Wikipedia:WikiProject_Medicine/Translation_task_force/RTT/Simple_syncope
{{translated page|en|Wikipedia:WikiProject_Medicine/Translation_task_force/RTT/Simple_syncope}}
{{Medical}}
{{Infobox symptom
| Name = Syncope (medicine)
| Image = Pietro_Longhi_027.jpg
| Caption = A 1744 oil painting by [[Pietro Longhi]] called fainting.
| DiseasesDB = 27303
| ICD10 = {{ICD10|R|55||r|50}}
| ICD9 = {{ICD9|780.2}}
| ICDO =
| OMIM =
| eMedicineSubj = med
| eMedicineTopic = 3385
| eMedicine_mult = {{eMedicine2|ped|2188}} {{eMedicine2|emerg|876}}
| MeshID = D013575
| MedlinePlus = 003092
}}
<!-- Definition and symptoms -->
Syncope (/ˈsɪŋkəpi/ sing-kə-pee), also known as fainting or passing out, is defined as a short loss ofconsciousness and muscle strength, characterized by a fast onset, short duration, and spontaneous recovery. It is due to a decrease in blood flow to the entire brain usually from low blood pressure. Some causes have prodromal symptoms before the loss of consciousness occurs. These symptoms may include: light headedness, sweating, pale skin, blurred vision, nausea, vomiting, and feeling warm among others. Syncope may also be associated with a short episode of muscle twitching. If a person does not completely lose consciousness and muscle strength it is referred to as presyncope. It is recommended that presyncope be treated the same as syncope.[1]
<!-- 定義與症狀 -->
’’’昏厥’’’（英文：syncope，或口語稱fainting或passing out）的定義為快速發生、暫時性的、可自發性回復的[[意識]]及肌肉張力喪失之狀態。昏厥起因為血液供應[[腦|大腦]]的灌流不足，且通常由[[低血壓]]引起。某些原因引起的昏厥在失去意識前會有{{link-en|前驅症狀|prodrome}}（英文：prodrome），包括頭暈、{{link-en|盜汗|diaphoresis}}、{{link-en|皮膚蒼白|pallor}}、視力模糊、噁心、[[嘔吐]]以及異常溫暖的感覺等。昏厥也可能伴隨著短暫的肌肉抽搐。{{link-en|昏厥前期|presyncope}}（英文：presyncope）指的是類似症狀，但尚未完全喪失意識及肌肉張力的狀態。根據目前建議，不論是昏厥或昏厥前期的病人其醫療處置都是一樣的[1]。
<!-- Cause -->
Causes range from non-serious to potentially fatal. There are three broad categories of causes: heart or blood vessel related, reflex also known as neurally mediated, and orthostatic hypotension. Issues with the heart and blood vessels are the cause in about 10% and typically the most serious while neurally mediated is the most common. Heart related causes may include an abnormal heart rhythm, problems with the heart valves or heart muscle and blockages of blood vessels from apulmonary embolism or aortic dissection among others. Neurally mediated syncope occurs when blood vessels expand and heart rate decreases inappropriately. This may occur from either a triggering event such as exposure to blood, pain or strong feelings or a specific activity such as urination, vomiting, or coughing. This type of syncope may also occur when an area in the neck known as the carotid sinus is pressed. The final type of syncope is due to a drop in blood pressure from standing up. This is often due to medications that a person is taking but may also be related to dehydration, significant bleeding or infection.[1]
<!-- 病因 -->
