哮喘联盟

   摘要
   目的：旨在评估我们对复发性哮吼和慢性咳嗽多学科诊疗的效果。
   方法：回顾性分析一家三级儿童保健院中由气道、呼吸和食管（CARE）综合团队管理的所有复发性哮吼和慢性咳嗽患者的数据。调查所有诊断为复发性哮吼或慢性咳嗽患者，排除没有得到完整病情检查的患者，包括微型直接喉镜、纤维和/或硬质支气管镜、细支气管肺泡灌洗（BAL）和上消化道内镜检查与切片活检。我们审查了出现胃肠不适，腹痛和发育停滞（FTT）的记录，并将有食管炎的孩子与其余孩子进行比较。
   结果：40例患者符合纳入标准，其中53％有呼吸道异常；最常见的原因为气管软化，其次是扁桃体肿大。38％的患者为食管炎（第1组），而62％的患者食管活检正常（第2组）。第1组儿童中，27％为嗜酸性粒细胞性食管炎（每高倍视野多于15个嗜酸性粒细胞）。根据出现胃肠不适、腹痛和/或FTT，第1组和第2组之间没有显著差异（P> 0.05）。根据气道异常（P> 0.05）的位置或是否存在气道异常，两组间差异无显著性（P> 0.05）。
   结论：反复哮吼和慢性咳嗽的儿童可能会受益于多学科诊疗方法的管理。我们的CARE团队使近95％的患者得到特异性诊断。
 

（苏欣 审校）
 Int J Pediatr Otorhinolaryngol. 2015 May;79(5):749-52. doi: 10.1016/j.ijporl.2015.03.007. Epub 2015 Mar 14.

 

Pediatric patients with chronic cough and recurrent croup: The case for a multidisciplinary approach.
 

Greifer M1, Santiago MT2, Tsirilakis K2, Cheng JC3, Smith LP4.

Abstract
OBJECTIVE:To evaluate the results of our multidisciplinary approach to recurrent croup and chronic cough.
METHODS:Retrospective chart review of all patients with recurrent croup and chronic cough managed at a tertiary care children's hospital by our Comprehensive Airway, Respiratory, and Esophageal (CARE) Team. Charts were reviewed for all patients who carried a diagnosis of recurrent croup or chronic cough. Patients were excluded if they did not receive a full workup, including micro-direct laryngoscopy, flexible and/or rigid bronchoscopy, bronchioalveolar lavage (BAL), and upper endoscopy with biopsies. We reviewed the records for the presence of gastrointestinal complaints, abdominal pain and failure to thrive (FTT) and compared the children with documented esophagitis to the remaining children.
RESULTS:Forty patients met inclusion criteria. 53% had airway abnormalities; the most common was tracheomalacia, followed by enlarged adenoids. 38% had esophagitis (group 1) while 62% had normal esophageal biopsies (group 2). Among the children in group 1, 27% met criteria for eosinophilic esophagitis (>15 eosinophils per high powered field). There was no significant difference between groups 1 and 2 based on the presence of gastrointestinal complaints, abdominal pain and/or FTT (p>0.05). There was no significant difference between the groups based on the location or presence of an airway abnormality (p>0.05).
CONCLUSIONS:Children with recurrent croup and chronic cough may benefit from a multidisciplinary approach to management. Our CARE Team approach led to a specific diagnosis in almost 95% of patients.

Int J Pediatr Otorhinolaryngol. 2015 May;79(5):749-52. doi: 10.1016/j.ijporl.2015.03.007. Epub 2015 Mar 14.