小结
定义
病史和体格检查
关键诊断因素
- cough
- tachypnea
- wheezing
- retractions, grunting, and nasal flaring
其他诊断因素
- rhinitis
- fluctuating clinical findings
- irritability, malaise, and poor feeding
- fever <104°F (<40°C)
- crackles
- apnea
- thoracoabdominal asynchrony
危险因素
- children <2 years
- winter months
- prematurity or bronchopulmonary dysplasia
- passive tobacco smoke exposure and air pollution
- impaired airway clearance and function
- congenital heart disease
- immunodeficiency
诊断性检查
首要检查
- pulse oximetry
Tests to avoid
- broad respiratory pathogen panels
需考虑的检查
- enzyme-linked immunosorbent assay (ELISA) rapid antigen detection
- chest x-ray
- reverse transcriptase polymerase chain reaction (RT-PCR)
治疗流程
confirmed bronchiolitis
撰稿人
作者
Howard B. Panitch, MD
Emeritus Professor
Division of Pulmonary and Sleep Medicine
Children's Hospital of Philadelphia
Philadelphia
PA
利益声明
HBP is a member of the American Thoracic Society's Guideline Committee, Long-Term Oxygen Therapy for Infants and Children, past Chair of the American College of Chest Physicians' Home Based Mechanical Ventilation and Neuromuscular Disease NetWork, a member of the ATS guideline committee on bronchopulmonary dysplasia (BPD), and a member of the current new guideline committee updating the BPD Statement. He is a member of the planning committee of the Pediatric Assembly of the American Thoracic Society, and receives royalties from Up-To-Date for the review of two topics (Spirometry in Children and Bronchopulmonary Dysplasia).
鸣谢
Professor Panitch would like to gratefully acknowledge Dr Isaac Desheng Liu, Dr Woon Li Seo, Dr Jennifer L. Nayak, Dr Caroline B. Hall, and Dr Clement L. Ren, previous contributors to this topic.
利益声明
IDL, WLS, JLN, and CLR declare that they have no competing interests. CBH is an author of a number of references cited in this topic.
同行评议者
Michael D. Patrick, Jr. MD
Associate Professor of Pediatrics
The Ohio State University College of Medicine
Columbus
OH
利益声明
MDP declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
参考文献
关键文献
American Academy of Pediatrics Publications. AAP recommendations for the prevention of RSV disease in infants and children. Jul 2025 [internet publication].全文
Canadian Paediatric Society. Bronchiolitis: recommendations for diagnosis, monitoring and management of children one to 24 months of age. Nov 2021 [internet publication].全文
Cunningham S, Rodriguez A, Adams T, et al. Oxygen saturation targets in infants with bronchiolitis (BIDS): a double-blind, randomised, equivalence trial. Lancet. 2015 Sep 12;386(9998):1041-8.全文 摘要
Lin J, Zhang Y, Xiong L, et al. High-flow nasal cannula therapy for children with bronchiolitis: a systematic review and meta-analysis. Arch Dis Child. 2019 Jun;104(6):564-76. 摘要
Farley R, Spurling GK, Eriksson L, et al. Antibiotics for bronchiolitis in children under two years of age. Cochrane Database Syst Rev. 2014 Oct 9;(10):CD005189.全文 摘要
参考文献
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
鉴别诊断
- Bacterial pneumonia
- Chlamydial pneumonia
- Cystic fibrosis (CF)
更多 鉴别诊断指南
- Australasian bronchiolitis guideline
- 2022 Italian guidelines on the management of bronchiolitis in infants
更多 指南患者教育信息
Bronchiolitis
Asthma in children
更多 患者教育信息
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