功能性上气道阻塞的诊断和治疗

Diagnosis and treatment of functional upper airway obstruction

目的探讨功能性上气道阻塞（ＦＵＡＯ）的临床特点、伴随症状和误诊原因，以提高对其认识和诊断水平。方法结合文献回顾性分析６例患者的临床症状。结果ＦＵＡＯ患者常出现吸气喘鸣的呼吸困难，发作时用力吸气流速容量环扁平，喉镜检查可见吸气相和（或）呼气相声带内收。缓解期则纤支镜和喉镜检查（阴性），一半的病人合并哮喘。结论对发作性呼吸困难者应行肺功能、气道反应性、喉镜检查，尽快明确哮喘抑或上气道器质性阻塞，避免不必要的治疗。

Objective To investigate the clinical characteristic, accompaning symptom and misdiagnostic reasons of functional upper airway obstruction (FUAO) in order to improve physician's recognizing and diagnosing level on it. Methods The data of six patients with FVAO was analyzed and summarized in clinical view of point with reviewing articles. Results Patients with FUAO al- ways appeared dyspnea of inspiratory strdor. While the episode was hapening, both the inspiratory and expiratory parts of the forced flow-volume loop was flat, Laryngoscopy showed inspiratory and/or expiratory abduction of vocal cores. Bronchoscopy and langnoscopy examination showed nothing abnormal during remission. Half of the patients were complicated with asthma. Conclusion patients with paroxysmal dyspnea should further recieve lung function test, airway reactivity and laryngoscopy to confirm asthma and/or organic upper airway obstruction as quickly as possible, which might avoid unnecessary treatment.