新型冠状病毒肺炎流行期间耳鼻咽喉科门急诊焦虑症患者的诊治

Diagnosis and treatment of anxiety during coronavirus disease 2019 epidemic period in Otorhinolaryngology emergency

目的探讨新型冠状病毒肺炎(COVID-19)流行期间耳鼻咽喉科门急诊中焦虑症患者的诊治和注意事项。方法我科在2020年1月25日~2月29日期间门急诊患者中有疑似精神相关症状的患者12例,其主诉分别为3例鼻塞、6例咽异物感、1例听力下降、1例呼吸困难、1例颈淋巴结肿大、1例会厌囊肿,均伴有难以入睡、情绪低落、心情烦躁等。积极询问病史排除器质性疾病后,分析其焦虑状况,其中8例通过既往病史已诊断焦虑症;4例患者经过沟通配合,用焦虑自评量表(SAS)进行测评。结果4例患者SAS测评值是分别为56、58、62、64分。所有患者采用心理疏导联合药物治疗后症状均缓解。结论COVID-19疫情期间,在排除疫区及相关人员接触史,排除相关症状后,临床医师需详细询问病史并建议患者进行心理量表检测;如确诊焦虑症,医师需与患者反复沟通,进行心理疏导和治疗,并由相关科室诊疗。

Objective To explore the diagnosis and treatment of anxiety during coronavirus disease 2019(COVID-19)epidemic period in otorhinolaryngology emergency.Methods From January 25 to February 29 in 2020,12 patients in our department appear suspected mental related symptoms.The main complaints were:nasal obstruction in 3 cases,foreign body sensation in pharynx in 6 cases,hearing loss in 1 case,dyspnea in 1 case,cervical lymphadenopathy in 1 case and epiglottic cyst in 1 case,all of which were accompanied with difficulty in sleeping,depression,and restlessness.After inquiring the medical history and eliminating the organic diseases,the anxiety status was analyzed,among which 8 cases had been diagnosed as anxiety in previous medical history;4 cases were evaluated by self-rating anxiety scale(SAS)after communication and cooperation.Result The SAS values of 4 patients were 56,58,62 and 64 respectively.The symptoms of all patients were relieved after the treatment of psychological counseling combined with drugs.Conclusions During COVID-19 epidemic period,the COVID-19 related symptoms and the contact history of the affected areas and related personnel should be excluded firstly.Under special circumstances,doctors need to inquire about the medical history of anxiety in detail and suggest patients to test the psychological scale.For patients with anxiety,doctors need to communicate with them repeatedly,and to conduct psychological counseling and treatment,and to transfer them to the relevant departments for further diagnosis and treatment if necessary.