急诊室对非器质性呼吸困难的临床分析

【】　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　Tosummarizethemedicalexperiencesoftreatingnonorganicdyspneaintheemergencydepartmentandraisephysicians’awarenessofpsychological-physiologicaldiseases.　Methods　Theclinicaldataof32patientswithnonorganicdyspneabetween2005and2009intheemergencydepartmentofourhospitalwereanalyzedretrospectively.　Results　Allthe32patientshadpsychogenicincentivesbeforeonsetofthedisease,suchasmentalinjury,over-exhaustion,nervousnessoremergency.Allofthemhadtypicalclinicalmanifestations.Theresultsofhyperventilationprovocationtestwerepositive.Arterialbloodgasanalysisimpliedrespiratoryalkalosis.Eighteenofthem(56.2%)hadamark≤23ontheNijmegenquestionnaire.Auxiliaryexaminationsshowednootherprimarydiseases.　Conclusions　Withtheincreaseofemotionalstressinthemodernsociety,thenumberofpatientswithnonorganicdyspneahavemarkedlyincreased.Cliniciansshouldstrengthentheawarenessofsocialpsychology-physiologicaldiseases,andimprovediagnosticaccuracy,whichwillhaveanobviousclinicalvalueinrelievingpatients’mentalstressandavoidingexcessivemedicaltreatment.