概括
诊断昏迷往往需要一个有针对性的方法. 虽然病史和体检可以确定许多原因,但对于难以捉摸的心律失常,可能需要进一步的测试,例如长时间的心电图监测或电生理学研究.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 内部医学 内部医学
背景情况:
- 昏迷,暂时失去意识,是一个诊断挑战.
- 显著比例的昏迷病例仍然未被诊断出来.
- 有效的诊断策略对于患者管理至关重要.
研究的目的:
- 审查关于昏迷诊断评估的现有文献.
- 提出一种结构化的方法,用于诊断测试和的管理.
主要方法:
- 系统审查已发表的英语语言关于昏迷评估的研究.
- 包括队列研究,病例系列和针对诊断测试的专注研究.
- 长时间 (≥12小时) 的心电图监测的具体标准.
主要成果:
- 病史和体检可以确定56-85%的昏迷原因.
- 门诊心电图 (Holter) 监测对症状性心律失常 (4%) 的收益率较低.
- 电生理学研究和直立倾斜测试提供了诊断价值,特别是在特定的患者群体.
结论:
- 有针对性的,基于证据的方法来评估昏迷是可行的.
- 诊断测试应根据个体患者的表现量身定制.
- 考虑精神病学评估的不知来源的复发性昏迷.
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