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目的总结心理性咳嗽患儿的临床诊治,提高对本病的认识。方法对2013年12月至2015年10月在北京儿童医院确诊为心理性咳嗽的33例患儿的诊疗情况进行回顾性分析。结果中位年龄为8岁个6月,病程7周至7个月,12例表现为犬吠样咳嗽,14例为清嗓子样咳嗽,7例表现为类似下呼吸道感染干咳,有人在场时发生或明显加重,转移注意力可减轻,睡眠时消失。6例伴有眨眼或吸鼻子或耸肩动作。5例有哮喘或鼻炎病史,肺部和其他部位查体未见异常,全部均有心理因素诱因。12例心理测试存在焦虑和抑郁,心理治疗有效,4例患儿应用硫必利治疗有效。结论心理性咳嗽的咳嗽特性是诊断的线索,具有心理诱因,辅助检查正常,对其他治疗无持续反应,心理治疗有效。
Objective To summarize the clinical diagnosis and treatment of children with psychological cough and to raise awareness of the disease. Methods The clinical data of 33 cases diagnosed as psychological cough at Beijing Children’s Hospital from December 2013 to October 2015 were analyzed retrospectively. Results The median age was 8 years old and 6 months. The course of disease ranged from 7 weeks to 7 months. Twelve cases showed bark-like cough, 14 cases had clear throat-like cough, 7 cases showed dry cough similar to lower respiratory tract infection, some occurred in the presence or obvious Increased, shift attention can be reduced, disappear while sleeping. Six cases accompanied by blinking or sniffing or shrugging. 5 cases had a history of asthma or rhinitis, the lungs and other parts of the physical examination showed no abnormalities, all with psychological factors. There were anxiety and depression in 12 cases of psychological test, psychotherapy was effective, and 4 cases were treated with tiapride. Conclusions The cough characteristics of psychological cough are the clues of diagnosis, with psychological incentive, normal auxiliary examination, no continuous response to other treatments and effective psychotherapy.