【摘要】 目的 總結(jié)非器質(zhì)性呼吸困難患者的急診診治經(jīng)驗，提高急診醫(yī)生對心理-生理性疾病的認(rèn)識?！》椒ā?005年-2009年急診科32例非器質(zhì)性呼吸困難患者的診治經(jīng)過進(jìn)行回顧性分析?！〗Y(jié)果 32例患者發(fā)病前均有精神創(chuàng)傷或過度勞累、精神緊張、或應(yīng)急等心因性誘因；有典型的臨床癥狀；過度通氣激發(fā)試驗陽性；血氣分析提示呼吸性堿中毒；Nijmegen問卷積分≤23分者18例（56.2%）；輔助檢查未見其他原發(fā)性疾病?！〗Y(jié)論 隨著現(xiàn)代社會身心壓力的增大，非器質(zhì)性呼吸困難患者明顯增加，臨床醫(yī)生應(yīng)加強(qiáng)對社會心理-生理性疾病的認(rèn)識，提高診斷率，對減輕患者的精神壓力及避免過度醫(yī)療具有重要的臨床意義。【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.
【摘要】 目的 研究自貢市急救中心院前急救流行病學(xué)特征?！》椒ā』仡櫺苑治?009年度自貢市急救中心出診的院前急救數(shù)據(jù)，研究院前急救疾病譜及性別、年齡構(gòu)成，并分析時刻及季節(jié)分布特點，描述院前急救轉(zhuǎn)歸?！〗Y(jié)果 2009年度自貢市急救中心院前急救共4 588例，排前6位疾病依次為損傷、中毒和外因的某些其他后果（45.6%），循環(huán)系統(tǒng)疾?。?5.0%），呼吸系統(tǒng)疾?。?.3%），神經(jīng)系統(tǒng)疾?。?.0%），精神和行為障礙（5.6%），消化系統(tǒng)疾?。?.9%）；性別構(gòu)成男性多于女性（Plt;0.05）；年齡構(gòu)成以中老年較多，青少年兒童較少（Plt;0.05）；時刻分布規(guī)律高峰點為15點40分（Plt;0.05），季節(jié)分布以冬季較多（Plt;0.05）；患者轉(zhuǎn)歸以住院、留院觀察為主，院前死亡人數(shù)占比例為3.8%?！〗Y(jié)論 根據(jù)院前急救流行病學(xué)規(guī)律，可以合理配置急診資源，增強(qiáng)應(yīng)急救援能力，滿足民眾不斷增加的醫(yī)療需求?！続bstract】 Objective To research on the epidemiological characteristics of the prehospital cases in Zigong emergency rescue center. Methods We retrospectively analyzed the database of prehospital cases in Zigong emergency rescue center in 2009, and reviewed the prehospital disease spectrum, gender composition, age structure, the circadian and seasonal distribution, and the outcomes of these cases. Results A total of 4 588 prehospital victims in Zigong emergency rescue center were enrolled. In the study, six leading diseases were injury, poisoning and certain other consequences due to external causes (45.6%), diseases of the circulatory system (15.0%), diseases of the respiratory system (6.3%), diseases of the nervous system (6.0%), mental and behavioral disorders (5.6%), and diseases of the digestive system (4.9%). Male patients were more than female patients (Plt;0.05). The proportion of the aged and the middle-aged was significantly larger than that of young population in the same districts (Plt;0.05), and the occurrence of prehospital care usually peaked at 15:40 (Plt;0.05). Prehospital care had a higher incidence in winter (Plt;0.05), and the outcome of prehospital cases was mainly in hospital and in observation ward. The proportion of deaths was 3.8%. Conclusion We can allocate emergency resources reasonably in prehospital care, and promote the ability of rescuing in order to meet people′s medical demands on the basis of the epidemiological study in our city.