10. 一过性意识丧失
概 述
一过性意识丧失是由于脑供血不足所致的短暂意识丧失状态,发作时患者因肌张力消失不能保持正常姿势而倒地。一般为突然发作,迅速恢复,很少有后遗症。以下是一过性意识丧失诊治的临床路径。
表10.1 发生一过性意识丧失后进行重点评估
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T10.1_7991.jpg?sign=1739664389-RL3lEdmm55ASpbcqswonsNCf3O0JZu1A-0-b3935a4bb61074d0a1f4d647904a17ef)
表10.2 晕厥后的心电图
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T10.2_59961.jpg?sign=1739664389-KIM5GZpNYk7WGwj5gGq0KFRmkrr1n3Cg-0-92de2e4abe51d385cdcc1fd594de5a49)
续表
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T10.2_1_59962.jpg?sign=1739664389-aMEejifVGsHK0xxVr3ueaISdcsM5qPMn-0-cd08151d53029d72510215f4dd783b6c)
注:AV,房室的;WPW综合征,沃尔夫-帕金森-怀特综合征
表10.3 全身性抽搐、血管迷走神经性晕厥及心源性晕厥(阿-斯发作)的鉴别要点
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T10.3_59963.jpg?sign=1739664389-nr3eFpUfYTtluu7oLR9rFhF29toRzV0b-0-ef942515dedf3b729f56e2948ede12c0)
续表
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T10.3_1_59964.jpg?sign=1739664389-2oEhVOjNt7YS7NMlRpq4vZUoBkEV1G1o-0-a954b349f1efa2e8ca8875a86f7b5abe)
表10.4 晕厥的病因
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T10.4_59965.jpg?sign=1739664389-4koPcyKDSZkYruutiLISVf8G5S1sJ9nV-0-733c041c06b7de33ba03b2ed3c2ca67f)
续表
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T10.4_1_59966.jpg?sign=1739664389-yT70747h5Nr03ckdbUrarJj7jqQ9KxjN-0-9c936e8e9784709d5e19a87c9fc3a249)
注:TIA,短暂性脑缺血发作;境遇性晕厥:晕厥发生在咳嗽、排尿、排便或吞咽时,不伴有其他引起心电图或体格检查的明显异常
表10.5 颈动脉窦过敏的检查
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T10.5_8304.jpg?sign=1739664389-T68o2wUhPEqtCKxBj75NTXJqBDECNIHm-0-2b4172fa957d48726c202fbccb78d4af)