討論:過度換氣症候群

合併前

機械翻譯?

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| 1=zh:HVS; zh-hant:過度換氣綜合症; zh-hans:过度换气综合症
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过度换气综合症（HVS；也叫做慢性过度换气综合症或者CHVS）是一种生理性或心理性的呼吸系统疾病，症状是呼吸过快和过深。HVS可能表现为胸痛、指尖及口唇附近刺痛（无缘由的感觉异常），亦可能会导致惊恐。

HVS患者会觉得空气不足。事实上，他们的动脉血中有跟其它人基本相同的氧化量（血红蛋白饱和的正常值是98%），但是其血液及其它组织中的二氧化碳含量很低。由于血液中的氧过多，HVS减低了对重要器官的送氧效率，会导致血管收缩以及波尔抑制效果。

由于呼吸过快导致了二氧化碳低于健康数值以及呼吸碱中毒（血液Ph值过高），过度换气便会发生。这会让症状更明显，会令患者呼吸更快并将情况恶化。

呼吸碱中毒会改变神经系统，这种情况一般会伴随感觉异常、晕眩和知觉改变。其它症状也有可能出现，一些患者对于这样的情况会比其它患者更敏感。

== 危险因素 ==
很多患有恐惧症以及陌生环境恐惧症的患者可能会出现过度换气综合症。然而，大多数患有过度呼吸综合中的患者没有这些疾病。

== 诊断 ==
过度换气综合症是晕眩症十分常见的诱因。25%的晕眩症患者被诊断患有HVS。最佳诊断发放是让患者快速呼吸两分钟。这样会诱发症状，以确定患者的症状是由于呼吸过度导致的。这项检查只能在患者没有症状的时候进行。

== 流行慢性病 ==

每分钟呼吸量是每分钟由一个人的肺一分钟吸入或呼出的空气量。呼吸医学资料（见下表）显示病人的呼吸的空气量是未患病人士的2-3倍。

== 情况 ==
每分钟呼吸量（±偏差） 病人数量 参考 
呼吸正常 6 l/分钟 无 医学教科书： [8] [9] [10] [11] 
哮喘 12 l/分钟 101 [12] 
哮喘 15 l/分钟 8 [13] 
哮喘 14.1 (±5.7) l/分钟 39 [14] 
心脏病 14 (±4) l/分钟 88 [15] 
心脏病 12.2 (±3.3) l/分钟 132 [16] 
心脏病 16 (±2) l/分钟 11  [17] 
心脏病 15 (±4) l/分钟 22 [18] 
糖尿病 10-20 l/分钟 28 [19] 
糖尿病 12-17 l/分钟 26. [20] 
囊肿性纤维化 11-14 l/分钟 6 [21] 
囊肿性纤维化 13 (±1.8) l/分钟 10 [22] 
慢性阻塞性肺病 12.2 (±1.9) l/分钟 10 [23] 
肝硬化 11-18 l/分钟 24 [24] 
过度换气 14.9 (±0.6) l/分钟 42 [25] 
癫痫 12.8 l/分钟 12 [26] 

{{transH}}
There are many more medical studies that found 100% prevalence of chronic hyperventilation in patients with various chronic diseases.

处理
A rapid traditional intervention is to have the patient breathe into a paper bag, causing rebreathing and restoration of [27] levels. Some physicians do not advise the paper bag rebreathing method (or limiting its use to one or two minutes) due to the possibility of inhaling too much carbon dioxide and decreasing inspired oxygen to a hypoxic patient.

The same benefits can be obtained more safely from deliberately slowing down the breathing rate by counting or looking at the second hand on a watch. This is often referred to as "7-11 breathing", because a gentle inhalation is stretched out to take 7 seconds (or counts), and the exhalation is slowed to take 11 seconds. 

Most patients benefit from carefully, deliberately slowing down their breathing twice a day for five minutes at a time.[29] The goal is to reduce breathing to no more than five breaths per minute. The goal is to reduce breathing to no more than five breaths per minute. 
This helps retrain their habits and convince them that faster breathing is unnecessary.

Acupuncture has recently been proposed as a treatment.[31]

Buteyko Method is a medical breathing retraining therapy developed by Soviet Doctor Konstantin Buteyko. The goal of the therapy is to reduce minute ventilation or to breathe less, normalize the breathing pattern and restore normal breathing parameters.


