上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

呼吸科门诊非器质性呼吸困难的临床分析

彭印印1，郭述良2   

  1. 重庆医科大学附属第一医院 1.血液科， 2.呼吸科， 重庆 400016
  • 出版日期:2014-08-28 发布日期:2014-09-02
  • 通讯作者: 郭述良, 电子信箱: GUOSL999@sina.com。
  • 作者简介:彭印印（1988—）， 女， 硕士生; 电子信箱: joyce802320@163.com。
  • 基金资助:

    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）

Clinical analysis of non-organic dyspnea of respiratory outpatient department

PENG Yin-yin1, GUO Shu-liang2   

  1. 1.Department of Hematology Medicine, 2.Department of Respiratory Medicine, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
  • Online:2014-08-28 Published:2014-09-02
  • Supported by:

    National Major Science and Technology Program in “the 12th Five-Year” Plan，2012ZX10003-009；National Key Clinical Specialty Foundation of China, 2012-949

PDF (PC)

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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。

关键词: 呼吸困难, 焦虑, 失眠

Abstract:

Objective To investigate the incidence and clinical features of non-organic dyspnea. Methods A total of 783 dyspnea patients who visited the respiratory outpatient department were surveyed. The diagnostic criteria for non-organic dyspnea were determined. The self-assessment surveys were conducted for dyspnea patients who visited the hospital for the first time or many times without clear causes by means of Nijmegen Questionnaire and Athens Insomnia Scale (AIS). The clinical features were analyzed and words for describing the dyspnea were collected. Results Among 783 dyspnea patients, causes of dyspnea of 721 patients were determined (92.08%) and 62 patients were with non-organic dyspnea (7.92%). The frequency and onset time of patients with non-organic dyspnea were different, but their clinical manifestations were typical. Common describing words were air blocked in the chest and out of breath, chest discomfort and compressed, breath with effort, etc. Before onset of dyspnea, 43 patients (69.53%) felt pressures of work, life, and study were high; 54 patients (87.10%) were anxious and/or depressed; 48 patients (77.42%) were with insomnia; and all patients were with at least one of above three manifestations. The manifestations were alleviated rapidly after being properly treated by the anti-anxiety, sedation, repose, and suggestion therapy. Conclusion Clinical physicians should improve the understanding and diagnosis of non-organic dyspnea, conduct early diagnosis and proper treatment, decrease misdiagnosis and wrong diagnosis, and avoid over treatment.

Key words: dyspnea, anxiety, insomnia