METHODS: VVS patients were treated with a 2 step protocol. Step I - counseling, hydration, physiotherapy, and Tadasana Yoga maneuver. Patients with ≥2 VVS recurrences were given step II care - intensification of step I, elastic stockings,and pharmacotherapy. Follow-up included assessment by periodic functional status questionnaires.
RESULTS: 157 patients (103 males & 54 females,mean age - 53 ± 20 years & mean LVEF - 62 ± 5%.) experienced 867 total events - 382 syncopal, and 485 near syncopal episodes over 14 ± 9 months. After step I protocol, the mean total, syncopal and near syncopal events declined from 5 ± 7 to 0.3 ± 1.2 (P < 0.0001), 3 ± 2 to 0.1 ± 0.4 (P < 0.0001) and 3 ± 6 to 0.2 ± 1.1 (P < 0.0001) respectively. Twenty (12.7%) patients had 53 event recurrences, 15- syncopal episodes in 7 and 38 near syncope events in 13. After step II, 5 patients had 14 events. At 33 ± 15 months, in 152 patients (96.8%) there were no recurrences and syncope was prevented in all (100%). The median total, syncopal and near syncopal events declined from 3 to 0,(p < 0.001) 2 to 0 (p < 0.001) and 1 to 0 (p < 0.001) respectively. There was an improvement in all the 3 quality of life parameters.
CONCLUSIONS: We demonstrate a simple and effective protocol that can be universally adopted to prevent VVS recurrences,with improvement in quality of life.
方法:VVS患者采用2步方案治疗。第一步-咨询,水合作用,物理治疗,和Tadasana瑜伽动作。VVS复发≥2例的患者给予步骤II护理-强化步骤I,弹力长袜,和药物治疗。后续行动包括通过定期的功能状态问卷进行评估。
结果:157例患者(男103例,女54例,平均年龄-53±20岁和平均LVEF-62±5%。)总共经历了837次事件-382次晕厥,在14±9个月内有485次接近晕厥发作。在第一步协议之后,平均总数,晕厥和近晕厥事件从5±7下降到0.3±1.2(P<0.0001),3±2至0.1±0.4(P<0.0001)和3±6至0.2±1.1(P<0.0001)。20例(12.7%)患者有53例事件复发,15-晕厥发作7次,13次晕厥事件38次。第二步后,5例患者发生14例事件。在33±15个月时,在152例患者(96.8%)中,无复发,所有患者均可预防晕厥(100%).中位数总数,晕厥和近晕厥事件分别从3降至0,(p<0.001)2降至0(p<0.001)和1降至0(p<0.001).所有3个生活质量参数都有改善。
结论:我们展示了一种简单有效的方案,可以普遍采用该方案来防止VVS复发,随着生活质量的提高。