咳嗽为主诉疾病经验性诊疗探讨.docVIP

咳嗽为主诉疾病经验性诊疗探讨 　　[摘要] 目的 探讨基层医院以咳嗽为主诉的疾病的经验性诊疗措施，给广大基层医生提供可靠的诊疗依据，更好的为基层患者服务。 方法 整群选取2010年3月―2015年3月在该院门诊就诊的1 401例咳嗽为主症的患者。通过详细的询问病史，体格检查及相关辅助检查，行经验性拟诊及治疗。 结果 532例拟诊急性鼻窦炎或慢性鼻窦炎急性发作、187例拟诊鼻后滴流征、308例拟诊急性鼻炎或慢性鼻炎急性发作、372例拟诊肺炎支原体感染、1例拟诊胃食管反流性咳嗽、1例拟诊上呼吸道咳嗽综合征及胃食管反流性咳嗽患者，经针对病因治疗，均获得满意效果。结论 以咳嗽为主诉的鼻-鼻窦炎、上气道咳嗽综合征、肺炎支原体感染、胃食管反流性咳嗽的经验性诊疗正确率高，值得基层医师应用、推广。 　　[关键词] 咳嗽；鼻-鼻窦炎；上气道咳嗽综合征；肺炎支原体感染；胃食管反流性咳嗽 　　[中图分类号] R249 [文献标识码] A [文章编号] 1674-0742（2015）09（b）-0114-03 　　[Abstract] Objective Discuss the measures of empirical diagnosis and treatment of the chief complaint cough of the disease in the primary hospital，to provide reliable diagnostic basis for the vast grassroots doctors and provide better serve for the grassroots patients. Methods Select 1，401 outpatients with chief cough symptom in our hospital from March 2010 to March 2015.Through asked about disease histories in detail and physical examinations and related auxiliary examinations，then to empirical diagnosis and treatment. Results 532 patients were diagnosed as acute sinusitis or chronic sinusitis acute epiodes and 187 patients were diagnosed as postnasal drip syndrome and 308 patients were diagnosed as acut rhinitis or chronic rhinitis acute epiodes and 372 patients were diagnosed as Mycoplasma pneumoniae infection and 1 patient was diagnosed as gastroesophageal reflux cough and 1 patients was diagnosed as upper airway cough syndrom and gastroesophageal reflux cough. After treatment，obtained satisfactory effect. Conclution Empirical diagnose and treat the chief complaint cough of those diseases： rhinosinusitis and upper airway cough syndrom and Mycoplasma pneumoniae infection and gastroesophageal reflux cough.，attain a very high accuracy， it is worth to be applicated and popularized for the vast grassroots doctors. 　　[Key words] Cough； Rhinosinusitis； Upper airway cough syndrom； Mycoplasma pneumoniae infection； Gastroesophageal reflux cough 　　以咳嗽为主诉的疾病临床特征复杂，给基层医生诊疗工作带来不便。为了提高基层医生对此类症状的正确认识及诊疗，现将2010年3月―2015年3月该院门诊资料较