哮喘联盟

   摘要
   慢性咳嗽有不同的定义,咳嗽持续时间有超过3周、4周或8周不等。很多病毒感染后或百日咳样病变都伴有需一定时间才能痊愈的长时间咳嗽。咳嗽的处理涉及首先试图做出诊断和确定是否存在任何潜在因素。接下来才能实施有针对性的治疗。用于治疗的方法通常也被用来诊断。由于咳嗽常常可自然痊愈，任何用于确诊的治疗试验都应该是有时间限制，只有在咳嗽复发时才重新开始治疗。只有一小部分患有孤立性的非特异性干咳的儿童患有哮喘，需要注意不要误诊为哮喘。患有慢性湿咳的儿童，可能伴有持久的细菌性支气管炎（PBB），并对整个疗程的抗菌药物有应答。患有PBB的儿童如对治疗或特定指标无应答，则需要进行化脓性肺部疾病的特异性病因检查。

 

（林江涛 审校）
Paediatr Respir Rev. 2013 Jun;14(2):100-6. doi: 10.1016/j.prrv.2012.05.002. Epub 2012 Jun 12.

 

Chronic cough in children.

Shields MD, Doherty GM.
 

Abstract
Chronic cough has been variably defined as a cough lasting longer than 3, 4 or 8 weeks. Many post viral or pertussis like illnesses are associated with prolonged coughing that resolves over time. Management involves first trying to make a diagnosis and identify the presence of any underlying condition. Targeted treatments can then be employed. Trials of treatments are often used to make a diagnosis. Because natural resolution of cough is so common any trial of treatment to confirm a diagnosis should be time limited and the treatment only restarted if the coughing returns. Only a small proportion of children with an isolated non-specific dry cough have asthma and care is needed not to over diagnose asthma. Children with chronic wet cough may have protracted bacterial bronchitis (PBB) that responds to a full course of antibiotics.Children with PBB failing to respond to treatment or with specific pointers should be investigated for specific causes of suppurative lung disease.
 

Paediatr Respir Rev. 2013 Jun;14(2):100-6. doi: 10.1016/j.prrv.2012.05.002. Epub 2012 Jun 12.