{"nowTime30":1780452299231,"lyBarModerator":null,"metaSearch":{"description":"在病因治疗的同时，我们也要对头昏眩晕给予药物治疗，来控制眩晕，消除恶心，呕吐、和焦虑紧张的情绪，此类药物归纳起来可分为以下几类，我和大家一起分享。\n\n\n步骤/方法：\n1镇定剂和安定剂：常用的药物有巴比妥类以及安定、阿普锉仑等。此类药物有镇静和安定情绪的作用，从而减少紧张不安和焦虑。例如安定2.5毫克","keywords":"治疗头昏眩晕的常用药物有哪些？_洞医","title":"治疗头昏眩晕的常用药物有哪些？_洞医","channels":null},"identificate":{"id":"0300b4bddfaf11e6a61c00163e04584d","isDel":0,"createAt":1484985344390,"createBy":"b1a5ca4ddfad11e6a61c00163e04584d","createName":"小海螺","updateAt":0,"updateBy":null,"updateName":null,"userId":"b1a5ca4ddfad11e6a61c00163e04584d","realName":"赵玉","certifiedStatus":2,"phone":"111111111111","email":"2276635444@qq.com","hospitalId":"31c19c1b453011e69d4700163e005165","departmentId":"2000","illName":"","illId":"793a72a2bb5f11e6a61c00163e04584d","cardType":1,"cardImg":"http://01luntan.com/ly_img/1484985951761.jpg","idCardImg":"","identityType":2,"stop":0,"departmentName":"儿科","hospitalName":null},"canEdit":null,"adList":[],"lyBar":{"id":"1927","isDel":0,"createAt":1483430798726,"createBy":"system","createName":"system","updateAt":0,"updateBy":null,"updateName":null,"userId":null,"name":"头晕","type":102,"twoCode":"http://zhao01.com/zly_img/zly_wx.jpg","image":null,"provinceId":null,"cityId":null,"illId":"0b987362badb11e6a61c00163e04584d","hospitalId":null,"keyWord":null,"totleTopic":0,"barDesc":null,"discussBarType":null,"metaSearch":"{\"channels\":{\"病友社区\":{\"description\":\"为病友提供:头晕论坛_病友交流平台_病友论坛，让病友在便捷的求医路上不花一分冤枉钱。\",\"keywords\":\"头晕论坛_病友交流平台_病友论坛\",\"title\":\"头晕论坛_病友交流平台_病友论坛\"},\"治疗\":{\"description\":\"为您提供:缓解头晕恶心的方法_头晕脑供血不足怎么治疗等相关信息，让病友在便捷的求医路上不花一分冤枉钱。\",\"keywords\":\"缓解头晕恶心的方法_头晕脑供血不足怎么治疗\",\"title\":\"缓解头晕恶心的方法_头晕脑供血不足怎么治疗\"},\"症状\":{\"description\":\"为您提供:头晕脑供血不足的症状_老是头晕有什么症状等相关信息，让病友在便捷的求医路上不花一分冤枉钱。\",\"keywords\":\"头晕脑供血不足的症状_老是头晕有什么症状\",\"title\":\"头晕脑供血不足的症状_老是头晕有什么症状\"},\"并发症\":{\"description\":\"为您提供:头晕有什么危害_头晕不良后果等相关信息，让病友在便捷的求医路上不花一分冤枉钱。\",\"keywords\":\"头晕有什么危害_头晕不良后果\",\"title\":\"头晕有什么危害_头晕不良后果\"},\"饮食\":{\"description\":\"为您提供:女人头晕吃什么食物好_男性头晕吃什么食物好等相关信息，让病友在便捷的求医路上不花一分冤枉钱。\",\"keywords\":\"女人头晕吃什么食物好_男性头晕吃什么食物好\",\"title\":\"女人头晕吃什么食物好_男性头晕吃什么食物好\"},\"病因\":{\"description\":\"为您提供:突然感觉头晕怎么回事_经常头晕恶心是怎么回事等相关信息，让病友在便捷的求医路上不花一分冤枉钱。\",\"keywords\":\"突然感觉头晕怎么回事_经常头晕恶心是怎么回事\",\"title\":\"突然感觉头晕怎么回事_经常头晕恶心是怎么回事\"},\"病友求助\":{\"description\":\"为您提供:头晕如何快速缓解_缓解头晕的小妙招等相关信息，让病友在便捷的求医路上不花一分冤枉钱。\",\"keywords\":\"头晕如何快速缓解_缓解头晕的小妙招\",\"title\":\"头晕如何快速缓解_缓解头晕的小妙招\"},\"预防\":{\"description\":\"为您提供:头晕怎么预防_头晕常见的预防方法等相关信息，让病友在便捷的求医路上不花一分冤枉钱。\",\"keywords\":\"头晕怎么预防_头晕常见的预防方法\",\"title\":\"头晕怎么预防_头晕常见的预防方法\"}},\"description\":\"为您提供:早上起来头晕恶心想吐是怎么回事_头晕是怎么回事感觉脑袋在动_头晕病友的治疗经验等相关信息，让病友在便捷的求医路上不花一分冤枉钱。\",\"keywords\":\"早上起来头晕恶心想吐是怎么回事_头晕是怎么回事感觉脑袋在动\",\"title\":\"早上起来头晕恶心想吐是怎么回事_头晕是怎么回事感觉脑袋在动\"}","adInfo":null},"isLikeThisTopic":null,"lastTopics":[{"id":"2601","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"怎样预防头晕发生","content":"<p style=\"margin-top: auto; margin-bottom: auto; text-align: left;\"><span style=\"font-size: 16px; font-family: 宋体;\">&nbsp;&nbsp;</span><span style=\"font-size: 16px; font-family: 宋体;\">怎样预防<a href=\"http://www.zhao01.com/bbs/topic/4431\">头晕</a>发生？很多的因素都影响着我们身体的健康，同样，头晕的发生也是受各种因素的影响，那面对着让我们无法忍受的头晕病症，我们该如何预防呢？有什么措施能够让我们防患于未然呢？我们接下来看看怎样预防头晕的发生？</span></p>\n<p style=\"margin-top: auto; margin-bottom: auto; text-align: left;\"><span style=\"font-size: 16px; font-family: 宋体;\">&nbsp;&nbsp;</span><span style=\"font-size: 16px; font-family: 宋体;\">头晕，在现在各种疾病中是发病率比较高的一种，生活中百分之八十的人都备受头晕的折磨，很多人并不在意，但是头晕的发生，很可能预示着更大的疾病。我们日常生活中有很多的方式方法可以预防头晕的发生的。</span></p>\n<p style=\"margin-top: auto; margin-bottom: auto; text-align: left;\"><span style=\"font-size: 16px; font-family: 宋体;\">&nbsp;</span></p>\n<p style=\"margin-top: auto; margin-bottom: auto; text-align: left;\"><strong><span style=\"font-size: 16px; font-family: 宋体;\">头晕的预防措施</span></strong></p>\n<ol class=\" list-paddingleft-2\">\n<li>\n<p><span style=\"font-size: 16px; font-family: 宋体;\">正确对待休息与锻炼头晕急性发作期需卧床休息。急性期过后有两种恢复形式，一种是旋转感瞬息即逝，或一觉醒后霍然而愈；另一种是剧烈眩晕消失后，仍持续有头昏，步态不稳，不敢走动。如长期卧床不能奏效，应鼓励病人下床活动，既有利于树立信心保持乐观情绪，又能通过锻炼提高前庭适应性。</span></p>\n</li>\n<li>\n<p><span style=\"font-size: 16px; font-family: 宋体;\">积极的参加运动，锻炼身体。积极参加体育锻炼。体质差者可提高身体素质，体胖者可增强气血运行，加速排泄水湿痰饮。</span></p>\n</li>\n<li>\n<p><span style=\"font-size: 16px; font-family: 宋体;\">不要过多饮水，注意异体蛋白的摄入，如鱼、虾、蛋、蟹、乳等。</span></p>\n</li>\n<li>\n<p><span style=\"font-size: 16px; font-family: 宋体;\">感觉不适要马上休息：发作期宜卧床休息，防止起立跌倒受伤。减少头部转动。</span></p>\n</li>\n<li>\n<p><span style=\"font-size: 16px; font-family: 宋体;\">保持心情舒畅，防止七情（喜、怒、忧、思、悲、恐、惊）过度。忧郁恼怒等精神刺激可致肝阳上亢或肝风内动，而诱发眩晕。