以晕厥为首发症状的锁骨下动脉盗血综合征20例临床分析

摘要

Objective:To investigate the clinical characteristics, methods of emergency diagnosis in patients with subclavian steal syndrome (SSS ) presenting with syncope. Methods: Analyze clinical manifestations, reasons of misdiagnosis, cervical vascular ultrasound and TCD were collected among 20 SSS cases with syncope as first symptom. Results s The most common misdiagnosed diseases were cerebrovascular syncope (6 cases). The other misdiagnosed diseases included epilepsy (3 cases), reflex syncope (4 cases), cardiogenic syncope(5 cases) , metabolic causes of syncope(2 cases). 6 patients were cured successfully by using Percutaneous Transluminal Angioplasty (PTA), and symptoms were improved in 12 patients,and 2 patients abandoned threrapy. Backward blood of VA was of great importance in diagnosis SSS . Conclusion: SSS with syncope as first symptom is easily misdiagnosed. The chief cause of SSS are atherosclerosis. Cervical vascular ultrasound and TCD are the primary means of diagnosis in the emergency.%目的:探讨以晕厥为首发症状的锁骨下动脉盗血综合征(SSS)的临床特征及急诊诊断方法.方法:分析急诊20例以晕厥为首发症状的SSS患者的临床特征、误诊原因、TCD和颈动脉彩色多普勒超声检查的结果.结果:最常见的误诊诊断:脑血管性晕厥6例,癫痫3例,反射性晕厥4例,心源性晕厥5例,代谢性晕厥2例.6例经皮腔内血管成形术(PTA)治愈,12例病因治疗症状改善,2例放弃治疗.椎动脉(VA)反向血流是SSS的重要诊断依据.结论:以晕厥为首发症状的SSS极易误诊.主要的病因是动脉粥样硬化.急诊确诊SSS主要靠颈动脉彩色多普勒超声、TCD.