不同原因晕厥29例临床误诊分析

Clinical misdiagnosis of 29 cases with different causes of syncope

目的了解不同原因晕厥的临床特点、误诊原因、预防措施。方法对我院2008-02—2013-12收治的7例及近10a国内有关文献发表的不同原因引起晕厥的病例45例作回顾性分析。结果 45例中首诊误诊29例(64.4%),经相关检查后确诊急性心肌梗死(AMI)14例,膀胱嗜铬细胞瘤3例,自发性脾破裂、原发性肝癌各2例,左房黏液瘤、Ⅲ度房室传导阻滞、主动脉夹层破裂、原发性肺癌、十二指肠球部溃疡并出血、Ⅱ度Ⅱ型房室传导阻滞、病态窦房结综合征、锁骨下动脉盗血综合血征各1例。结论晕厥的正确诊断,应认真采集病史,全面体格检查并完善相应检查,如心电图、超声心动图、脑CT和MRI、胸部CT、腹部B超等,以期早诊断。

Objective To understand the clinical characteristics,misdiagnosis and preventive measures of different kinds of syncope.Methods The 45 cases of different kinds of syncope included 7patients in our hospital from February 2008 to December 2013 and related domestic articles in the recent ten years were analyzed retrospectively.Results In the 45 cases,misdiagnosis of first-diagnosis was 29(64.4%),14 acute myocardial infarction(AMI),3pheochromocytoma of bladder,2spontaneous rupture of spleen and primary liver cancer,1left atrial myxoma,third degree atrioventricular block,aortic dissection,primary lung cancer,duoedenal ulcer with bleeding,typeⅡdegreeⅡatrioventricular block,sick sinus syndrome,subclavian artery steal syndrome were diagnosed by relevant inspection.Conclusion The right and early diagnosis of syncope was mainly based on history collection,completed medical examination and improving relevant inspection,such as electrocardiograms,echocardiography,cerebral CT and MRI,chest CT,abdominal ultrasonic-B.