Edlow Jonathan A
Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 1 Deaconess Place, Boston, MA 02215, USA.
Emerg Med Clin North Am. 2016 Nov;34(4):717-742. doi: 10.1016/j.emc.2016.06.004. Epub 2016 Sep 7.
Dizziness is a common chief complaint in emergency medicine. The differential diagnosis is broad and includes serious conditions, such as stroke, cardiac arrhythmia, hypovolemic states, and acute toxic and metabolic disturbances. Emergency physicians must distinguish the majority of patients who suffer from benign self-limiting conditions from those with serious illnesses that require acute treatment. Misdiagnoses are frequent and diagnostic test costs high. The traditional approach does not distinguish benign from dangerous causes and is not consistent with best current evidence. This article presents a new approach to the diagnosis of acutely dizzy patients that highly leverages the history and the physical examination.
头晕是急诊医学中常见的主要症状。鉴别诊断范围广泛,包括一些严重疾病,如中风、心律失常、低血容量状态以及急性中毒和代谢紊乱。急诊医生必须将大多数患有良性自限性疾病的患者与那些需要紧急治疗的严重疾病患者区分开来。误诊情况屡见不鲜,且诊断检查费用高昂。传统方法无法区分良性病因和危险病因,也不符合当前最佳证据。本文提出了一种针对急性头晕患者的新诊断方法,该方法高度依赖病史和体格检查。