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引用次数: 0
摘要
不明原因的呼吸困难是指经过临床检查、胸部 X 光检查、生物学检查和心电图检查后仍未确诊的慢性(≥ 3 个月)和明显(mMRC ≥ 2)呼吸困难。这种情况影响 15% 的呼吸困难患者,并与诊断延误时间长和患者转诊困难有关。本文介绍了不明原因呼吸困难的定义和流行病学,以及病史和临床检查的有用要素。文章还介绍了具体的鉴别诊断,并为初级保健医生提出了诊断算法。最后,它讨论了该领域的可能发展,以改善对这些患者的管理。
Unexplained dyspnoea is defined as a chronic (≥ 3 months) and significant (mMRC ≥ 2) dyspnoea without a diagnosis after clinical examination, chest X-ray, biological work-up and electrocardiogram. This condition affects 15 % of patients with dyspnoea and is associated with prolonged diagnostic delay and difficulties in patient referral. This article presents the definition and epidemiology of unexplained dyspnoea, as well as the useful elements of the history and clinical examination. It covers the specific differential diagnosis and proposes a diagnostic algorithm for the primary care physician. Finally, it discusses possible developments in this field to improve the management of these patients.
期刊介绍:
Destinée aux professionnels de santé, la plateforme revmed.ch regroupe la version électronique de la Revue Médicale Suisse et les applications de formation et d"aide à la prise de décision eRMS. La eRMS est le fruit d’une large collaboration entre institutions et praticiens de Suisse romande.