Causes
Most cases are caused by anxiety or stress. However, medical conditions such as infection, blood loss, heart attack,[33] hypocapnia or alkalosis due to chemical imbalances, decreased cerebral blood flow, and increased nerve sensitivity may also underlie this symptom.[35]

In one study, one third of patients with HVS had "subtle but definite lung disease" that prompted them to breathe too frequently or too deeply.[37]

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== 参见 ==
Hyperventilation
Da Costa's syndrome
Buteyko Method (Buteyko breathing retraining method)


== 参考文献 ==
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[38]


Anxiety disorders


Respiration

[39]
[40]

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[10] ^ McArdle W.D., Katch F.I., Katch V.L., Essentials of exercise physiology (2-nd edition); Lippincott, Williams and Wilkins, London 2000.
[11] ^ Straub NC, Section V, The Respiratory System, in Physiology, eds. RM Berne & MN Levy, 4-th edition, Mosby, St. Louis, 1998.
[12] ^ McFadden ER & Lyons HA, Arterial-blood gases in asthma, The New Engl J of Med 1968 May 9, 278 (19): 1027-1032.
[13] ^ Johnson BD, Scanlon PD, Beck KC, Regulation of ventilatory capacity during exercise in asthmatics, J Appl Physiol. 1995 Sep; 79(3): 892-901.
[14] ^ Bowler SD, Green A, Mitchell CA, Buteyko breathing techniques in asthma: a blinded randomised controlled trial, Med J of Australia 1998; 169: 575-578.
[15] ^ Clark AL, Chua TP, Coats AJ, Anatomical dead space, ventilatory pattern, and exercise capacity in chronic heart failure, Br Heart J 1995 Oct; 74(4): 377-380. 
[16] ^ Fanfulla F, Mortara , Maestri R, Pinna GD, Bruschi C, Cobelli F, Rampulla C, The development of hyperventilation in patients with chronic heart failure and Cheyne-Stokes respiration, Chest 1998; 114; p. 1083-1090.
[17] ^ Johnson BD, Beck KC, Olson LJ, O'Malley KA, Allison TG, Squires RW, Gau GT, Ventilatory constraints during exercise in patients with chronic heart failure, Chest 2000 Feb; 117(2): 321-332.
[18] ^ Dimopoulou I, Tsintzas OK, Alivizatos PA, Tzelepis GE, Pattern of breathing during progressive exercise in chronic heart failure, Int J Cardiol. 2001 Dec; 81(2-3): 117-121.
[19] ^ Tantucci C, Scionti L, Bottini P, Dottorini ML, Puxeddu E, Casucci G, Sorbini CA, Influence of autonomic neuropathy of different severities on the hypercapnic drive to breathing in diabetic patients, Chest. 1997 Jul; 112(1): 145-153.
[20] ^ Bottini P, Dottorini ML, M. Cordoni MC, Casucci G, Tantucci C, Sleep-disordered breathing in nonobese diabetic subjects with autonomic neuropathy, Eur Respir J 2003; 22: p. 654–660.
[21] ^ Tepper RS, Skatrud B, Dempsey JA, Ventilation and oxygenation changes during sleep in cystic fibrosis, Chest 1983; 84; p. 388-393. 
[22] ^ Bell SC, Saunders MJ, Elborn JS, Shale DJ, Resting energy expenditure and oxygen cost of breathing in patients with cystic fibrosis, Thorax 1996 Feb; 51(2): 126-131.
[23] ^ Sinderby C, Spahija J, Beck J, Kaminski D, Yan S, Comtois N, Sliwinski P, Diaphragm activation during exercise in chronic obstructive pulmonary disease, Am J Respir Crit Care Med 2001 Jun; 163(7): 1637-1641.
[24] ^ Epstein SK, Zilberberg MD; Facoby C, Ciubotaru RL, Kaplan LM, Response to symptom-limited exercise in patients with the hepatopulmonary syndrome, Chest 1998; 114; p. 736-741.
[25] ^ Kahaly GJ, Nieswandt J, Wagner S, Schlegel J, Mohr-Kahaly S, Hommel G, Ineffective cardiorespiratory function in hyperthyroidism, J Clin Endocrinol Metab 1998 Nov; 83(11): 4075-4078.
[26] ^ Esquivel E, Chaussain M, Plouin P, Ponsot G, Arthuis M, Physical exercise and voluntary hyperventilation in childhood absence epilepsy, Electroencephalogr Clin Neurophysiol 1991 Aug; 79(2): 127-132.
[29] ^ [28]
[31] ^ [30]
[33] ^ [32]
[35] ^ [34]
[37] ^ [36]

-P1ayer (留言) 2010年4月24日 (六) 14:28 (UTC)