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頁籤選單縮合
| 題 名 | 急診暈厥病患的診斷流程=Evaluation of Syncope in the Emergency Department |
|---|---|
| 作 者 | 胡為雄; | 書刊名 | 中華民國重症醫學雜誌 |
| 卷 期 | 5:1 2003.01[民92.01] |
| 頁 次 | 頁1-16 |
| 分類號 | 415.932 |
| 關鍵詞 | 心電生理檢查; 神智喪失; 暈厥; 傾斜床; Electrophysiological testing; Loss of consciousness; Syncope; Tilt testing; |
| 語 文 | 中文(Chinese) |
| 中文摘要 | 暈厥是急診室常見的問題,約佔所有急診病患的3%。暈厥的診斷是極為嚴厲的挑戰,因為引起的原因有良性的,亦有威脅生命的而有猝死的危險。 暈厥的診斷,首重病史的詢問,身體檢查及12導程心電圖檢查。如需進一步檢查則可包括隨身攜帶式心電圖、平均信號心電圖、傾斜床測試及心電生理檢查。這些檢查皆會增加醫療成本及健保的財務負擔,因此發展出一套經濟有效的診斷流程是極重要的。病史的詢問、身體檢查及12導程心電圖即常足以初步評估心源性暈厥病患及猝死的危險,亦可做為病患是否住院或門診評估的依據。如何獲得診斷所需的重點?如何選擇適當的檢查?如何解讀檢查異常?如何確立診斷?皆需有清楚的指引。本文將對暈厥的病理生理、原因、診斷、預後做一綜合論述。 |
| 英文摘要 | Syncope is a common clinical problem accounting for approximately 3% of emergency room visits. The patient with syncope often poses a formidable diagnostic challenge. The differential diagnosis of syncope is extensive and range from benign disorders to life-threatening illness with potential for sudden death. A careful systematic clinical evaluation beginning with a history, physical examination and electrocardiogram will establish the diagnosis in most patients, and the judicious use of specialized testing, such as tilt testing, loop recorder, and electrophysiological testing will confirm or uncover the cause in many of the remaining cases. With the advent of these newer diagnostic tests, it is likely that patients are undergoing a greater number of tests of considerably higher cost; the financial burden of undiagnosed syncope is high. Therefore there is a need for specific criteria to aid diagnosis from history and physical examination, and clear-cut guidelines on how to choose tests, how to evaluate abnormalities and how to use the results to establish a cause of syncope. The development of cost-effective diagnostic strategies continues to be of great importance. We will provide an up-to-date review of the pathophysiology and causes of syncope as well as detailed information concerning its diagnostic evaluation and the patients prognosis. |
本系統中英文摘要資訊取自各篇刊載內容。