小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 咳嗽
- 呼吸急促
- 哮鸣音
- 肋间回缩、痰鸣音、鼻翼煽动
其他诊断因素
- 鼻炎
- 反复出现的临床发现
- 易激惹、周身不适和喂养不良
- 发热<40°C(<104°F)
- 湿啰音
- 呼吸暂停
- 胸腹部运动不同步
危险因素
- 婴幼儿大于3岁
- 冬月
- 早产或支气管肺发育不良
- 被动烟草烟雾暴露与空气污染
- 气道清除能力和功能障碍
- 先天性心脏病
- 免疫缺陷
诊断性检查
首要检查
- 脉搏血氧测量测定法
需考虑的检查
- 酶联免疫吸附测定 (ELISA) 快速抗原检测
- 胸部 X 线检查
- 逆转录酶聚合酶链反应(RT-PCR)
新兴检查
- 婴儿肺功能试验
治疗流程
具有严重 RSV 感染高风险的婴儿
确诊细支气管炎
撰稿人
作者
Howard B. Panitch, MD
Professor
Division of Pulmonary 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
Robert Welliver, MD
Professor of Pediatrics
Women and Children's Hospital
Buffalo
NY
利益声明
RW declares that he has no competing interests.
Giovanni Piedimonte, MD
Wyeth Research Scholar Professor and Chair
Department of Pediatrics
WVU School of Medicine
Physician-in-Chief
WVU Children's Hospital
Morgantown
WV
利益声明
GP declares that he has no competing interests.
H. Cody Meissner, MD
Professor of Pediatrics
Infectious Disease
Department of Pediatrics
Tufts-New England Medical Center
Boston
MA
利益声明
HCM is an author of a number of references cited in this topic.
John Henderson, MBBS
Professor of Paediatric Respiratory Medicine
University of Bristol
Bristol
UK
利益声明
JH declares that he has no competing interests.
鉴别诊断
- 细菌性肺炎
- 衣原体肺炎
- 囊性纤维化(CF)
更多 鉴别诊断指南
- 儿童毛细支气管炎:诊断和管理
- 5 岁以下儿童的发热:评估和初始管理
更多 指南患者教育信息
毛细支气管炎
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