會導致患者引發昏厥的原因眾多，包含了輕微的疾病，亦包括有可能危及生命的重症，可大致分為三類：[[心臟|心]][[血管]]相關、[[反射 (生理學)|反射]]或[[神經系統]]調控引起的昏厥、[[姿位性低血壓|姿勢性低血壓]]。心血管部分雖僅占10%，卻最嚴重；而神經系統調控引起的昏厥則為最為常見。心臟相關引起的昏厥包括[[心律不整]]、[[心瓣|心臟瓣膜]]疾病、心肌或大血管問題如[[肺栓塞]]或[[主體脈夾層|主動脈剝離]]。神經系統調控引起的昏厥發生於當血管擴張時，而[[心跳過緩|心率卻不適當地降低]]。其通常為誘發事件導致，例如看到鮮血、疼痛、強烈感覺，或特定活動如排[[尿]]、[[嘔吐]]、[[咳嗽]]等。此外，當[[頸動脈竇]]受壓迫時也可能導致神經系統調控引起的昏厥。姿勢性低血壓為站起時血壓降低，通常與藥物相關，但也可能為[[脫水]]、失血、[[感染]]所引發[1]。
<!-- Diagnosis and management -->
A medical history, physical examination, and electrocardiogram (ECG) are the most effective ways to figure out the underlying cause. The ECG is useful to detect an abnormal heart rhythm,poor blood flow to the heart muscle, and other electrical issue such as long QT syndrome and Brugada’s. Heart related causes also often have little history of a prodrome. Low blood pressure and a fast heart rate after the event may indicate blood loss or dehydration, while low blood oxygen levels may be seen following the event in those with pulmonary embolism. More specific test such as implantable loop recorders, tilt table testing or carotid sinus massage may be useful in uncertain cases. Computer tomography (CT) is generally not required unless specific concerns are present. Other causes of similar symptoms that should be considered including: seizure,stroke, concussion, low blood oxygen, low blood sugar, drug intoxication and some psychiatric disorders among others.
<!-- 診斷與處置 -->
釐清何種原因導致患者的昏厥，其首先需要了解藥物史，身體檢查，以及[[心電圖]]。心電圖在偵測以下狀況最有用：心律不整、[[冠狀動脈疾病|心肌灌流差]] (心肌缺血)、以及其他電生理相關問題如[[長QT症|ＱＴ節段延長症候群]]和[[布魯格達氏症候群]]（英文：Brugada’s syndrome）。心臟相關的原因通常很少有前驅症狀。昏厥後的低血壓及心率快可能代表失血或脫水，若為肺栓塞則可能有[[缺氧|低血氧]]的情形。其他特定的檢查如((link-en|植入式心臟監察儀|Implantable loop recorder}}、{{link-en|傾斜床測試|tilt table test}}或[[頸動脈竇]]按摩等，則可能在病因不明的案例中有所助益。除非有特殊考量，否則通常不會進行[[X射線電腦斷層掃描|電腦斷層掃描]]。另外必須考慮其他會造成類似症狀的病因，包括:{{link-en|痙攣|epileptic seizure}}、[[中風]]、[[腦震盪]]、[[缺氧|低血氧]]、[[低血糖]]、藥物中毒及某些精神疾患。
<!-- Epidemiology and prognosis-->
Treatment depends on the underlying cause. Those who are considered at high risk following investigation may be admitted to hospital for further monitoring of the heart.[1]
Syncope is common, affecting about three to six out of every thousand people each year.[1] It is more common in older people and females. It is the reason for one to three percent of visits to emergency departments and admissions to hospital. Up to half of women over the age of 80 and a third of medical students describe at least one event at some point in their life.[2] Of all those with syncope about 4% die in the next 30 days.[1] The risk of a bad outcome, however, depends very much on the underlying cause.[3]
<!-- 流行病學與預後-->
治療方式必須針對背後的原因。在初步評估後風險較高的患者應該住院觀察((link-en|症狀變化|Telemetry#Medicine.2FHealthcare}}[1]。昏厥相當常見（每年每千人當中會有三到六個人發生昏厥），在年紀較長者與女性身上尤其常發生（舉例來說，八十歲以上的女性約有一半有昏厥經驗，而對醫學生當中則有三分之一的人在一生中曾有過至少一次的昏厥經驗）。[1][2]昏厥的患者佔急診來診原因與住院病患就醫原因的百分之一到三。昏厥的患者在症狀發生後三十天內死亡的比率是4%[1]，決定預後好壞的主要因素是造成昏厥的原因[3]。