因此，眩晕病人应胸怀宽广，精神乐观，心情舒畅，情绪稳定，这对预防眩晕症发作和减轻发作次数十分重要。</span></p>\n</li>\n<li>\n<p><span style=\"font-size: 16px; font-family: 宋体;\">饮食宜素净和容易消化。不宜食用烟、酒、浓茶、咖啡、韭菜、辣椒、大蒜等刺激性食物。冬瓜、萝卜、芋艿、慈菇、地栗、赤小豆、米仁具有化痰结、利水湿的作用，可以选作辅助治疗。</span></p>\n</li>\n<li>\n<p><span style=\"font-size: 16px; font-family: 宋体;\">头晕病人的饮食应以富有营养和新鲜清淡为原则。要多食蛋类、瘦肉、青菜及水果。忌食肥甘辛辣之物，如肥肉、油炸物、酒类、辣椒等。营养丰厚的食物，可补充身体之虚，使气血旺盛，脑髓充实。</span></p>\n<p>&nbsp;</p>\n<p>&nbsp;</p>\n<p><span style=\"font-size: 16px; font-family: 宋体;\">&nbsp;</span></p>\n</li>\n</ol>\n<p style=\"margin-top: auto; margin-bottom: auto; text-align: left;\"><strong><span style=\"font-size: 16px; font-family: 宋体;\">注意事项</span></strong></p>\n<p style=\"margin-top: auto; margin-bottom: auto; margin-left: 48px; text-align: left;\"><span style=\"font-size: 16px; font-family: 宋体;\">乘汽车遇到急转弯时立即感眩晕、出冷汗、呕吐 ,许多年来一直以为晕车 ,随着年龄增长 ,即使不乘车也会发生眩晕 ,数年前 ,眩晕现象在没有外因的情况下也会突然发生 ,而且发生后天旋地转必须立即躺下、眼睛闭上 ,否则呕吐不止。</span></p>\n<p>&nbsp;</p>\n<p>&nbsp;</p>\n<p>&nbsp;</p>\n<p>&nbsp;</p>","barId":"1927","topicTypeId":null,"topicThemeId":"1036","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":0,"metaSearch":null,"rn":1},{"id":"4431","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"头晕的家庭护理的注意事项","content":"<p>1<span style=\"font-family: 宋体;\">、嘱其患者<a href=\"http://www.zhao01.com/bbs/topic/2721\">卧床</a>休息，防止跌倒。</span></p>\n<p>&nbsp;</p>\n<p>2<span style=\"font-family: 宋体;\">、遵医嘱用药，观察药物疗效及副作用。</span></p>\n<p>&nbsp;</p>\n<p>3<span style=\"font-family: 宋体;\">、监测生命体征的变化，尤其血压的变化。</span></p>\n<p>&nbsp;</p>\n<p>4<span style=\"font-family: 宋体;\">、保持周围环境无障碍物，防止地面光滑，以免摔倒。</span></p>\n<p>&nbsp;</p>\n<p>5<span style=\"font-family: 宋体;\">、患者下床活动时，要有人搀扶。</span></p>\n<p>&nbsp;</p>\n<p>6<span style=\"font-family: 宋体;\">、患者经常使用的物品要放在容易拿到的地方。</span></p>\n<p>&nbsp;</p>\n<p>7<span style=\"font-family: 宋体;\">、保持病房安静，操作轻柔。</span></p>\n<p>&nbsp;</p>\n<p>8<span style=\"font-family: 宋体;\">、告知患者变换体位时，动作要慢，尤其转动头部时。</span></p>\n<p>&nbsp;</p>\n<p>9<span style=\"font-family: 宋体;\">、心理护理。</span></p>","barId":"1927","topicTypeId":null,"topicThemeId":"1035","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":0,"metaSearch":null,"rn":1},{"id":"8028","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"头晕并发症有哪些","content":"<p style=\"text-indent:32px;line-height:200%\"><br/></p><p style=\"text-indent:32px;line-height:200%\"><span style=\"font-family: 宋体;line-height: 200%;letter-spacing: 0;font-size: 16px\"><span style=\"font-family:宋体\">头晕并发症之一：头晕患者发作期会出现旋转、呕吐</span>,同时还会造成迷路、前庭、耳蜗器官损害,造成耳蜗毛细胞死亡和前庭功能丧失,进而引起耳鸣、耳聋、共济失调等危害性。如不及时治疗很容易引起思维下降、头痛痴呆、脑血栓、脑溢血、半身不遂、中风偏瘫,甚至猝死。</span></p><p style=\"text-indent: 32px; line-height: 200%; text-align: center;\"><img src=\"http://01luntan.com/ly_img/uimgs/1511314325758.jpg\" title=\"头晕并发症有哪些\" alt=\"头晕并发症有哪些\" width=\"600\" height=\"372\"/></p><p style=\"text-indent:32px;line-height:200%\"><br/></p><p style=\"text-indent:32px;line-height:200%\"><br/></p><p style=\"line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\">&nbsp;</span></p><p style=\"text-indent:32px;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\"><span style=\"font-family:宋体\">头晕并发症之二：中老年患者</span>,多次发作可影响脑血管调节机能及大脑微循环，加重脑供血不足，诱发脑梗塞等症。</span></p><p style=\"line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\">&nbsp;</span></p><p style=\"text-indent:32px;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\">头晕病并发症之三：影响交际，生活圈缩小，精神压力加大等。</span></p><p style=\"line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\">&nbsp;</span></p><p style=\"text-indent:32px;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\"><span style=\"font-family:宋体\">头晕并发症之四：坑边、井边、过马路、旅游登山等正常活动由于担心美尼尔氏综合症突然发作，都成为危险活动，所以医生提醒中年人一定要特别注意休息和睡眠，避免过度疲劳，美尼尔氏综合症患者需要注意的是在急性期里小心活动</span>,尽量卧床休息，免得因为眩晕而导致摔伤、骨折等危险。</span></p><p style=\"line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\">&nbsp;</span></p><p style=\"text-indent:32px;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\">以上就是头晕会给患者带来的并发症，希望大家都能对这个疾病有一定的重视，一旦发现头晕就要尽早的投入治疗。</span></p><p><br/></p>","barId":"1927","topicTypeId":null,"topicThemeId":"1034","readLevel":0,"files":"[]","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":0,"metaSearch":null,"rn":1},{"id":"4332","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"头晕目眩怎么办，太痛苦了","content":"<p><span class=\"con\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 蹲在地上一站起来,就觉得头晕晕的,眼前是黑黑的一片，头嗡嗡的响，要站上5.6秒才能好,有的时候坐在沙发上站起来也是这样,请问这是什么原因?