胃食管反流病致咳嗽-晕厥综合征误诊为哮喘  

Cough Syncope Syndrome Caused by GERD Misdiagnosed as Asthma

作　　者：田书瑞[1] 汪忠镐[1,2] 吴继敏[1] 刘建军[1] 

机构地区：[1]解放军第二炮兵总医院胃食管反流病中心,北京100088 [2]首都医科大学宣武医院血管外科研究所,北京100053

出　　处：《临床误诊误治》2012年第5期29-30,共2页Clinical Misdiagnosis & Mistherapy

基　　金：国家863高技术研究发展计划资助项目(2007AA0Z4Z6)

摘　　要：目的提高对胃食管反流病致咳嗽-晕厥综合征的认识,以减少误诊。方法回顾分析1例胃食管反流病致咳嗽-晕厥综合征误诊病例的临床资料。结果患者因咳嗽、喘憋6年,伴发作性晕厥2年入院。多次在外院就诊,先后诊断为慢性咽炎、咳嗽变异型哮喘,给予相应治疗无效。后经胃镜、24 h食管pH及肺功能等相关检查,诊断为胃食管反流病致咳嗽-晕厥综合征,予食管微量射频消融治疗,患者咳嗽明显减轻出院。随访1年,未再出现晕厥,夜间睡眠好。结论胃食管反流病引起的咳嗽-晕厥综合征,以往未见相关报道。提高对胃食管反流病消化道外并发症的认识,可防止该病误诊。Objective To improve awareness of cough syncope syndrome caused by gastroesophageal reflux disease （GERD） and reduce misdiagnnsis rate. Methods The clinical data of 1 case of cough syncope syndrome caused by misdiagnosis of GERD was retrospectively analyzed. Results The patient was admitted for cough, asthma for 6 years with episodes of syncope for 2 years. The pa- tient was diagnosed as having chronic pharyngitis and coughing variant asthma successively in other hospitals, and was given correspond- ing treatment, which was invalid. Then the patient underwent the gastroscopy, 24 h pH DeMeester （pH DeM）, PF （puhnonary func- tion） and other related examinations, and was then diagnosed as having cough syncope syndrome caused by GERD. Through esophagus low level radiofrequeney treatment, coughing was relieved significantly. The patient was followed up for one year, and no occurrence of syncope was recorded slept well at night. Conclusion Coughing syncope syndrome caused by GERD has never been reported before. hnproved awareness of GERD with the complications out of the digestive tract can help to aviod misdiagnosis.

关 键 词：胃食管反流 咳嗽 晕厥 误诊 咽炎 哮喘 

分 类 号：R571[医药卫生—消化系统]