Department of Respiratory and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China.
Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China.
Can Respir J. 2020 Jul 4;2020:2451703. doi: 10.1155/2020/2451703. eCollection 2020.
In recent years, we have observed respiratory difficulty manifested as paroxysmal laryngospasm in a few outpatients, most of whom were first encountered in a respiratory clinic. We therefore explored how to identify and address paroxysmal laryngospasm from the perspective of respiratory physicians.
The symptoms, characteristics, auxiliary examination results, treatment, and prognosis of 12 patients with paroxysmal laryngospasm treated in our hospital from June 2017 to October 2019 were analyzed.
Five males (42%) and 7 females (58%) were among the 12 Han patients sampled. The average age of the patients was 49.25 ± 13.02 years. The disease course ranged from 14 days to 8 years and was characterized by sudden dyspnea, an inability to inhale and exhale, a sense of asphyxia, and voice loss during an attack. Eight patients with gastroesophageal reflux were cured after antacid treatment. One case of upper respiratory tract infection (URI) was completely relieved after symptomatic treatment. One patient with left vocal cord paralysis experienced complete relief after specialist treatment by an otorhinolaryngologist. Episodes in 1 patient were significantly reduced after lifestyle improvement. One patient experienced spontaneous relief after rejecting treatment.
Paroxysmal laryngospasm is a rare laryngeal disease that generally occurs secondary to gastroesophageal reflux disease (GERD), and antireflux therapy is frequently effective for its treatment. A respiratory physician should master and identify the symptoms and differentiate this condition from hysterical stridor, reflux-related laryngospasm, and asthma. Timely referral to otolaryngologists, gastroenterologists, and other specialists for standardized examination and regular treatment should be provided when necessary.
近年来,我们观察到少数门诊患者出现以阵发性喉痉挛为表现的呼吸苦难,这些患者大多数最初在呼吸科就诊。因此,我们从呼吸科医生的角度探讨如何识别和处理阵发性喉痉挛。
分析我院 2017 年 6 月至 2019 年 10 月收治的 12 例阵发性喉痉挛患者的症状、特征、辅助检查结果、治疗及预后。
12 例患者均为汉族,其中男 5 例(42%),女 7 例(58%),平均年龄(49.25±13.02)岁。病程 14 天至 8 年,表现为突发呼吸困难、吸气及呼气困难、窒息感、发作时声音嘶哑。8 例胃食管反流患者经抑酸治疗后痊愈。1 例上呼吸道感染(URI)患者经对症治疗后痊愈。1 例左侧声带麻痹患者经耳鼻喉科专家治疗后完全缓解。1 例患者通过改善生活方式后发作明显减少。1 例患者拒绝治疗后自行缓解。
阵发性喉痉挛是一种罕见的喉部疾病,通常继发于胃食管反流病(GERD),抗反流治疗通常有效。呼吸科医生应掌握并识别其症状,并将其与癔症性喉痉挛、反流相关性喉痉挛和哮喘相鉴别。必要时应及时转介耳鼻喉科、消化内科等专科医生进行规范化检查和定期治疗。