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[应激诱导的功能性喉痉挛:支气管哮喘的鉴别诊断考量]

[Stress-inducible functional laryngospasm: differential diagnostic considerations for bronchial asthma].

作者信息

Schmidt M, Brugger E, Richter W

出版信息

Laryngol Rhinol Otol (Stuttg). 1985 Sep;64(9):461-5.

PMID:2934594
Abstract

Since 1974 about 30 cases of functional upper airway obstruction are known in literature. We report the findings in a 19 year old woman, who was free from any symptoms during rest. During exercise (swimming, jogging) she showed a loud inspiratory stridor, cyanosis, and dyspnoea. We found this stridor was induced by exercise or hyperventilation only (thread mill, CO2 rebreathing), and was caused by paradoxical vocal cord movement (fibreoptic laryngoscopy in local anaesthesia during CO2 rebreathing). All lung function parameters improved after inhalation of ipratropium bromide. We believe that it is important to investigate these patients during stridor attacks and without general anaesthesia. Otherwise it will be impossible, to get a correct diagnosis.

摘要

自1974年以来,文献中已报道了约30例功能性上气道梗阻病例。我们报告了一名19岁女性的检查结果,该女性在休息时没有任何症状。在运动(游泳、慢跑)期间,她出现了响亮的吸气性喘鸣、发绀和呼吸困难。我们发现这种喘鸣仅由运动或过度通气(跑步机、二氧化碳重复呼吸)诱发,并且是由矛盾性声带运动引起的(在二氧化碳重复呼吸期间进行局部麻醉下的纤维喉镜检查)。吸入异丙托溴铵后,所有肺功能参数均有所改善。我们认为,在喘鸣发作期间且不进行全身麻醉的情况下对这些患者进行检查很重要。否则,将无法做出正确诊断。

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