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1、106例儿童一过性意识丧失的病因及临床特征刘慧，李章勇，张蕾，刘晓燕(匝庆庆科大学附属儿童氏院心血管内科，儿童发育疾病研究教育部朿点实验室,儿科学重庆市重点实验室，重庆市儿童发育重大疾病诊治与预防国际科技合作基地，重庆，400014)【摘要】目的探讨小儿一过性意识丧失(transientlossofconsciousness,TLOC)的病因及临床特征，提高对此病的认识。方法收集2013年1月至2014年3月在重庆医科大学附属儿童医院门诊就诊或住院的106例TLOC患儿的临床资料，对其病因及临床特征进行
2、分析总结。结果106例患儿屮，杲厥型89例(84.0%),非晕厥型17例(16.0%)o在晕厥型屮，肓•立不耐受(orthostaticintolerance,OI)42例(39.6%),心源性晕厥(cardiacsyncope,CS)16例(15.1%),境遇性晕厥1例(0.9%),不明原因晕厥30例(28.3%)；在非晕厥型中,神经源性疾病5例(4.7%),心因性疾病10例(9.4%),代谢性疾病2例(1.9%)o92.9%(39/42)的01有诱因及先兆，59.5%(25/42)意识丧失VI分钟，
3、26.2%(11/42)存在晕厥家族史。CS起病急剧,56.3%(9/16)CS在劳累时诱发,100%(16/16)心电图异常'，住院期间死亡3例。80.0%(8/10)心因性疾病有明确的诱因，70.0%(7/10)的患儿意识丧失＞10分钟。结论OI是儿童TLOC最常见病因，具有明显临床特征，诊断过程屮首先需排除CS,其次应注意与心因性假性晕厥及癫痫相鉴别。［关键词］儿童；一-过性意识丧失；病因；临床特征［中图法分类号］［文献标志码］AEtiologyandclinicalfeaturesin106ch
4、ildrenwithtransientlossofconsciousness・LiuHui,LiZhangyong,ZhangLei,LiuXiaoyan(DepartmentofCardiology,Children'sHospitalofChongqingMedicalUniversity;MinistryofEducationKeyLaboratoryofChildDevelopmentandDisorders;KeyLaboratoryofPediatricsinChongqing;Intern
5、ationalScienceandTechnologyCooperationCenterforChildDevelopmentDisorders.Chongqing,400014,China.)［Abstract］Objective:Tostudyetiologyandclinicalfeaturesinchildrenwithtransientlossofconsciousness(TLOC).Methods:106caseswithTLOCwerecollectedfromoutpatientdep
6、artmentorinpatientdepartmentofChildren'sHospitalofChongqingMedicalUniversityduringJan.2013〜Mar.2014.Andtheetiologyandclinicalfeatureswereanalyzed.Results:Among106caseswithTLOC，89cases(84.0%)weresyncope,17cases(16.0%)werenon-syncope・Amongsyncopecases,42(3
7、9.6%)wereorthostaticintolerance(OI),16(15.1%)werecardiacsyncope(CS),1(0.9%)wassituationalsyncope,and30(28.35)wereunexplained・Inthesenon-syncopechildren,5(4.7%)hadneurogenicdiseases,1()(9.4%)hadpsychogenicpseudo-syncope,2(1.9%)hadmetabolicdisorders.In42OI
8、patients,39(92.9%)hadinducementandpre-syncope,25(59.5%)hadlossofconsciousnesswithin1minute,11(26.2%)hadfamilyhistory.CSoftenoccurswithsuddenonset.Exertionrelatedsyncopespellswerefoundin9cases(56.3%,9/16).AllCSpatientshadab