<br />我应该<a href=\"http://www.zhao01.com/bbs/topic/2559\">怎么办</a>呢```</span></p>\n<pre class=\"line mt-10 q-supply-content\">我现在还是学生</pre>\n<p>&nbsp;</p>","barId":"1927","topicTypeId":null,"topicThemeId":"1033","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":0,"metaSearch":null,"rn":1},{"id":"2103","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"头晕脑胀是什么原因","content":"<p><span style=\"color: #333333; font-family: 'PingFang SC', 'Lantinghei SC', 'Microsoft YaHei', arial, 宋体, sans-serif, tahoma; font-size: 14px; line-height: 24px; background-color: #ffffff;\">头晕脑胀一般是由三种情况诱发：</span></p>\n<p><span style=\"color: #333333; font-family: 'PingFang SC', 'Lantinghei SC', 'Microsoft YaHei', arial, 宋体, sans-serif, tahoma; font-size: 14px; line-height: 24px; background-color: #ffffff;\">第一种情况是血压高引起的，但这种头晕看东西不转</span></p>\n<p><span style=\"color: #333333; font-family: 'PingFang SC', 'Lantinghei SC', 'Microsoft YaHei', arial, 宋体, sans-serif, tahoma;\"><span style=\"font-size: 14px; line-height: 24px;\">第二种情况是由休息不好或者动脉硬化造成的，这种头晕也是看东西不转<br /></span></span><span style=\"color: #333333; font-family: 'PingFang SC', 'Lantinghei SC', 'Microsoft YaHei', arial, 宋体, sans-serif, tahoma; font-size: 14px; line-height: 24px; background-color: #ffffff;\">第二种是耳鼻喉的前庭功能引起的，这种疾病看东西是转的。一般是由两种疾病引发：梅尼埃和耳石症</span></p>\n<p><span style=\"color: #333333; font-family: 'PingFang SC', 'Lantinghei SC', 'Microsoft YaHei', arial, 宋体, sans-serif, tahoma;\"><span style=\"font-size: 14px; line-height: 24px;\"><br /></span></span><span style=\"color: #333333; font-family: 'PingFang SC', 'Lantinghei SC', 'Microsoft YaHei', arial, 宋体, sans-serif, tahoma; font-size: 14px; line-height: 24px; background-color: #ffffff;\">根据这三点看你具体属于属于哪种情况，以便采取相应治疗措施</span></p>","barId":"1927","topicTypeId":null,"topicThemeId":"1032","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":0,"metaSearch":null,"rn":1},{"id":"4209","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"头晕的症状及特点","content":"<p><a href=\"http://www.zhao01.com/bbs/topic/3911\">头晕</a>可见于(晕车、晕船)、高血压病、贫血、脑动脉硬化、烟酒过量等，以下是几种类型的头晕：</p>\n<p>1.眼性头晕 系视力障碍所致，睁眼时加重，闭眼时减轻或消失。多由屈光不正、视网膜黄斑病变和多种先天性眼病导致视力障碍以及眼外肌麻痹所致。</p>\n<p>2.深感觉性头晕 为深感觉障碍所致。于行立中出现，闭眼和暗处加重，睁眼和亮处时减轻(因视力能代偿)，坐卧后消失。伴有肌体肌张力降低，腱反射和深感觉减退或消失等神经体征。系由脊髓后索或下肢周围感觉神经病变等所致。</p>\n<p>3.小脑性头晕 因小脑性共济失调所致。于行立中出现，坐卧后消失，睁闭眼无影响，伴有肌体肌张力降低，腱反射减弱和小脑性共济失调等小脑体征。系由绒球、小结叶以外的小脑病变所致。</p>\n<p>4.耳石性头晕 系耳石功能障碍所致，在头位直线运动中出现，动作停止后消失。如椭圆中耳石病变，头晕仅限于仰位起卧之中。重症病人也可伴有恶心、呕吐等不适。睁闭眼无影响，耳石功能检查有异常。</p>\n<p>5.脑源性头晕 见于脑动脉硬化(如基底动脉硬化)或颈椎骨关节病引起的脑部血液循环障碍，或由此导致的一过性脑供血不足。其临床特点是头晕、睡眠障碍、记忆力减退三大症状，还有顶枕部头痛、轻瘫、言语障碍、情绪易激动等表现，一般病情缓慢发展，此类头晕的特点是在体位转变时容易出现或加重。</p>\n<p>6.心源性头晕 可见于急性心源性脑供血不足综合征，系心脏停搏、阵发性心动过速、阵发性心房纤颤、心室纤颤导致的急性脑缺血，可表现为头晕、跟花、胃部不适、晕厥等。</p>\n<p>7.血管抑制性头晕 常因情绪紧张、疼痛、恐惧、出血、天气闷热、疲劳、空腹、失眠等而促发。患者常有头晕、眩晕、恶心、上腹部不适、面色苍白、出冷汗等植物神经功能紊乱。此时血压下降，脉搏微弱。血管抑制性头晕多见于体弱的年轻妇女。直立性低血压指站立时出现头晕、服花、腿软、眩晕甚至晕厥等，常伴有无汗、大小便障碍。</p>\n<p>8.药物中毒性头晕 以链霉素、新霉素、卡那霉素、庆大霉素等的中毒为多见。患者除头晕外还有眩晕和耳蜗神经损害所致的感音性耳聋。慢性铅中毒多表现为神经衰弱综合征(以头晕、头痛、失眠、健忘、乏力、多梦为主要症状)，又有体温减低、食欲减退等。</p>\n<p>9.功能性低血糖亦可引起头晕、心慌、虚弱感，在空腹或用力时可有震颤。有时出现抽搐、意识丧失等。情绪紧张或过度换气时。由于二氧化碳排出量增加，可出现呼吸性碱中毒，脑细胞缺氧，引起头晕、乏力，患者并感到面部和手足麻凉，间或有恍惚感。</p>\n<p>&nbsp;</p>","barId":"1927","topicTypeId":null,"topicThemeId":"1029","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":0,"metaSearch":null,"rn":1},{"id":"2267","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"重视头晕与眩晕的正确诊断 (转载) ","content":"<p style=\"margin-top: 0px; margin-bottom: 0px; padding: 0px; text-align: center;\"><span style=\"margin: 0px; padding: 0px; font-size: 14px;\">作者：戚晓昆教授（海军总医院神经内科）</span></p><p style=\"margin-top: 0px; margin-bottom: 0px; padding: 0px;\">&nbsp;</p><p style=\"margin-top: 0px; margin-bottom: 0px; padding: 0px;\"><span style=\"margin: 0px; padding: 0px; font-size: 14px;\">&nbsp; &nbsp; &nbsp; 初步调查<strong style=\"margin: 0px; padding: 0px;\">头晕</strong>、<strong style=\"margin: 0px; padding: 0px;\">眩晕</strong>症候的诊断，使用最多的术语是“颈性头晕”、“颈性眩晕”、“脑供血不足”或“椎基底动脉供血不足”。连患者本人也会像大多数医生一样给自己冠以颈性头晕/眩晕(认为与颈椎病有关)或椎基底动脉脑供血不足(误以为动脉受压)的诊断。这正是由于部分医师不能正确理解头晕或眩晕的概念，缺乏仔细区分和判断病因所致。因此，正确认识头晕及眩晕的概念，了解症候相关常见疾病的特点，正确诊断，对于临床医师的日常临床工作就显得尤为重要。笔者结合国外头晕诊治进展及自己的临床实践经验，介绍头晕的正确概念、常见头晕与眩晕疾病的特点，以供相关临床医师在实践中参考，避免盲目地选择检查手段和药物治疗。</span></p><p style=\"margin-top: 0px; margin-bottom: 0px; padding: 0px;\">&nbsp;</p><p style=\"margin-top: 0px; margin-bottom: 0px; padding: 0px;\"><span style=\"margin: 0px; padding: 0px; color: rgb(178, 34, 34);\"><span style=\"margin: 0px; padding: 0px; font-size: 14px;\"><strong style=\"margin: 0px; padding: 0px;\">一、头晕的流行病学特点及诊断中存在的问题 <br/></strong></span></span></p><p style=\"margin-top: 0px; margin-bottom: 0px; padding: 0px;\"><span style=\"margin: 0px; padding: 0px; color: rgb(178, 34, 34);\"><span style=\"margin: 0px; padding: 0px; font-size: 14px;\"><strong style=\"margin: 0px; padding: 0px;\"><br/></strong></span></span></p><p style=\"margin-top: 0px; margin-bottom: 0px; padding: 0px;\"><span style=\"margin: 0px; padding: 0px; font-size: 14px;\">&nbsp; &nbsp;\n &nbsp; \n头晕与眩晕几乎是最常见的临床症候之一，其发病率和患病率均较高，是内科、神经内科及耳鼻咽喉科门诊就诊的主要症候群，也是急诊的主要病症之一。