最后审阅: 18 九月 2021
最后更新: 19 八月 2021

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 哮鸣音
  • 呼吸短促
  • 呼吸急促
  • 胸闷

其他诊断因素

  • 咳嗽
  • 运动受限
  • 心动过速
  • 不能讲话或喂养困难
  • 肋间隙、肋缘下或胸骨凹陷
  • 辅助呼吸肌参与呼吸
  • 奇脉
  • 睡眠障碍
  • 心动过缓
  • 紫绀
  • 疲惫
  • 意识障碍

危险因素

  • 病毒感染
  • 未得到控制的哮喘症状
  • 大量使用短效 ß2-受体激动剂
  • 吸入皮质类固醇使用不足
  • 吸入器使用方法不正确
  • 一秒用力呼气容积(FEV₁)偏低
  • 对支气管舒张剂可逆性高
  • 吸入过敏原
  • 锻炼
  • 对规律哮喘治疗药物依从性差
  • 哮喘病史
  • 过敏性疾病病史
  • 过敏性疾病家族史
  • 哮喘加重住院史
  • 过去 12 个月内发生一次或多次严重急性发作
  • 社会经济地位低
  • 环境刺激物
  • 非洲裔美国人
  • 维生素 D 缺乏
  • 肥胖
  • 较小的年龄
  • 父母受教育水平低
  • 细菌感染
  • 情感
  • 使用非甾体类抗炎药(NSAID)

诊断性检查

首要检查

  • 对短效 β-2 受体激动剂的治疗反应
  • PEFR(呼气峰流速)或 FEV₁(第一秒用力呼气容积)
  • 血氧饱和度

需考虑的检查

  • 动脉或静脉血气分析
  • 胸部 X 线检查

治疗流程

撰稿人

作者

Paul D. Robinson, MBChB, MRCPCH, FRACP, PhD

Respiratory and Sleep Physician

The Children's Hospital at Westmead

Clinical Associate Professor

Discipline of Paediatrics and Child Health

Sydney Medical School

University of Sydney

Sydney

New South Wales

Australia

利益声明

PDR declares that he has no competing interests.

Anne Chang, MBBS, FRACP, MPHTM, PhD

Professor

Menzies School of Health Research

Charles Darwin University

Northern Territory

Respiratory and Sleep Physician

Queensland Children's Hospital

Queensland University of Technology

Brisbane

Australia

利益声明

AC's institution has received fees from her work on the independent data monitoring committee board for an unlicensed vaccine (GSK) and as an advisory member of study design for an unlicensed molecule for chronic cough (Merck), outside the work for this topic. AC also received fees from UpToDate for writing topics on cough in children. AC is an author of references cited in this topic.

同行评议者

Lucille A. Lester, MD

Professor of Pediatrics

University of Chicago Comer Children's Hospital

Chicago

IL

利益声明

LAL declares that she has no competing interests.

Caro Minasian, BSc (Hons), MB, BS, FCPCH, MD (Res)

Consultant in Paediatrics

Adolescent Medicine & Paediatric Respiratory Medicine

University College London Hospitals NHS Foundation Trust

London

UK

利益声明

CM declares that he has no competing interests.

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