诊断青壮年晕厥的现代方法

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这篇综述文章主要介绍晕厥状态的现代诊断方法，近年来，晕厥在年轻人中越来越常见。本文讨论了晕厥状态的原因和机制，以及诊断和鉴别晕厥状态的方法。特别关注因正位性低血压导致的晕厥状态。不幸的是，晕厥长期以来一直未得到医生和患者的足够重视。通常情况下，患者会忽视单次的意识丧失，并将其归因于生活方式的特殊性。长期缺乏诊断和治疗会导致潜在引起晕厥的疾病恶化。然而，晕厥的诊断问题不仅取决于患者，还取决于医生。由于缺乏能够准确诊断和区分晕厥的明确算法，医生的诊断能力受到了限制。然而，这并不是唯一的问题，大多数医疗机构缺乏专门设备也影响了晕厥诊断质量的下降。根据欧洲心脏病学会 2018 年的建议，倾斜试验是目前诊断晕厥的金标准。 该设备价格昂贵，且这种方法的诊断能力无法提供理想的结果。如今，人们对这一问题的态度正在发生变化，2023年，俄罗斯心脏病学会开始制定临床建议计划，其中将晕厥情况单独列为一章。晕厥的准确诊断不仅是确定潜在疾病所必需的。在临床实践中，医生经常会遇到适龄青年出于个人目的模拟晕厥的病例。目前，临床上几乎不可能对既往晕厥进行确诊（尤其是在单次意识丧失的情况下）。缺乏明确的算法大大增加了确诊的复杂性。本文旨在研究最有效的诊断方法，以便最准确地确定特定晕厥病症的病因。

作者简介

Mark S. Tyuryupov

Military Medical Academy

编辑信件的主要联系方式.
Email: mark.tfyuryupov@icloud.com
ORCID iD: 0000-0002-8366-0594
SPIN 代码: 2886-7181
俄罗斯联邦, Saint Petersburg

Arina A. Shershneva

Military Medical Academy

Email: mark.tfyuryupov@icloud.com
ORCID iD: 0009-0007-3002-1418
SPIN 代码: 3439-2092

cadet

俄罗斯联邦, Saint Petersburg

Vladimir P. Butikov

Military Medical Academy

Email: mark.tfyuryupov@icloud.com
ORCID iD: 0000-0002-8850-8516
SPIN 代码: 2132-6604

Associate Professor of the Naval Therapy Department

俄罗斯联邦, Saint Petersburg

Gennadiy G. Kutelev

Military Medical Academy

Email: gena08@yandex.ru
ORCID iD: 0000-0002-6489-9938
SPIN 代码: 5139-8511

MD, Dr. Sci. (Medicine)

俄罗斯联邦, Saint Petersburg

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2. Fig. 1. The main pathogenetic mechanisms of Syncopal state development: ANS is the autonomic nervous system; PNS is the parasympathetic nervous system; SNS is the sympathetic nervous system; BCC is the volume of circulating blood; BP is blood pressure; DM — diabetes mellitus

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3. Fig. 2. The procedure for diagnosing Syncopal state [5]

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