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超声引导下穿刺术并发血管迷走神经性晕厥的护理

目的　探讨超声引导下穿刺术后并发血管迷走神经性晕厥患者的护理方法及要点。 方法　对2011年7月－2012年6月32例血管迷走神经性晕厥患者进行严密观察，并针对血管迷走神经性晕厥发生的相关因素采取积极的应对护理措施。 结果　所有患者经过及时正确的处理后生命体征恢复稳定。 结论　及时观察、早期发现及早期处理是超声引导下穿刺致血管迷走神经性晕厥并发症护理的正确原则。

旧金山晕厥规则对急诊晕厥患者的评估价值

目的　探讨旧金山晕厥规则对国内以晕厥就诊的急诊患者发生严重不良后果及需要住院治疗有无评估价值。 方法　根据旧金山晕厥规则，将2009年1月1日－3月31日期间纳入的100例患者分为高危晕厥组（29例）和低危晕厥组（71例），比较两组患者入院情况，进而评估旧金山晕厥规则对晕厥患者是否需要入院和再入院情况有无预测价值。 结果　高危组和低危组住院的患者分别为25例和40例，分别占所在组总人数的86.2%和56.3%，两组间差异有统计学意义（P=0.004）。 结论　旧金山晕厥规则对急诊晕厥患者的快速评估和分流有一定的临床应用价值。

Analysis of misdiagnosed cases: epilepsy and syncope

Objective To explore how to differentiate the epilepsy and syncope in order to minimize the misdiagnosis. Methods Retrospectively analyzed the medical record of 6 cases which were misdiagnosed as epilepsy or syncope during April 2008 to September 2012 and reviewed the literatures about the differential diagnosis. Results Among the clinical characteristics, the ictal positional tone and loss of consciousness as well as the duration of postictal confusion are very important to the differential diagnosis. The ictal EEG shows highly rhythmic abnormal discharges when epileptic seizures occur. However, the ictal EEG would become slower and flatler during syncope. Conclusions When the automomic disorder and signs such as chest distress, arrhythmia. appear, the causes should not be limited in the cardiac diseases, the functional or structural abnormalities of the nervous system innervating the heart should also be considered; on the contrary, convulsions might not only due to the abnormal electrical activity in the brain, but syncope.

咳嗽性晕厥综合征一例

Interpretation of the 2019 American Heart Association focused update on guidelines for cardiopulmonary resuscitation and emergency cardiovascular care: adult basic and advanced life support and first aid

American Heart Association updated the guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiovascular care in November 2019. This focused update incorporates the systematic review conducted by the International Liaison Committee on Resuscitation, an expert group consisting of hundreds of international resuscitation scientists, to identify the new evidence supporting the basic and advanced life support and first aid in emergency medical care. This focused update involves the life chain of CPR (dispatcher-assisted CPR and cardiac arrest centers), advanced cardiovascular life support (advanced airways, vasopressors, and extracorporeal CPR), and first aid for presyncope. This present review aims to interpret these updates by reviewing the literature and comparing the recommendations in this update with previous guidelines.

癫痫样发作疾病的研究进展

癫痫样发作疾病的临床症状与癫痫发作相似，临床上易误诊为癫痫并给予不恰当的治疗，误诊的后果非常严重。因此，早期正确诊断显得尤为重要。临床上常见的癫痫样发作疾病包括：晕厥、震荡性抽搐、心因性非癫痫发作、睡眠障碍、短暂性脑缺血发作、面-臂肌张力障碍发作、发作性运动障碍等。文章就癫痫样发作疾病作一综述，为相关疾病的临床诊疗提供参考。