晕厥 Syncope

　　patient ： Doctor I have been suffering from " fits" for a few years . I wonder what matter is with me and hope you'll help me get rid of them soon.

　　Doctor ： What do you mean by a "fit"？

　　P： By "fit" I mean I lose consciousness and fall on the ground on sudden .

　　D： What time did your attack begin？

　　P： When I was married and only 25 years old .

　　D： How many years so far？

　　P： Over three years .

　　D： How long does each attack last？

　　P： About a minute.

　　D： How long is the interval between two successive attacks？

　　P： Sometimes round a month ， and sometimes two months . Could it be related to circumstances？

　　D： What lind of cases usually provokes your attacks？

　　P： It is difficult to say exactly . Once when I was crossing the street ， a swiftly moving car suddenly drove by and I became very hervous ， I couldn't control myself. I screamed and blacked out .

　　D： Were you injured？

　　P： No ， the car stopped at once . I came to quickly ， then walked home .

　　D： Any other attacks？

　　P： On another occasion ， no sooner had a nurse drawn blood from a patient than I felt perspiration and weakness followed by loss of consciousness.

　　D： Did you have other manifestations during the attack？

　　P： I was told by eyewitmesses that I became pale and sweated excessively during the attack ， but I had no convulsions ， incontinence or anything else.

　　D： Have you had any special examinations？

　　P： The doctors working in our county's hospital told me that my physical examination ， electr ocardiogram ， and chest and skull x-ray examination results were normal . I've had no other special examinations.

　　D： Let me give you a thorough physical and neurological examinaltion . Some furtherexaminations should be done ， including an electroencephalogram and a brain scan . Also the electrocardiogram should be repeated . Here are your referral sheets . After you have had all these examinations please come back for another checkup.

　　P： I have had all the examinations you ordered. Are all the results back yet？

　　D： Yes ， and all the results are normal.

　　P： Then what is the cause of my "fits"？ form www.med66.com

　　D： The normal results of physical and neurological examinations and other special examinations suggest neither organic heart or brain diseases nor epilepsy . The symptoms and signs which occus during an attack ， such as palpitations ， paleness and excessive sweating coincide with an imbalance of the autonomic nervous system function . Dysfunction of the autonomic nervous system can lead to a decrease in the cardiac output ， cerebral anemia ， suppression of brain function ， and finally to a loss of consciousness . Such an attack is termed syncope.

　　P： Can you give me some medicine to calm the syncope down？

　　D： Yes . You should pay more attention to regulating your life such as getting up and going to bed regularly and not drinking or smoking too much . I'll give you some medicine to regulate the function of your autonomic nervous system . If you follow my advice， I'm sure your condition will get better soon. Sometimes your symptoms may recur ， this is a natural phenomenon . Don't worry ， such recurrences don't mean regression . During the struggle against disase ， you must feel confident that you can overcome it ， then the medicine， which I'll give you ， will help you defeat the enemy-syncope . Medicine is one way ， confidence is another . The latter is more important than the former . You must keep my words in your mind .

　　P： Thanks a lot ， doctor.

　　病人：医生，近几年来我常常"突然发作".我真想知道我得了什么病，希望您快些给治好。

　　医生：您说的"突然发作"是什么意思？

　　病人：我所说的"突然发作"是指我突然不醒人事，摔倒地上。

　　医生：您的发作是什么时候开始的？

　　病人：在我结婚时，当时我才25岁。

　　医生：至今有多少年了？

　　病人：3年多了。

　　医生：每次犯病持续多长时间？

　　病人：大约1分钟。

　　医生：每次发作相隔多久？

　　病人：有时候约1个月，有时2个月左右。我的病发作与周围环境有关系吗？

　　医生：平常在什么情况容易引起您的病发作？

　　病人：很难说清楚。有一次我过马路时，忽然一辆小轿车飞快地向我开来，当时我十分紧张，控制不住自己了。我大叫一声就什么也不知道了。

　　医生：您伤着了吗？

　　病人：没有，汽车马上停下来了。我很快醒过来就回家了。

　　医生：还怎样发作过？

　　病人：另一次，我看一位护士给别的病人抽血，就冒汗、发软，随后就晕过去了。

　　医生：在发病的时候还有什么其他的表现吗？

　　病人：据看到我发病的人说，在我发作时，脸色苍白，大量出汗，但是没有摔搐、大小便失禁或其他情况。

　　医生：您做过专门的检查吗？

　　病人：我们县医院的医生对我说过，我的体格检查、心电图、胸部和头颅的 X线检查都正常。其他的专门检查就没有做过了。

　　医生：我给您做一个内科和神经科的全面检查吧。您还需要做些进一步检查，包括脑电图和脑扫描。心电图也再做一个。这是各项检查单，把所有的检查做完后再来门诊看病。

　　病人：您让我做的都做完了。结果都出来吗？

　　医生：结果出来了，结果都正常。

　　病人：那我的"突然发作"是怎么回事？

　　医生：根据内科、神经科以及一些其他专门检查看来，您既不是器质性的心脏病或颅脑病，也不是颠痫。您突然发作时的病状和体征，如心跳、苍白和过多的血汗等，跟您自主神经系统功能失调是相符的。自主神经系统的功能失调能引起心博出量的减少、脑贫血、大脑功能抑制，最后失去知觉。象这样的病我们就称做晕厥。

　　病人：您能用什么药治疗我的晕厥吗？

　　医生：您要注意的是生活要有规律，比如按时起床，睡觉，不要过多地抽烟和喝酒。我给您开点调节您的自主神经功能的药。如您能听从我的劝告，我相信您一定会很快好起来的。一些症状有时可能有反复，这是常有的事情。不过，不要紧。这并不说明病情恶化。当你和疾病做斗争时，必须树立能克服的它的信心，另外，我再给您开些药，会治好您这是晕厥病的。药是一方面，信心和精神又是一方面，后者比前者更重要。您一定要记住我的话。

　　病人：多谢了，医生。