非心源性晕厥住院患儿18例临床分析

Analysis of the medical record of 18 cases of children hospitalized with non-cardiac syncope

目的分析非心源性晕厥住院患儿的发病情况及病因。方法回顾分析近10年来住院治疗的18例非心源性晕厥住院患儿临床资料。结果18例患儿年龄在8～14(10.6±1.3)岁,男性7例,女性11例。脑源性晕厥6例,占33.3%,包括癫痫1例,脑震荡1例,颅内基底动脉供血不足4例;精神心理性晕厥—癔症2例,占11.1%;血液成分异常晕厥—月经失血性贫血1例,占5.6%;不明原因晕厥9例,占50.0%。结论非心源性晕厥住院患儿以学龄期女性多见,多表现为反复发作性晕厥或伴抽搐、或诊断不能及时明确者,以不明原因晕厥发生率最高,但青少年女性也可因严重的月经失血性贫血导致晕厥。一般预后较好,但不明原因晕厥多次频繁发作也易造成意外,或引发严重心律失常危及生命,故应加强随访。

Objective To analyze the etiology and clinical manifestations of children hospitalized with non-cardiac syncope. Methods The medical records of 18 children, who were referred to our hospital clinics for non-cardiac syncope from June 1995 to June 2004 were retrospectively reviewed. Results The 18 children were 7 （38.9%） male and 11 （61.1%） female, whose mean age was 10.6 years. In 9 cases （50.0%）, an etiology for syncope was found as follows： cerebral syncope in 6 cases （33.3%）, including seizure in 1 case, concussion of brain in 1 case,and ischemia of basilar artery in 4 cases. Psychiatric origin （hysteria） was found in 2 case （11.1%）. Abnormity of blood （anaemia） was 1 case （5.6%）. The other 9 cases （50.0%） were found with uncertain etiologies. Conclusion The children hospitalized with non-cardiac syncope mostly occurred in school-age girls, showed recurrence of syncope or with convulsion, or the cause of syncope was difficult to diagnose at once. Uncertain etiologies occurred most frequently. Severe anaemia of menorrhagia in adolescent girls may bring on syncope. Non-cardiac syncope generally has a benign prognosis. Because the frequency of syncope of uncertain etiology may induce damage, fatal arrhythmia, so follow-up must be administered.