美国的一项年度国家卫生服务调查研究显示，65岁以上人群中大约19.6%有头晕及平衡障碍症候。这与美国和英国另一项基于社区并基于人口所获得的调查数据相当(21%一29%的发生率)。荷兰一项所有年龄人群的头晕调查显示，年发生率为4.7‰。头晕绝大多数是发作性的，不到5%为持续性。头晕发作的频率在不同的研究有所不同。在一项基于社区的头晕研究中每月有头晕发作者占51%，每周发作者占14%，每天发作者占35%。</span></p><p style=\"margin-top: 0px; margin-bottom: 0px; padding: 0px;\"><span style=\"margin: 0px; padding: 0px; font-size: 14px;\"><br/></span></p><p style=\"margin-top: 0px; margin-bottom: 0px; padding: 0px;\"><span style=\"margin: 0px; padding: 0px; font-size: 14px;\">&nbsp;\n &nbsp; &nbsp; \n尽管头晕的发生率较高，但某些临床医生对于头晕的诊断常常比较“困惑”和“随意”。所谓“困惑”是指某些头晕的确会由于患者表述不清或问诊者缺乏相关经验而难以诊断；所谓“随意”是指医生对于“病因不清”的头晕或眩晕较随意地给予了“脑供血不足”、“颈性头晕”的诊断，或者干脆就以“头晕”二字进行症侯学诊断，而不是深入进行头晕与眩晕的诊断分析与思考。</span></p><p style=\"margin-top: 0px; margin-bottom: 0px; padding: 0px;\"><span style=\"margin: 0px; padding: 0px; font-size: 14px;\"><br/></span></p><p style=\"margin-top: 0px; margin-bottom: 0px; padding: 0px;\"><span style=\"margin: 0px; padding: 0px; font-size: 14px;\">&nbsp;\n &nbsp; &nbsp;&nbsp; \n例如，当患者以头部活动时出现头晕或眩晕为主述时，不同专科医生对其诊断常常不同，部分医生常常以己之见或从所在学科的视角片面地加以诊断。有的医生仅仅根据颈椎X线所示有骨质增生、椎间隙狭窄就考虑为颈性头晕或颈性眩晕；有的看到经颅多普勒超声提示某支动脉血流速度偏快就诊断动脉狭窄或痉挛造成了脑供血不足；有的根据单纯的眩晕直接诊断梅尼埃病或前庭周围性眩晕；还有的医师笼统的以“虚”字辩证。结果，同一患者像被“盲人摸象”一样得出了不同的诊断，并给予不同的诊疗措施及药物，而收效甚微，有的甚至病情加重。因此，必须理清头晕、眩晕的概念与诊断思路。</span></p><p style=\"margin-top: 0px; margin-bottom: 0px; padding: 0px;\">&nbsp;</p><p style=\"margin-top: 0px; margin-bottom: 0px; padding: 0px;\"><span style=\"margin: 0px; padding: 0px; color: rgb(178, 34, 34);\"><span style=\"margin: 0px; padding: 0px; font-size: 14px;\"><strong style=\"margin: 0px; padding: 0px;\">二、正确把握头晕的概念</strong></span></span></p><p style=\"margin-top: 0px; margin-bottom: 0px; padding: 0px;\"><span style=\"margin: 0px; padding: 0px; color: rgb(178, 34, 34);\"><span style=\"margin: 0px; padding: 0px; font-size: 14px;\"><strong style=\"margin: 0px; padding: 0px;\"><br/></strong></span></span></p><p style=\"margin-top: 0px; margin-bottom: 0px; padding: 0px;\"><span style=\"margin: 0px; padding: 0px; font-size: 14px;\">&nbsp; &nbsp; &nbsp;&nbsp; 2009年Bisdorff等Mo对前庭疾病提出了新的分类。该新分类对前庭症状分为眩晕、头晕(狭义的非眩晕性头晕)、视前庭症状、体位性症状。且由于每一症候相关更细的分类非常繁复，实际上并不特别适合临床操作，所以，此分类尚未被广泛应用。</span></p><p style=\"margin-top: 0px; margin-bottom: 0px; padding: 0px;\"><span style=\"margin: 0px; padding: 0px; font-size: 14px;\"><br/></span></p><p style=\"margin-top: 0px; margin-bottom: 0px; padding: 0px;\"><span style=\"margin: 0px; padding: 0px; font-size: 14px;\">&nbsp;\n &nbsp; &nbsp;&nbsp; \n广义地说，2010年Post和DickersonHl从临床实用的角度将头晕(dizziness)概念分为下列4类情况：头昏(1ightheadedness)、眩晕(vertigo)、平衡不稳(disequilibrium)、晕厥前状态(presyncope)。这个分类对于头晕的诊治非常简便，且易于把握。这些症状发生在患者意识清醒之下。换言之，在意识丧失时发生的晕厥、癫痫等疾病不包括在内。由此，我们明白头晕是广义的大概念，而眩晕、头昏仅仅是它的一部分。</span></p><p style=\"margin-top: 0px; margin-bottom: 0px; padding: 0px;\"><span style=\"margin: 0px; padding: 0px; font-size: 14px;\"><br/></span></p><p style=\"margin-top: 0px; margin-bottom: 0px; padding: 0px;\"><span style=\"margin: 0px; padding: 0px; font-size: 14px;\">&nbsp; &nbsp;\n &nbsp; \n头昏是指阵发或持续性的大脑不清晰感、头昏头沉、头胀、头部发紧感等。高血压、精神因素等常常引起头昏表现。头昏症候有时可能属生理过程，不一定是病理机制，如睡眠不足、疲劳、长时间加夜班等，若适时调整可以纠正。眩晕是患者主体对静态的周围客体或自身位置产生了运动错觉的症候，多为病理现象。常常表现为视物旋转或自身旋转感，也可有摇摆不稳、波浪起伏、跌落感等。眩晕时一般患者不敢睁眼，常伴有恶心，严重时出现呕吐、多汗、血压波动等自主神经症候，有的可伴眼震、共济失调等神经系统定位体征。晕厥前状态是指晕厥前发生的胸闷、心悸、头昏沉、眼前发黑、乏力等症兆。如直立性低血压发生时，容易出现晕厥前状态。平衡不稳是指有行动中站立不稳或运动失调的头晕症候。</span></p><p style=\"margin-top: 0px; margin-bottom: 0px; padding: 0px;\"><span style=\"margin: 0px; padding: 0px; font-size: 14px;\"><br/></span></p><p style=\"margin-top: 0px; margin-bottom: 0px; padding: 0px;\"><span style=\"margin: 0px; padding: 0px; font-size: 14px;\">&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 因此，对于就诊的头晕患者应当区分他们是否为头晕，若是，为哪种类型。当然，对于患者个体而言，在头晕症候发生时可以有头昏、眩晕或平衡不稳症状的单独出现、同时出现或相继出现的情况。