過度換氣症候群

過度換氣症候群（hyperventilation syndrome，HVS）又称通气过度综合征、高通气综合征，是由于通气过度，超过生理代谢所需而引起的综合征，具有与焦虑相关（情绪紧张、癔病发作等）的呼吸困难及呼吸急促，并伴有全身很多躯体和精神神经表现的临床症状。 過度換氣症候群有许多历史异名：“慢性過度換氣症候群”chronic hyperventilation syndrome、CHVS）、“失能性過度換氣症候群”（dysfunctional breathing hyperventilation syndrome）、“隐秘搐搦”（cryptotetany）、“痉挛素质”（spasmophilia）、“潜伏搐搦”（latent tetany）、“中枢神经元过度兴奋综合征”（central neuronal hyper excitability syndrome）等等。 過度換氣症候群表现为精神紧张、焦虑、恐惧、害怕死亡，呼吸困难、胸闷窒息感、胸部不适或胸痛、呼吸深或快，心慌或心悸、心动过速，头昏、视物模糊，四肢末梢、面部及口周麻木、发紧与针刺感；严重者手指、上肢强直，手足搐搦，意识模糊，晕厥等。但查无相应的器质病因。 過度換氣症候群的病理机制是二氧化碳排出过量导致呼吸性碱中毒，由過快或過深的呼吸所造成，導致身體排出過多的二氧化碳，引發呼吸性碱中毒，亦即血液pH值過高，影響了神经系统的正常放电生理过程，部分患者會感到在手、足、唇等部位感到麻痺或微微叮咬感、口齒不清、暈眩、胸痛、心跳加速。患者越緊張，呼吸越快，令症狀出現惡性循環，嚴重者更會昏厥。 該症狀可由生理或心理造成，患者誤以為自己缺氧，加快呼吸，但其動脈血中的氧化量仍然正常，只是二氧化碳含量過低，引致血管收縮，同时因為玻尔效应的影響，讓人體對重要器官的輸氧量減少。 过度换气综合症是暈眩症十分常見的誘因。 25%的暈眩症患者被診斷患有HVS。最佳診斷方法是讓患者快速呼吸兩分鐘。這樣會誘發症狀，以確定患者的症狀是由於呼吸過度導致的。這項檢查只能在患者沒有症狀的時候進行。 每分鐘呼吸量是每分鐘由一個人的肺一分鐘吸入或呼出的空氣量。呼吸醫學資料（見下表）顯示病人的呼吸的空氣量是未患病人士的2-3倍。[來源請求] 由于呼吸快速的原因很多，必须先排除器质病因后，才给予过度通气症状治疗。 罩袋治疗：利用口罩、面罩、纸袋、塑料袋等，使口鼻不透气重复呼吸，此时吸入气体中二氧化碳浓度提高而减轻症状；但是有些学者不建议使用。 调整呼吸节律与深度：腹式呼吸训练等。 药物治疗：抗焦虑药、β受体拮抗剂、选择性5-羟色胺再摄取抑制剂，严重者需要镇静催眠、补充钾盐、推注葡萄糖酸钙。 当症状缓解后，随诊可加强： 认知行为疗法 心理疗法 中医中药治疗 通气过度综合征. 术语在线. 全国科学技术名词审定委员会.  （简体中文） 高通气综合征. 术语在线. 全国科学技术名词审定委员会.  （简体中文） eMedicine - Hyperventilation Syndrome: Article by Edward Newton, MD. 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Breathing exercises for dysfunctional breathing/hyperventilation syndrome in adults (review) (PDF). The Cochrane Database of Systematic Reviews. May 31, 2013, 5 (5): CD009041. PMID 23728685. doi:10.1002/14651858.cd009041.pub2.  Hyperventilation Syndrome Medication. Medscape. [31 December 2013].  呼吸病学（第3版）, 第3版, 978-7-117-31906-5 中国心理卫生协会临床心理卫生手册. 内科分册, 第1版, 978-7-117-13017-2 "Hyperventilation syndrome" - 搜索 Google 圖書 "過度換氣症候群" - 搜索 Google 圖書 The impact of dysfunctional breathing on the assessment of asthma control - Respiratory Medicine