以头晕为表现的未分化疾病诊治进展

蒋睿娟; 胡梦杰; 朱佳宏; 任菁菁

doi:10.16766/j.cnki.issn.1674-4152.003971

以头晕为表现的未分化疾病诊治进展

doi: 10.16766/j.cnki.issn.1674-4152.003971

浙江大学医学院附属第一医院全科医学科，浙江杭州 310003

基金项目:

国家自然科学基金资助项目 72274169

详细信息

通讯作者:
任菁菁，E-mail：3204092@zju.edu.cn

中图分类号: R441.2
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- 文章访问数: 4
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- PDF下载量: 1
- 被引次数: 0
出版历程
- 收稿日期: 2024-04-15
- 网络出版日期: 2025-06-30

Research progress in the diagnosis and treatment of medically unspecified disease manifested by dizziness

Department of General Practice, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003, China

摘要

摘要: 头晕是全科门诊患者常见的主诉之一，其会影响患者生活、社交、工作等多个方面，造成相关功能损害。头晕症状具有主观性和非特异性, 其病因可能涉及多个学科，目前仍缺乏精确、迅速评估头晕的相关工具。正确地认识、治疗头晕对患者及其家庭具有重要意义。鉴于头晕的病因多样且表现复杂，头晕的管理对全科医生而言仍是一大挑战。对于以头晕为表现的患者，目前全科医生的处理方法包括对因治疗、对症治疗、康复治疗及心理治疗，以减轻症状、缓解情绪及降低日常功能损害。全科医生怎样协助部分头晕患者与病情共存、寻求合理的干预措施和管理办法，仍有待深入研究。本文总结了近年来国内外头晕诊治相关文献资料，对头晕的流行病学、临床特征、病因类型、诊断、治疗和预防等领域的研究成果进行综述，以期为全科医生管理以头晕为表现的未分化疾病提供参考。
- 头晕 /
- 临床特点 /
- 未分化疾病 /
- 诊治进展
Abstract: Dizziness is the most common complaint among patients in general practice clinics. Dizziness can have negative effects on patients' life, social, work, and other aspects, causing functional impairment. The symptom of dizziness is subjective and non-specific, and the cause may involve multiple disciplines. There is still a lack of tools to assess dizziness accurately and rapidly at present. Understanding and treating dizziness correctly is of great significance to patients and their families. The etiology of dizziness is numerous and diverse, and the management of dizziness remains a challenge for general practitioners. For patients manifested by dizziness, the current management methods of general practitioners include cause-based treatment, symptomatic treatment, rehabilitation, and psychotherapy to reduce symptoms, relieve mood, and reduce impairment of daily functioning. Further research is needed on how general practitioners can help some people with dizziness to live with symptoms and find effective interventions and treatments. This article summarizes domestic and international literature on the diagnosis, and treatment of dizziness in recent years, and reviews the epidemiology, clinical characteristics, diagnosis, and treatment of dizziness, in order to provide general practitioners with reference for the management of medically unspecified diseases manifested by dizziness.
- Dizziness /
- Clinical characteristics /
- Medically unexplained symptoms /
- Research progress in the diagnosis and treatment

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表 1 头晕的常见病因

Table 1. Common causes of dizziness

疾病分类	常见病因
前庭周围性病变	前庭神经炎、突发性耳聋、急性中耳炎、迷路炎、BPPV、梅尼埃病、前庭阵发症
前庭中枢性病变	脑干和小脑出血：脑梗死、脑出血、多发性硬化、肿瘤、感染、变性病；前庭性偏头痛；短暂性脑缺血发作；痫性发作；后颅凹占位性病变：第四脑室占位、脑干及小脑肿瘤；神经系统变性：脑干小脑退行性病变、遗传性共济失调；颅颈交界区发育异常
精神心理性头晕	持续性姿势性感知性头晕
全身疾病相关性头晕	直立性低血压、药源性眩晕、视性眩晕、严重的心肌梗死或心律失常、心力衰竭、晕动症、部分贫血、低血糖、甲状腺功能减退或亢进、电解质酸碱紊乱
其他	病因不明的头晕

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