</span></p><p style=\"margin-top: 0px; margin-bottom: 0px; padding: 0px;\"><span style=\"margin: 0px; padding: 0px; font-size: 14px;\"><br/></span></p><p style=\"margin-top: 0px; margin-bottom: 0px; padding: 0px;\"><span style=\"margin: 0px; padding: 0px; font-size: 14px;\"></span></p><p style=\"margin-top: 0px; margin-bottom: 0px; padding: 0px; color: rgb(52, 52, 52); font-family: Tahoma, Arial, 宋体, sans-serif; font-size: 12px; line-height: 26px; white-space: normal;\"><span style=\"margin: 0px; padding: 0px; color: rgb(178, 34, 34);\"><span style=\"margin: 0px; padding: 0px; font-size: 14px;\"><strong style=\"margin: 0px; padding: 0px;\">三、掌握头晕的常见疾病及其症候特点</strong></span></span></p><p style=\"margin-top: 0px; margin-bottom: 0px; padding: 0px; color: rgb(52, 52, 52); font-family: Tahoma, Arial, 宋体, sans-serif; font-size: 12px; line-height: 26px; white-space: normal;\"><span style=\"margin: 0px; padding: 0px; color: rgb(178, 34, 34);\"><span style=\"margin: 0px; padding: 0px; font-size: 14px;\"><strong style=\"margin: 0px; padding: 0px;\"><br/></strong></span></span></p><p style=\"margin-top: 0px; margin-bottom: 0px; padding: 0px; color: rgb(52, 52, 52); font-family: Tahoma, Arial, 宋体, sans-serif; font-size: 12px; line-height: 26px; white-space: normal;\"><span style=\"margin: 0px; padding: 0px; font-size: 14px;\">&nbsp; &nbsp; &nbsp;\n &nbsp; \n头晕一般分为非前庭系统疾病性头晕和前庭系统疾病性头晕两大类。非前庭系统疾病性头晕主要指由内科系统疾病[如心血管疾病(血压高低、心律失常)、血液疾病(贫血、红细胞增多症)、内分泌疾病]、环境变化及活动过度(高温、中暑、久立、过劳等)、头部轻微外伤后综合征、视觉疲劳及眼部肌病(如重症肌无力、青光眼等)、五官的炎症(口腔、副鼻窦炎)、上呼吸道感染及药物影响或药物中毒、周围神经疾病等引起。此外，也还包括心因性头晕，如抑郁焦虑状态、轻度躁狂等。这些头晕并非前庭系统本身受累。多数以头昏、平衡不稳、晕厥前状态为主。</span></p><p style=\"margin-top: 0px; margin-bottom: 0px; padding: 0px; color: rgb(52, 52, 52); font-family: Tahoma, Arial, 宋体, sans-serif; font-size: 12px; line-height: 26px; white-space: normal;\"><span style=\"margin: 0px; padding: 0px; font-size: 14px;\"><br/></span></p><p style=\"margin-top: 0px; margin-bottom: 0px; padding: 0px; color: rgb(52, 52, 52); font-family: Tahoma, Arial, 宋体, sans-serif; font-size: 12px; line-height: 26px; white-space: normal;\"><span style=\"margin: 0px; padding: 0px; font-size: 14px;\">&nbsp;\n &nbsp; &nbsp; &nbsp; \n前庭系统疾病性头晕又分成中枢性及周围性。周围前庭系统疾病性头晕主要有良性阵发性位置性眩晕(BPPV)、梅尼埃病、前庭神经元炎、迷路炎、淋巴管漏等。中枢性前庭系统疾病性头晕包括椎基底动脉供血不足、后循环缺血、脑出血、脑肿瘤、脑炎或脱髓鞘病、眩晕性癫痫等。还有的既有中枢前庭受累，又有周围前庭受累性表现，如偏头痛性眩晕(即偏头痛等位症)可有视野缺损、短暂意识模糊等中枢症候，且外周前庭检查少数可有单侧半规管轻瘫。</span></p><p style=\"margin-top: 0px; margin-bottom: 0px; padding: 0px; color: rgb(52, 52, 52); font-family: Tahoma, Arial, 宋体, sans-serif; font-size: 12px; line-height: 26px; white-space: normal;\"><span style=\"margin: 0px; padding: 0px; font-size: 14px;\"><br/></span></p><p style=\"margin-top: 0px; margin-bottom: 0px; padding: 0px; color: rgb(52, 52, 52); font-family: Tahoma, Arial, 宋体, sans-serif; font-size: 12px; line-height: 26px; white-space: normal;\"><span style=\"margin: 0px; padding: 0px; font-size: 14px;\">&nbsp;\n &nbsp;&nbsp;&nbsp;&nbsp;&nbsp; \n根据国内外最新的文献资料统计来看，头晕常见病因主要为BPPV、偏头痛性眩晕、心因性头晕、非前庭系统疾病性头晕、后循环缺血或卒中。而像梅尼埃病、前庭神经元炎或其他中枢神经系统疾病(脱髓鞘、肿瘤、炎症)等属于较少见的头晕情况，颈性头晕国外越来越少提及，除非是颈椎过度屈伸损伤或颈部外伤所致。</span></p><p style=\"margin-top: 0px; margin-bottom: 0px; padding: 0px; color: rgb(52, 52, 52); font-family: Tahoma, Arial, 宋体, sans-serif; font-size: 12px; line-height: 26px; white-space: normal;\"><span style=\"margin: 0px; padding: 0px; font-size: 14px;\"><br/></span></p><p style=\"margin-top: 0px; margin-bottom: 0px; padding: 0px; color: rgb(52, 52, 52); font-family: Tahoma, Arial, 宋体, sans-serif; font-size: 12px; line-height: 26px; white-space: normal;\"><span style=\"margin: 0px; padding: 0px; font-size: 14px;\">&nbsp;\n &nbsp;&nbsp;&nbsp;&nbsp;&nbsp; \nBPPV也称耳石症，是指耳内负责平衡的前庭器官椭圆囊内的耳沙石脱落掉到了相连接的像呼啦圈样的半规管内，因为半规管内有感受平衡的壶腹嵴，受到体位变化时耳石的碰撞而产生眩晕的症候。因此，其临床特点为：(1)头位变化时发作眩晕：起床和卧床、抬头、转头时可诱发，患者常“望床兴叹”、“不堪回首”；(2)每次头位变化的眩晕发作时间是以秒来计，多在10s以内，故眩晕“瞬间即逝”；(3)发作时是眩晕，发作后短时间内仍可有头昏沉感；(4)这种眩晕症候有自我好转性，也可复发；(5)不伴发听力下降、耳鸣，亦无复视、行走不稳感等脑干症候；(6)治疗主要采用耳石手法复位。</span></p><p style=\"margin-top: 0px; margin-bottom: 0px; padding: 0px; color: rgb(52, 52, 52); font-family: Tahoma, Arial, 宋体, sans-serif; font-size: 12px; line-height: 26px; white-space: normal;\"><span style=\"margin: 0px; padding: 0px; font-size: 14px;\"><br/></span></p><p style=\"margin-top: 0px; margin-bottom: 0px; padding: 0px; color: rgb(52, 52, 52); font-family: Tahoma, Arial, 宋体, sans-serif; font-size: 12px; line-height: 26px; white-space: normal;\"><span style=\"margin: 0px; padding: 0px; font-size: 14px;\">&nbsp;\n &nbsp; &nbsp; &nbsp;\n偏头痛性眩晕，也称前庭性偏头痛，实际就是偏头痛等位症。临床特点是：(1)该病好发于女性；(2)各年龄段均有发病，以青中年和老年为多；(3)临床表现为头晕或眩晕为主，有的有明显的偏头痛发生，少数无偏头痛或头痛症状；(4)头位变化时头晕或可加重，但无方向性；(5)可有或无先兆症状；(6)眩晕发作时多伴恶心、呕吐，吐后症状减轻，多有明显畏声、畏光、喜静、心情烦躁等表现；(7)可有视物模糊，少数患者可有极短暂的意识模糊；(8)该病常反复发作，频度不一，有的数年1次，有的数周或数天1次，稀密不定；(9)症状持续多在2~3\n h内(短的数十秒，长的数小时或2~3 d)，一般经过安静休息或睡眠后(次日)症状好转。有的在发作期间接受输液3~4 \nh自觉好转，实际上病情好转多为自然过程，而并非药物之效；(10)多数有而少数无偏头痛史，有的年轻时有偏头痛表现，随年龄增大，只出现头晕或眩晕的症候，不再头痛了，头痛、眩晕形式转变要掌握；(11)前庭功能检查：可正常或单侧半规管轻瘫，文献报告发生率8．1%~23．8%，随着时间推移及治疗，多数可基本恢复；(12)治疗：按偏头痛的治疗原则进行，对症止痛或配合镇静药物，并适当休息。