厥的发生。 [关键词] 晕厥； 老年人；临床特征 [中图分类号] R 544．2 [文献标识码] A [文章编号] 1002—1949(2007)l1—0961—03 Clinical features of syncope in the elderly ZHANG Xin—chao，WANG Jun，LENG Bin，et a1．Emer— gency Department，Beijing Hospital，Chinese Ministry ofHealth。Beijing 100730。China [Abstract] Objective To investigate the clinical features of syncope in the elderly．Method To arrange and analyse the clinical data of 106 elderly eases with syncope．Results The elderly syncope OC— eurred mostly in male．Cardiovascular diseases were the principal reasons for syncope in the elderly (5 1．9％)，and encephalon causes were secondary(29．2％)．The majority of syncope episodes occurred in movements(70．7％)．There were two fundamental diseases or more and／or complications in most ca— ses(89．6％)．When the episodes of syncope were accompanied with abnormal cardiac rhythm or heart rate，abnormal blood pressure and changes of electrocardiogram。and angina pectoris or chest distress or dyspnea were followed，the reasons of cardiovascular diseases for syncope were mainly considered．In this group，10 cases died and 7 cases belonged to cardiac causes．Conclusion The syncope is common syn— drome in the elderly．The cardiovascular causes contribute mainly to the episodes of syncope and indicate a poor self—restriction，which is the risk factor of malignant prognosis．The complex fundamental