儿童急性哮喘发作

儿童的急性哮喘发作表现为喘息和呼吸窘迫的急性或亚急性发作，其症状和体征因儿童的发育年龄和成熟年龄不同而存在差异。

激发因素包括病毒或细菌感染、吸入过敏原、环境刺激、情感、药物和对预防性治疗的依从性差。

大部分患儿对初始的支气管扩张剂治疗有效，那些对常规支气管扩张剂治疗无效的患儿应该早期给与糖皮质激素口服。

严重急性发作患者需要吸氧、雾化/静脉应用支气管扩张剂以及静脉应用皮质类固醇，可能需要硫酸镁静脉输注、静脉应用支气管扩张剂和肌肉注射肾上腺素（如果存在全身过敏反应）。

重度和致死性发作可能需要无创通气或气管插管，重症监护团队应尽早参与治疗。

如果患儿对标准哮喘治疗无反应，应考虑其他鉴别诊断。

出院时，明确的哮喘管理计划和宣教对于优化哮喘控制和预防未来急性发作至关重要。

An asthma exacerbation is an acute or sub-acute episode of airflow obstruction occurring on a background of chronic airway inflammation and airway hyper-responsiveness. The exacerbation is initiated by a trigger that produces bronchoconstriction and increased mucus production, thereby worsening asthma symptoms such as wheeze, cough, dyspnoea, and respiratory distress. This topic covers the treatment of children up to 11 years of age. Children 12 years and older are treated the same as adults. Please see our Acute asthma exacerbation in adults topic for more information.