</span></p><p style=\"margin-top: 0px; margin-bottom: 0px; padding: 0px; color: rgb(52, 52, 52); font-family: Tahoma, Arial, 宋体, sans-serif; font-size: 12px; line-height: 26px; white-space: normal;\"><span style=\"margin: 0px; padding: 0px; font-size: 14px;\"><br/></span></p><p style=\"margin-top: 0px; margin-bottom: 0px; padding: 0px; color: rgb(52, 52, 52); font-family: Tahoma, Arial, 宋体, sans-serif; font-size: 12px; line-height: 26px; white-space: normal;\"><span style=\"margin: 0px; padding: 0px; font-size: 14px;\">&nbsp;\n&nbsp;&nbsp; &nbsp; \n对头晕与眩晕的病因研究发现，长期、慢性持续性头晕或眩晕的病因主要与精神障碍有关，如抑郁、焦虑、惊恐、强迫或躯体化障碍等，这类头晕可占20%左右。Staab和Ruckenstein认为不明原因持续的头晕中60%为原发或继发的焦虑症所致。眩晕患者中有4．6%为心因性头晕。本期对我院208例心因性头晕患者的临床症候及诊治进行了详细的分析，在精神科专家指导下首次将心因性头晕分成3个类型，便于实践中操作，这对此类患者的诊治提供了有价值的经验参考。</span></p><p style=\"margin-top: 0px; margin-bottom: 0px; padding: 0px; color: rgb(52, 52, 52); font-family: Tahoma, Arial, 宋体, sans-serif; font-size: 12px; line-height: 26px; white-space: normal;\"><span style=\"margin: 0px; padding: 0px; font-size: 14px;\"><br/></span></p><p style=\"margin-top: 0px; margin-bottom: 0px; padding: 0px; color: rgb(52, 52, 52); font-family: Tahoma, Arial, 宋体, sans-serif; font-size: 12px; line-height: 26px; white-space: normal;\"><span style=\"margin: 0px; padding: 0px; font-size: 14px;\">&nbsp;\n &nbsp; &nbsp; &nbsp;\n眩晕也是后循环缺血的首发症状之一，过去常用椎基底动脉供血不足的诊断，但后循环缺血的概念既包括短暂性脑缺血发作，又有脑梗死的含义，因此比椎基底动脉供血不足更适合临床应用。有的后循环缺血开始仅表现为眩晕，而无其他症候，有时详细的MRI检查(含DWI像位)都未发现梗死表现，但很快发生脑干梗死，甚至累及呼吸，并伴意识障碍，一定要小心这种情况的发生。对于后循环缺血的诊断，一定要有其发生的病因，如吸烟史、“三高”史(高血压、高血糖、高血脂)，并能证实动脉粥样硬化斑块的形成，而不要强调颈椎病的存在。</span></p><p style=\"margin-top: 0px; margin-bottom: 0px; padding: 0px; color: rgb(52, 52, 52); font-family: Tahoma, Arial, 宋体, sans-serif; font-size: 12px; line-height: 26px; white-space: normal;\"><span style=\"margin: 0px; padding: 0px; font-size: 14px;\"><br/></span></p><p style=\"margin-top: 0px; margin-bottom: 0px; padding: 0px; color: rgb(52, 52, 52); font-family: Tahoma, Arial, 宋体, sans-serif; font-size: 12px; line-height: 26px; white-space: normal;\"><span style=\"margin: 0px; padding: 0px; font-size: 14px;\">&nbsp;\n &nbsp;&nbsp;&nbsp;&nbsp; \n当患者出现眩晕、耳鸣、耳聋(多次发作后出现)、耳内胀满感时应注意梅尼埃病的诊断。当患者对尖锐的声音或在自行用力情况下出现眩晕时，要注意上半规管裂的发生。当患者眩晕较重、强迫头(侧卧)位、体检站立时明确向一侧倾倒，且指鼻试验向患侧偏指，无其他听觉受累症状，应注意前庭神经元炎的诊断。老年人群应特别注意合并用药所引起的头晕问题，如降压药、前列腺治疗药物等；也应注意与营养不良、贫血、维生素缺乏及甲状腺功能减退等所引起头晕的鉴别。</span></p><p style=\"margin-top: 0px; margin-bottom: 0px; padding: 0px; color: rgb(52, 52, 52); font-family: Tahoma, Arial, 宋体, sans-serif; font-size: 12px; line-height: 26px; white-space: normal;\">&nbsp;</p><p style=\"margin-top: 0px; margin-bottom: 0px; padding: 0px; color: rgb(52, 52, 52); font-family: Tahoma, Arial, 宋体, sans-serif; font-size: 12px; line-height: 26px; white-space: normal;\"><span style=\"margin: 0px; padding: 0px; color: rgb(178, 34, 34);\"><span style=\"margin: 0px; padding: 0px; font-size: 14px;\"><strong style=\"margin: 0px; padding: 0px;\">四、熟悉头晕的诊断思路</strong></span></span></p><p style=\"margin-top: 0px; margin-bottom: 0px; padding: 0px; color: rgb(52, 52, 52); font-family: Tahoma, Arial, 宋体, sans-serif; font-size: 12px; line-height: 26px; white-space: normal;\"><span style=\"margin: 0px; padding: 0px; color: rgb(178, 34, 34);\"><span style=\"margin: 0px; padding: 0px; font-size: 14px;\"><strong style=\"margin: 0px; padding: 0px;\"><br/></strong></span></span></p><p style=\"margin-top: 0px; margin-bottom: 0px; padding: 0px; color: rgb(52, 52, 52); font-family: Tahoma, Arial, 宋体, sans-serif; font-size: 12px; line-height: 26px; white-space: normal;\"><span style=\"margin: 0px; padding: 0px; font-size: 14px;\">&nbsp; &nbsp;&nbsp;\n &nbsp; \n临床实践中对于头晕的患者如何快速诊断是相当重要的，清楚而简捷的头晕诊断思路可以使临床医生在繁忙的日常工作中迅速对头晕的病因加以判断。笔者结合临床实际总结出从头晕症候进行分析的诊断流程图旧J，很多临床医生使用后认为简便易行，可供借鉴与参考。此外，临床实践中应注重基本检查与细致体检相结合。如测血压，有的头昏实际上就是长期高血压所致；有时长时间看书出现头晕，实际上是青光眼的问题，只要通过阅读诱发出眼压迅速升高就不难进行初步判断。</span></p><p style=\"margin-top: 0px; margin-bottom: 0px; padding: 0px; color: rgb(52, 52, 52); font-family: Tahoma, Arial, 宋体, sans-serif; font-size: 12px; line-height: 26px; white-space: normal;\"><span style=\"margin: 0px; padding: 0px; font-size: 14px;\"><br/></span></p><p style=\"margin-top: 0px; margin-bottom: 0px; padding: 0px; color: rgb(52, 52, 52); font-family: Tahoma, Arial, 宋体, sans-serif; font-size: 12px; line-height: 26px; white-space: normal;\"><span style=\"margin: 0px; padding: 0px; font-size: 14px;\">&nbsp; &nbsp;&nbsp;\n &nbsp; \n总之，头晕是常见的临床症候，是一个看似“简单”，又的确诊断“不简单”的症候。常见病因是BPPV、偏头痛头晕或眩晕、心因性头晕以及后循环缺血等。前庭神经元炎、梅尼埃病或颈性头晕是少见的病因，尤其是颈性头晕。对于可能的后循环缺血患者一定要高度警惕，应立即到医院诊治，以免留下遗憾。对于头晕，需要相关专科医生在实践中不断掌握其不同疾患的特点，提高诊断与鉴别诊断的水平；同时，内科及神经科医生也应学会BPPV的手法复位技巧，为这些最先就诊于你的患者解除痛苦，妙手回春。