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成人急性操作性焦虑的治疗

Author
Yujuan Choy, MD
Section Editor
Murray B Stein, MD, MPH
Deputy Editor
Richard Hermann, MD
Translators
蒋文晖, 副主任医师

引言

急性操作性焦虑是指对内科、牙科或外科操作的过度恐惧而导致急性应激或回避。患者可能在预知或接受用于筛查(如乳腺X线摄影)、诊断(如羊膜穿刺术或内镜检查)和治疗(如血管成形术或大手术)的操作过程中体验到焦虑。因为急性操作性焦虑而回避临床操作会对健康产生负面后果[1-7]。

特定恐惧症是急性操作性焦虑各种表现形式中的一部分，在DSM-5的诊断标准中，只有当患者的恐惧是对该操作及其即时效应[例如，在磁共振成像(magnetic resonance imaging, MRI)检查中恐惧窒息]的特异性恐惧而不是该操作本身非特异性恐惧(例如，恐惧可能被诊断的潜在疾病)时才予以这个诊断。与临床操作相关的特定恐惧症包括血液-注射-损伤恐惧症、牙科恐惧症和MRI幽闭恐惧症。

本专题着重于并不构成特定恐惧症的急性操作性焦虑的治疗。对临床操作的特定恐惧症(包括血液-注射-损伤恐惧症、牙科恐惧症和MRI幽闭恐惧症)的治疗会单独讨论。急性操作性焦虑的流行病学、临床表现、病程、筛查、评估和鉴别诊断也将单独讨论。其他特定恐惧症的流行病学、临床表现、病程、诊断和治疗也将单独讨论。 (参见“Treatment of specific phobias of clinical procedures in adults”和“成人急性诊疗性焦虑的流行病学和临床表现”和“成人急性诊疗性焦虑的病程、筛查、评估和鉴别诊断”和“Specific phobia in adults: Epidemiology, clinical manifestations, course and diagnosis”和“成年人特定恐惧症的心理治疗”和“成人特定恐惧症的药物治疗”)

一般治疗原则

几条一般原则对急性操作性焦虑的治疗有用。这些指南是基于我们的临床经验，除非另有说明。

●建立信任的医患关系—一个受信任的医生可能更好地向患者解释为什么一个表明有指征进行的医疗操作是必要的，并且能更好地使患者对操作的安全性感到放心。

            

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Literature review current through: 2017-07 . | This topic last updated: 2017-02-28.
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