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目的 总结分析 1996～ 2 0 0 2年间在北京协和医院诊断的 34例少年儿童非器质性呼吸困难病例。方法 非器质性呼吸困难的临床诊断标准 :有突出的呼吸困难 ,经过询问病史、体格检查和相关的实验室检查 ,没有心肺或其他器质性病因。结果 少年儿童非器质性呼吸困难最小发病年龄 8岁 ,13～ 16岁为高峰发病年龄 ,17岁以后发病人数明显减少。大多数为慢性病程 ,伴症状急性发作。表现为呼吸困难 ,伴随明显的过度通气、低碳酸血症的症状。少年儿童患者焦虑不明显 ,与成人形成鲜明对比。多数患儿有明显的心因性诱因 ,中学阶段学习压力大为最重要的诱因。 13例患儿接受腹式呼吸训练治疗 2～ 3个月后复查 ,呼吸困难和伴随症状得到明显改善。结论 少年儿童非器质性呼吸困难呈慢性过程 ,需要引起足够的重视 ,提高医师警觉性是正确诊断处理的关键。
Objective To summarize and analyze the 34 cases of non-organic dyspnea diagnosed in Peking Union Medical College Hospital from 1996 to 2002. Methods Clinical diagnostic criteria for non-organic dyspnea: Outstanding dyspnea, no history of cardiopulmonary or other organic causes after medical history, physical examination, and related laboratory tests. Results The minimum age of onset of non-organic dyspnea in children and adolescents was 8 years old, 13 to 16 years old was the peak age of onset, and the incidence was significantly reduced after 17 years old. Most of the chronic disease, with symptoms of acute attack. Manifested as dyspnea, accompanied by significant hyperventilation, hypocapnia symptoms. Children’s anxiety is not obvious, in sharp contrast with adults. Most children have obvious causes of psychogenic, secondary school learning pressure is the most important incentive. Thirteen children underwent abdominal respiration training for 2 to 3 months after the review, dyspnea and concomitant symptoms were significantly improved. Conclusion Non-organic dyspnea in children is a chronic process, which needs to be given enough attention. Improving the alertness of doctors is the key to correct diagnosis and treatment.