【摘要】 目的 总结非器质性呼吸困难患者的急诊诊治经验，提高急诊医生对心理-生理性疾病的认识。 方法 对2005年-2009年急诊科32例非器质性呼吸困难患者的诊治经过进行回顾性分析。 结果 32例患者发病前均有精神创伤或过度劳累、精神紧张、或应急等心因性诱因；有典型的临床症状；过度通气激发试验阳性；血气分析提示呼吸性碱中毒；Nijmegen问卷积分≤23分者18例（56.2%）；辅助检查未见其他原发性疾病。 结论 随着现代社会身心压力的增大，非器质性呼吸困难患者明显增加，临床医生应加强对社会心理-生理性疾病的认识，提高诊断率，对减轻患者的精神压力及避免过度医疗具有重要的临床意义。
【Abstract】 Objective To summarize the medical experiences of treating nonorganic dyspnea in the emergency department and raise physicians’ awareness of psychological-physiological diseases. Methods The clinical data of 32 patients with nonorganic dyspnea between 2005 and 2009 in the emergency department of our hospital were analyzed retrospectively. Results All the 32 patients had psychogenic incentives before onset of the disease, such as mental injury, over-exhaustion, nervousness or emergency. All of them had typical clinical manifestations. The results of hyperventilation provocation test were positive. Arterial blood gas analysis implied respiratory alkalosis. Eighteen of them (56.2%) had a mark ≤23 on the Nijmegen questionnaire. Auxiliary examinations showed no other primary diseases. Conclusions With the increase of emotional stress in the modern society, the number of patients with nonorganic dyspnea have markedly increased. Clinicians should strengthen the awareness of social psychology-physiological diseases, and improve diagnostic accuracy, which will have an obvious clinical value in relieving patients’ mental stress and avoiding excessive medical treatment.
Citation：
LUO Changbin,ZHANG Cheng. A Clinical Analysis of Nonorganic Dyspnea in Emergency Department. West China Medical Journal, 2011, 26(11): 1653-1655. doi:
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Copyright © the editorial department of West China Medical Journal of West China Medical Publisher. All rights reserved
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- 1. 韩江娜, 朱元珏, 李舜伟. 非器质性呼吸困难的诊断与治疗[J]. 中国医学科学院学报, 2004, 26(1): 76-78.
- 2. 殷晓玲, 葛正行. 高通气综合征证治体会[J]. 实用中医药杂志, 2009, 25(2): 102.
- 3. 邓伟吾. 实用临床呼吸病学[M]. 北京: 中国协和医科大学出版社, 2004: 891-894.
- 4. Lewis RA, Howell JB. Definition of the hyperventilation syndrome[J]. Bull Eur Physiopathol Respir, 1986, 22(2): 201-205.
- 5. 韩江娜, 朱元珏, 李舜伟. 高通气综合征的临床诊断与治疗[J]. 中华结核和呼吸杂志, 1998, 21(2): 98-101.
- 6. Zhu YJ, Luo DM, LI SW. Fearful imagery induces hyperventilation and dyspnea inmedically nexplained dyspnea[J]. Chin Med J, 2008, 121(1): 56-62.
- 7. 胡光荣. 青年军人过度通气综合征42例分析[J]. 临床军医杂志, 2005, 33(6): 730-731.
- 8. 杨建坤, 赵丽. 44例非器质性呼吸困难患者的急诊诊治体会[J]. 中国急救医学, 2007, 27(3): 278-280.
- 9. Aronowitz RA. When do symptoms become a disease?[J]. Ann Intern Med, 2001, 134(9): 803-808.
- 10. 祝尔诚 于润江. 自发性过度通气后过度呼吸的发生机理[J]. 中国应用生理学杂志, 1991, 7(3): 276-278.
- 11. 周铭霞. 非器质性呼吸困难97例急诊诊治体会[J]. 吉林医学, 2010, 3l(3): 294-205.
- 12. 曾昭耆. 实事求是地评估心理性病因[J]. 中华全科医师杂志, 2003, 2(3): 131-132.
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