小结
定义
病史和体格检查
关键诊断因素
- 激越时症状加剧
- 特异性高音犬吠样咳嗽
- 年龄：6 个月至 6 岁
其他诊断因素
- 男性
- 深秋时节为发病高峰
- 前驱症状
- 突发性症状
- 症状在夜间加重
- 声音嘶哑
- 呼吸窘迫（胸骨/肋间凹陷、喘鸣）
- 持续激越
- 昏睡
- 胸腹反常运动
- 疲劳
- 缺氧体征（苍白或发绀）
- 高碳酸血症征象（继发于 PaCO₂ 升高，产生意识水平下降）
危险因素
- 年龄：6 个月至 6 岁
- 男性
- 插管前
诊断性检查
首要检查
- 临床检查
需考虑的检查
- 颈部正位、侧位 X 线检查
治疗流程
轻度（休息时无喘鸣）
中度（休息时有喘鸣；无激越或昏睡）
重度（休息时有喘鸣，伴激越或昏睡）
撰稿人
作者
Candice Bjornson, MSc, MD, FRCPC
Associate Professor
University of Calgary
Calgary
Canada
利益声明
CB declares that she has no competing interests. CB is the author of several references in this topic.
David Johnson, MD
Professor
Department of Pediatrics and Physiology and Pharmacology
University of Calgary
Calgary
Canada
利益声明
DJ declares that he has no competing interests. DJ is the author of several references in this topic.
同行评议者
Jeffrey Chapman, MD
Staff
Department of Pulmonary and Critical Care Medicine
Cleveland Clinic
Cleveland
OH
利益声明
JC declares that he has no competing interests.
Ken Farion, MD
Assistant Professor
Pediatrics and Emergency Medicine
University of Ottawa
Ottawa
Canada
利益声明
KF declares that he has no competing interests.
Doreen Matsui, MD, FRCPC
Associate Professor
Departments of Paediatrics and Medicine
Children's Hospital of Western Ontario
London
Ontario
Canada
利益声明
DM declares that she has no competing interests.
Jeremy Hull, MBBS
Consultant Paediatrician
Children's Hospital and West Wing
John Radcliffe Hospital
Oxford
UK
利益声明
JH declares that he has no competing interests.
Steve Cunningham, MBBS, PhD
Consultant Respiratory Paediatrician
Department of Respiratory & Sleep Medicine
Royal Hospital for Sick Children
Edinburgh
UK
利益声明
SC declares that he has no competing interests.
鉴别诊断
- 细菌性喉气管支气管炎
- 会厌炎
- 上气道异物
更多 鉴别诊断指南
- 急诊科哮吼的紧急处理
- 哮吼诊断与治疗指南
更多 指南
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