根据美国胸科医师学院指南对长期咳嗽儿童进行评估
2013/11/13
摘要
介绍：在儿童中，咳嗽持续长于4周即可认为是慢性咳嗽，可伴有各种各样的病因因素。
目的：本研究纳入慢性咳嗽儿童，随访1年。所有病例都根据美国胸科医师学院（ACCP）指导进行评估，并进行病因因素分析。
方法：本研究纳入270例2个月～14岁的儿童。记录他们表现的症状、体检结果和实验室数据。所有患者均进行了实验室检测，包括直接胸部X射线和肺量测定。一些患者还需额外进行进一步检查如出汗检查、免疫球蛋白水平测定和支气管镜检查。所有患者根据ACCP推荐进行重新评估并研究病因因素。
结果：本研究共纳入270例患者，其中女性占43.3%（n=153）且平均年龄为6.5 ± 2.3岁（7个月～17岁）。随访1年后，我们发现最常见的病因是哮喘（27%）、哮喘样症状（15.5%）和胃食管反流（10%）。其它病因分别包括上气道咳嗽综合症（UACS）和长期支气管炎。
结论：在慢性咳嗽儿童的治疗中，使用标准临床途径如ACCP可增加快速、准确诊断的可能性，因此，需要使用这些指南。
（刘国梁 审校）
Clin Respir J. 2013 Aug 26. doi: 10.1111/crj.12052. [Epub ahead of print]
The Evaluation of children with prolonged cough accompanied by American College of Chest Physicians guidelines.
Karabel M, Kelekçi S, Karabel D, Gürkan MF.
ABSTRACT
INTRODUCTION: In children, coughs lasting longer than four weeks are considered to be chronic, with etiological factors varying widely. Objective: This study included children with chronic cough who were followed for one year. All cases were evaluated with the guidance of the American College of Chest Physicians (ACCP) and etiological factors were analyzed.
METHODS: The study included 270 children between the ages of 2 months and 14 years. Their presenting symptoms, physical examination findings and laboratory data were recorded. All patients underwent laboratory tests including direct chest X-ray and spirometric measurements. Several patients required additional advanced examinations such as a sweat test, determination of immunoglobulin levels and bronchoscopy. Patients were reevaluated according to ACCP recommendations and etiological factors were investigated.
RESULTS: The total of 270 patients were included in the study included 43.3% (n=153) females with a mean age of 6.5 ± 2.3 years (7 months-17 years). After a one-year follow-up of patients, we determined that the most common etiologic factors were asthma (27%), asthma like syndrome (15.5%) and gastroesophageal reflex (10%). Other etiological factors included upper airway cough syndrome (UACS) and protracted bronchitis, respectively.
CONCLUSION: The use of a standardized clinical approach such as the ACCP increases the possibility for fast and accurate diagnosis during the treatment of children with chronic cough and the use of these guidelines should be required.
Clin Respir J. 2013 Aug 26. doi: 10.1111/crj.12052. [Epub ahead of print]
