呼吸科门诊非器质性呼吸困难的临床分析

发布时间：2018-05-08 20:20

本文选题：呼吸困难 + 焦虑　；参考：《上海交通大学学报(医学版)》2014年08期

【摘要】：目的调查非器质性呼吸困难在呼吸困难中的发生率及临床特征。方法选择在呼吸科门诊因呼吸困难就诊的783例患者进行调查,确定非器质性呼吸困难的诊断标准,对首次因呼吸困难就诊或在外院多次就诊未发现明确病因的呼吸困难患者进行Nijmegen症状学问卷和阿森斯失眠量表(AIS)的自我评估调查,分析临床特征并收集其对呼吸困难的描述语。结果在783例呼吸困难患者中,明确病因的有721例(92.08%),非器质性疾病62例(7.92%)。非器质性呼吸困难患者的发病时间和频率不等,但临床表现典型,常见描述语包括"空气堵在胸口提不上来气""胸口不适及压迫感""呼吸费力"等。发病前有43例(69.53%)患者感觉工作、生活和学习压力大,54例(87.10%)患者有焦虑和(或)抑郁症状,48例(77.42%)患者有失眠症状,所有患者有上述3种状态中的至少1种表现,经抗焦虑、镇静、安眠、暗示治疗等对症处理后可迅速缓解。结论临床医师应提高对非器质性呼吸困难的认识及诊治水平,早期诊断并适当治疗,降低漏诊率和误诊率,避免过度医疗。
[Abstract]:Objective to investigate the incidence and clinical characteristics of non-organic dyspnea in dyspnea. Methods 783 patients with dyspnea in respiratory outpatient department were investigated and the diagnostic criteria of non-organic dyspnea were determined. A self-assessment survey was carried out on patients with dyspnea who had not found a definite cause of dyspnea for the first time because of dyspnea or in other hospitals. The clinical features were analyzed and their descriptive expressions for dyspnea were collected by means of Nijmegen symptom questionnaire and Ascension Insomnia scale (AIS). Results among the 783 patients with dyspnea, 721 cases (92.08%) had definite etiology, and 62 cases of non-organic diseases (7.92%). Patients with non-organic dyspnea have different onset time and frequency, but their clinical manifestations are typical. Common descriptive expressions include "air clogging in the chest cannot lift breath", "chest discomfort and pressure", "breathing effort" and so on. Before the onset of the disease, 43 cases (69.53) had the feeling of work, 54 cases had great stress of life and study, and 54 cases had anxiety and / or depressive symptoms 48 cases had insomnia. All the patients had at least one of the three states mentioned above, which were treated with anti-anxiety and sedation. Sleep, hint treatment and other symptomatic treatment can be quickly alleviated. Conclusion clinicians should improve their understanding and diagnosis of non-organic dyspnea, early diagnosis and appropriate treatment, reduce the rate of missed diagnosis and misdiagnosis, and avoid excessive medical treatment.
【作者单位】：重庆医科大学附属第一医院血液科;重庆医科大学附属第一医院呼吸科;
【基金】：国家“十二五”重大专项基金(2012ZX10003-009) 国家临床重点专科专项基金(2012-949)~~
【分类号】：R56

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