进一步关注儿童青少年神经介导性晕厥的诊治及预防

Further attention to the diagnosis,treatment and the prevention of children and adolescents with neurally mediated syncope

神经介导性晕厥是指由于大脑一过性缺血缺氧所致的短暂性意识丧失,多伴有肌张力丧失而不能维持自主体位,是儿科门诊中的常见急症。约有15%的儿童及青少年18岁前至少发生过1次晕厥,晕厥患儿占所有儿科急诊的1%。近三十年来随着直立倾斜试验及晕厥诊断程序的提出,不明原因晕厥患儿的比例逐渐下降,但仍有14%左右的晕厥儿童病因未知,且晕厥发病机制仍需进一步探索。本文结合近年来相关领域新进展,介绍儿童青少年神经介导性晕厥的流行病学特点、发病机制、诊断程序及未来研究方向,以期提高临床医师对儿童青少年神经介导性晕厥的认识,进一步提高我国儿童晕厥的诊治水平。

Neurally mediated syncope is a transient loss of consciousness caused by transient ischemic hypoxia in the brain, which was often accompanied by loss of muscle tone and cannot maintain the posture.It is a common emergency in pediatric clinics.About 15% of children and adolescents have had at least once syncope before 18 years old, and syncope accounts for 1% of all pediatric emergencies.With the introduction of head-up tilt test and diagnostic protocol of syncope in the past 30 years, the proportion of children with unexplained syncope has gradually decreased, but still around 14% children or adolescents with syncope could not be explained, and the pathogenesis of syncope still needs to be further explored.Based on the recent developments in related fields in recent years, this review introduces the epidemiological characteristics, pathogenesis, diagnostic procedures and future research directions of children′s neuro-mediated syncope, with a view to improving clinicians′ understanding of children′s neuro-mediated syncope and further improving diagnosis and treatment of syncope in China.