</span></p><p style=\"margin-top: 0px; margin-bottom: 0px; padding: 0px; color: rgb(52, 52, 52); font-family: Tahoma, Arial, 宋体, sans-serif; font-size: 12px; line-height: 26px; white-space: normal;\">&nbsp;</p><p style=\"margin-top: 0px; margin-bottom: 0px; padding: 0px; color: rgb(52, 52, 52); font-family: Tahoma, Arial, 宋体, sans-serif; font-size: 12px; line-height: 26px; white-space: normal; text-align: right;\"><span style=\"margin: 0px; padding: 0px; font-size: 14px;\">（来源：中华内科杂志2014年10月第53卷第10期）</span></p><p><br/></p>","barId":"1927","topicTypeId":null,"topicThemeId":"1028","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":0,"metaSearch":null,"rn":1},{"id":"8027","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"引起头晕的常见原因","content":"<p style=\"text-indent:32px;line-height:200%\"></p><p style=\"text-indent:32px;line-height:200%\"><strong><span style=\";font-family:宋体;line-height:200%;font-size:16px\"><span style=\"font-family:宋体\">头晕</span></span></strong><span style=\";font-family:宋体;line-height:200%;font-size:16px\"><span style=\"font-family:宋体\">是</span>—个综合病症，是许多疾病的临床表现之一。引起头晕的原因常见以下几种：</span></p><p style=\"line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\">&nbsp;</span></p><p style=\"line-height: 200%; text-align: center;\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\"><img src=\"http://01luntan.com/ly_img/uimgs/1511313695358.jpg\" title=\"引起头晕的常见原因\" alt=\"引起头晕的常见原因\" width=\"600\" height=\"372\"/></span></p><p style=\"line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\"><br/></span></p><p style=\"text-indent:32px;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\">1、</span><span style=\";font-family:宋体;line-height:200%;font-size:16px\">神经系统病变：如脑缺血病变、小脑病变、脑部病变、脑外伤、某些类型的癫痫等。此外，植物神经功能失调以及某些神经症的病人也会常常感到头晕。</span></p><p style=\"line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\">&nbsp;</span></p><p style=\"text-indent:32px;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\">2</span><span style=\";font-family:宋体;line-height:200%;font-size:16px\">、</span><span style=\";font-family:宋体;line-height:200%;font-size:16px\">耳部疾病：如耳内疾病影响到平衡而引起头晕。</span></p><p style=\"line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\">&nbsp;</span></p><p style=\"text-indent:32px;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\">3、</span><span style=\";font-family:宋体;line-height:200%;font-size:16px\">内科疾病：如高血压病、低血压病、各种心脑血管病、贫血、感染、中毒、低血糖等。</span></p><p style=\"line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\">&nbsp;</span></p><p style=\"text-indent:32px;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\">4、</span><span style=\";font-family:宋体;line-height:200%;font-size:16px\">感冒：有时感冒可能会附带有头晕的症状。</span></p><p style=\"line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\">&nbsp;</span></p><p style=\"line-height: 200%; text-align: center;\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\"><img src=\"http://01luntan.com/ly_img/uimgs/1511314170180.jpg\" title=\"引起头晕的常见原因\" alt=\"引起头晕的常见原因\" width=\"600\" height=\"372\"/></span></p><p style=\"line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\"><br/></span></p><p style=\"text-indent:32px;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\">5、</span><span style=\";font-family:宋体;line-height:200%;font-size:16px\">颈椎骨退化：由于长期姿势或睡姿不良，造成颈椎增生、变形、退化，颈部肌肉扯紧，动脉供血受阻使脑供血不足，是头晕的主要原闲常颈部发紧、灵活度受限、偶有疼痛、发麻、发凉，有沉重感。</span></p><p style=\"line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\">&nbsp;</span></p><p style=\"text-indent:32px;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\">6、</span><span style=\";font-family:宋体;line-height:200%;font-size:16px\"><span style=\"font-family:宋体\">贫血：如有头晕伴有乏力、面色苍白的表现，应考虑贫血的可能性。健康状态下，老年人体内造血组织的存在量以及造血质和量已经有所下降，红细胞本身的老化，使其对铁的利用率大不如前。因此，老年人如果不注重营养保健，很容易患贫血。此外</span>.消化刁;良、消化性溃疡、消化道出血以及慢性炎症性疾病的患者均可继发贫血。</span></p><p style=\"line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\">&nbsp;</span></p><p style=\"text-indent:32px;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\">7、</span><span style=\";font-family:宋体;line-height:200%;font-size:16px\">血粘度高：高血脂、血小板增多症等均可使血粘度增高，血流缓慢，造成脑部供血不足，容易发生疲倦、头晕、乏力等症状。其中造成高血脂的的原因很多，最主要的是平素饮食结构的不合理，患者大量吃高脂肪、胆固醇的食物，而又不爱运动。目前该类疾病的发病率有上升趋势。</span></p><p style=\"line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\">&nbsp;</span></p><p style=\"text-indent:32px;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\">8、</span><span style=\";font-family:宋体;line-height:200%;font-size:16px\">脑动脉硬化病：患者自觉头晕，且经常失眠、耳鸣、情绪不稳、健忘、四肢发麻。脑动脉硬化使脑血管内径变小，脑内血流下降，产生脑供血、供氧不足，引起头晕。