临床误诊误治2012，Vol.25Issue(4)：14-16,3.DOI:10.3969/j.issn.1002-3429.2012.04.009
心因性过度换气综合征致低钾血症24例误诊分析
Misdiagnosis Analysis of 24 Cases of Hypokalemia Induced by Hyperventilation Syndrome from Psychological Factors
肖展翅 1夏光明 1邱斌 1王洲弈1
作者信息
- 1. 438000湖北黄冈,黄冈市中心人民医院神经内科
- 折叠
摘要
Abstract
Objective To study the clinical characteristics of hyperventilation syndrome from psychological factors, and analyze tnisdiagnosis of the disease. Methods The clinical syndromes of the 24 cases of hypokalemia misdiagnosed as hyperventilation syndrome from psychological factors in our hospital were analyzed retrospectively. Results The clinical manifestations of the 24 cases including 19 patients (accounting for 79. 16% ) with mental predisposing factors, were generally fear, anxiety, shortness of breath, and chest tightness, accompanied by limb numbness, convulsions, palpitations and asphyxia. In the primary survey, all were misdiagnosed as hypokalemia including 11 cases outside our hospital and 13 cases in our emergency department. The concentrations of serum potassium after admission were from 2.9 to 3.5 mmol/L, an average of 3.25 mmol/L. Blood gas a-nalysis showed that the value of carbon dioxide point pressures were from 27.82 to 36.09 mmHg and the values of pH were from 7.42 to7.52. The ECG of 21 cases (accounting for 87.5% ) manifested prolongation of QT interval, ST-segment declining, T-wave low-lying and level invertion and abnormal U-wave. The bronchial texture enhancement existed in 4 cases after X-ray examination. All cases from 0.5 to 2.0 hours after admission were diagnosed as hyperventilation syndrome from psychological factors, and were given implied treatment including oxygen, ECG monitoring, intravenous diazepam and supplemented potassium chloride after which the above symptoms were all relieved shortly. Conclusion The lack of knowledge may be the cause of misdiagnosis. To avoid misdiagnosis and excessive treatment, awareness of clinical characteristics of the disease should be raised and train of thoughts in diagnosis be broadened.关键词
过度换气综合征/癔症/误诊/低钾血症Key words
Hyperventilation syndrome/ Hysteria/ Diagnosis/ Hypokalemia分类
医药卫生引用本文复制引用
肖展翅,夏光明,邱斌,王洲弈..心因性过度换气综合征致低钾血症24例误诊分析[J].临床误诊误治,2012,25(4):14-16,3.
