Karpenko Anna, Keegan Joshua
Dartmouth Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH 03756, USA.
Dartmouth Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH 03756, USA.
Emerg Med Clin North Am. 2021 Feb;39(1):155-172. doi: 10.1016/j.emc.2020.09.009. Epub 2020 Nov 5.
The differential diagnosis for the comatose patient is includes structural abnormality, seizure, encephalitis, metabolic derangements, and toxicologic etiologies. Identifying and treating the underlying pathology in a timely manner is critical for the patient's outcome. We provide a structured approach to taking a history and performing a physical examination for this patient population. We discuss diagnostic testing and treatment methodologies for each of the common causes of coma. Our current understanding of the mechanisms of coma is insufficient to accurately predict the patient's clinical trajectory and more work needs to be done to investigate potential treatments for this often fatal disorder.
昏迷患者的鉴别诊断包括结构异常、癫痫发作、脑炎、代谢紊乱和毒理学病因。及时识别并治疗潜在病理状况对患者的预后至关重要。我们为这类患者群体提供了一种结构化的病史采集和体格检查方法。我们讨论了昏迷常见病因的诊断测试和治疗方法。我们目前对昏迷机制的理解不足以准确预测患者的临床病程，需要开展更多工作来研究针对这种往往致命疾病的潜在治疗方法。