</span></p><p style=\"line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\">&nbsp;</span></p><p style=\"line-height: 200%; text-align: center;\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\"><img src=\"http://01luntan.com/ly_img/uimgs/1511313805200.jpg\" title=\"引起头晕的常见原因\" alt=\"引起头晕的常见原因\" width=\"600\" height=\"372\"/></span></p><p style=\"line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\"><br/></span></p><p style=\"text-indent:32px;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\">9、</span><span style=\";font-family:宋体;line-height:200%;font-size:16px\">心脏病、冠心病早期，症状尚轻，有人可能没有胸闷、心悸、气短等显著不适，只感觉头痛、头晕、四肢无力、精神不易集中、耳鸣或健忘等。此时发生头晕的原因主要是心脏冠状动脉发生粥样硬化，管腔变细变窄，使心脏缺血缺氧。而心脏供血不足，可以造成供血不足，引起头晕。</span></p><p><br/></p>","barId":"1927","topicTypeId":null,"topicThemeId":"1026","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":0,"metaSearch":null,"rn":1}],"pageObj":{"list":[],"list4Map":null,"pageBegin":0,"pageSize":5,"pageNumber":0,"totalPage":0,"totalRow":0},"loginUser":null,"replies":[],"forumUserFans":null,"herfList":[],"only":"0","topic":{"id":"2559","isDel":0,"createAt":1485068842390,"createBy":"b1a5ca4ddfad11e6a61c00163e04584d","createName":"小海螺","updateAt":0,"updateBy":null,"updateName":null,"userId":"b1a5ca4ddfad11e6a61c00163e04584d","title":"治疗头昏眩晕的常用药物有哪些？","content":"<p>&nbsp;&nbsp;&nbsp; 在<a href=\"http://www.zhao01.com/bbs/topic/4209\">病因</a>治疗的同时，我们也要对头昏眩晕给予药物治疗，来控制眩晕，消除恶心，呕吐、和焦虑紧张的情绪，此类药物归纳起来可分为以下几类，我和大家一起分享。</p>\n<p>&nbsp;</p>\n<p style=\"text-align: center;\"><img title=\"1485069307637.jpg\" src=\"http://01luntan.com/ly_img/uimgs/1485069307637.jpg\" alt=\"04H58PICnpB_1024.jpg\" /></p>\n<p><span style=\"font-family: 宋体;\">步骤</span>/<span style=\"font-family: 宋体;\">方法：</span></p>\n<p><span style=\"font-family: 宋体;\">&nbsp;</span><em>1</em>镇定剂和安定剂：常用的药物有巴比妥类以及安定、阿普锉仑等。此类药物有镇静和安定情绪的作用，从而减少紧张不安和焦虑。例如安定2.5毫克，一日2到3次；阿普锉仑0.4毫克，一日2到3次。</p>\n<p><em>&nbsp; 2</em>抗眩晕、止呕吐：阿托品具有止吐，接解除血管痉挛的作用，还是很好的镇定剂。敏使朗，眩晕停，它们能选择性改善椎基底动脉供血和内耳血流量，还可以调节前庭功能，具有明显的止吐和抗眩晕的作用。敏使朗12毫克一日3次，眩晕停25到50毫克，一日三次。</p>\n<p><em>&nbsp; 3</em>脑血管扩张剂：由于治疗脑血管扩张的药物主要是选择性脑血管扩张剂，特别是有利于改善椎基底动脉和内耳血液循环，如西比灵5到10毫克，睡前服用；或者尼莫地平20~40毫克，一日3次。</p>\n<p><em>&nbsp; 4</em>中成药：眩晕宁2片，一日3次。临床应用安全，无明显副毒作用。镇肝熄风汤。治疗肝阳上亢，头晕目眩耳鸣等症状。定眩汤。治疗因供血不足引起的头晕目眩，颈性眩晕。</p>\n<p>注意事项：</p>\n<p><span style=\"font-size: 14px; font-family: 宋体;\">苯海拉明和晕海宁应用最多，</span><span style=\"font-size: 14px; font-family: 'Calibri','sans-serif';\">25</span><span style=\"font-size: 14px; font-family: 宋体;\">毫克一日</span><span style=\"font-size: 14px; font-family: 'Calibri','sans-serif';\">3</span><span style=\"font-size: 14px; font-family: 宋体;\">次，为防止晕动病，可于乘车（船）前服一片。一定要根据自身情况来选择用药！</span></p>\n<p>&nbsp;</p>","barId":"1927","topicTypeId":"2","topicThemeId":"1030","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":2102,"score":0,"partCount":0,"replayCount":0,"publishStatus":1,"publishTime":1485068842391,"isCream":0,"canReply":0,"shareUrl":null,"foodCouponVal":1,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":1485068842390,"metaSearch":null,"rn":null},"userAllInfo":{"id":null,"isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"username":null,"password":null,"level":0,"nickName":null,"realName":null,"signName":null,"head":null,"phone":null,"mobile":null,"wechat":null,"qq":null,"email":null,"address":null,"identityType":0,"userType":0,"isPhoneBind":0,"status":0,"accountSource":0,"isStrangerMsg":0,"departmentId":null,"departmentName":null,"sex":0,"provinceId":null,"cityId":null,"userLevel":0,"modifyNameCount":0,"forumUser":{"id":"b1a5ca4ddfad11e6a61c00163e04584d","isDel":0,"createAt":1484984778320,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"username":"小海螺","password":"yiren2921","level":0,"nickName":"小海螺78","realName":null,"signName":"开心每一天","head":"http://01luntan.com/ly_img/1484985295689.jpg","phone":null,"mobile":null,"wechat":null,"qq":null,"email":"2276635444@qq.com","address":null,"identityType":6,"userType":2,"isPhoneBind":0,"status":0,"accountSource":0,"isStrangerMsg":0,"departmentId":null,"departmentName":null,"sex":1,"provinceId":"110000","cityId":"110108","userLevel":0,"modifyNameCount":1},"forumUserActiveInfo":{"id":"b1ba5254dfad11e6a61c00163e04584d","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":1705892489293,"updateBy":"b1a5ca4ddfad11e6a61c00163e04584d","updateName":"小海螺","userId":"b1a5ca4ddfad11e6a61c00163e04584d","topicCount":2201,"replayCount":900,"favorteCount":0,"beFavorteCount":0,"creamCount":2,"focusCount":1,"fansCount":4,"integralCount":2357,"foodCouponCount":0,"lastLoginTime":0,"lastLoginIp":null,"downloadCount":0,"uploadCount":0},"newPass":null,"focusBar":null,"counter":null,"forumUserIdentificateDto":null},"theme":null,"page":1,"favorties":true,"isSelf":false,"order":"asc"}