儿童哮喘

最后审阅: 18 七月 2022
最后更新: 04 二月 2022

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 喘息发作诱因
  • 呼吸功增加
  • 特应性疾病的特点
  • 在适宜时间框内患者对治疗的反应情况史
更多 关键诊断因素

其他诊断因素

  • 年龄>3 岁
  • 夜间干咳
  • 劳力性呼吸困难
  • 呼气性喘鸣
  • 胸壁畸形
其他诊断因素

危险因素

  • 过敏原致敏
  • 特应性疾病
  • 由非病毒/非过敏性环境因素诱发的喘息
  • 早期呼吸道病毒感染
  • 血清痰嗜酸粒细胞(4% 或更高)
  • 哮喘家族史
  • 被动或主动吸烟
  • 肺功能异常和气道高反应性
  • 室外空气污染
  • 女性
  • 肥胖
  • 妊娠期间抑酸药物的使用
更多 危险因素

诊断性检查

首要检查

  • 肺量测定法
  • 肺量测定法评估疾病对支气管舒张剂的反应
  • 胸部 X 线检查
更多 首要检查

需考虑的检查

  • 呼气流速峰值 (peak expiratory flow rate, PEFR)
  • 气道激发试验
  • 运动激发试验
  • 全血细胞计数(FBC)
  • 支气管镜检查
  • 发汗试验
  • 痰培养
  • 电子显微镜下纤毛检查
  • 皮肤点刺试验
  • 呼出气一氧化氮 (FeNO)
  • 支气管肺泡灌洗
更多 需考虑的检查

治疗流程

持续性治疗

年龄为 0 至 5 岁

年龄为 6 到 11 岁

撰稿人

作者

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

Respiratory and Sleep Physician

The Children's Hospital at Westmead

Clinical 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, FAPSR, FThorSoc, FAHMS

Professor

Respiratory and Sleep Physician

Queensland Children's Hospital

Queensland University of Technology

Brisbane

Menzies School of Health Research

Charles Darwin University

Darwin

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 has received fees from UpToDate for writing chapters on cough in children. She is an author of a number of references cited in this topic.

同行评议者

Chris Cates, MA, FRCGP

Senior Clinical Research Fellow

Community Health Sciences

St. George's University of London

London

UK

利益声明

CC is an author of a number of references cited in this topic.

Peter Griffiths, MBChB

General Practitioner

Harborne Medical Practice

Birmingham

UK

利益声明

PG declares that he has no competing interests.

Karin A. Pacheco, MD, MSPH

Assistant Professor

Division of Environmental & Occupational Health Sciences

National Jewish Health

Denver

CO

利益声明

KAP declares that she has no competing interests.

Ware Kuschner, MD

Associate Professor of Medicine

Stanford University

Stanford

Staff Physician

US Department of Veterans Affairs

Palo Alto Health Care System

Palo Alto

CA

利益声明

WK declares that he has no competing interests.

  • 鉴别诊断

    • 毛细支气管炎
    • 发作性(病毒诱发)喘息
    • 吸入异物
    更多 鉴别诊断
  • 指南

    • 全球哮喘管理与预防策略(2021 年更新)
    • 哮喘:诊断、监测和慢性哮喘治疗
    更多 指南
  • 患者教育信息

    何为儿童哮喘?

    儿童哮喘:如何有效治疗?

    更多 患者教育信息
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