儿童咳嗽变异性哮喘62例临床剖析.docVIP

儿童咳嗽变异性哮喘62例临床剖析 　　[摘要] 目的:探讨儿童咳嗽变异性哮喘的临床特点和治疗效果。方法:选择本院2007年9月～2009年9月咳嗽变异性哮喘患儿62例,分析其临床表现、体检、实验室检查、误诊情况。全部患儿诊断明确后,立即给予抗哮喘治疗:雾化吸入布地奈德混悬液、给予复方异丙托溴氨、氯雷他定;怀疑患儿有支原体感染,可加用阿奇霉素;对于重症儿童要同时吸入沙丁胺醇等。结果:本组患儿实施治疗后,其中有42例患儿治疗5 d内咳嗽消失;13例患儿用药3 d后咳嗽明显减轻,但用药7 d咳嗽消失;7例患儿用药7 d咳嗽减轻,口服泼尼松每天1 mg/kg,每天2次,14 d内患儿咳嗽症状消失。结论:儿童慢性咳嗽时要排除咳嗽变异性哮喘,一旦确诊为咳嗽变异性哮喘,要根据哮喘的治疗原则进行规范化治疗,降低哮喘的发生率。 　　[关键词] 咳嗽变异性哮喘;儿童;慢性咳嗽 　　[中图分类号] R725.6[文献标识码]C [文章编号]1674-4721(2010)06(c)-038-02 　　 　　Clinical analysis of 62 children with cough variant asthma 　　XIE Cheng 　　(The Peoples Hospital of Puning City,Guangdong Province,Puning515300,China) 　　[Abstract] Objective:To explore the clinical character and clinical efficacy of child cough variant asthma.Methods:62 children with cough variant asthma were elected from September 2007 to September 2009,analyze the clinical manifestations,physical examination and laboratory examination,misdiagnosis. After all the patients were diagnosised as cough variant asthma.They were treated with asthma therapy:aerosol inhalation of budesonide suspension,ipratropium bromide,loratadine,children with suspected mycoplasma infection treated with azithromycin,severe casestreated with inhalation of salbutamol.Results:After treatment,the cough in 42 cases disappeared in 5 days;the cough in 13 cases markedly alleviated in 3 days,and the cough disappeared in 7 days;the cough in 7 cases markedly alleviated in 7 days,and prednisone was treated with 1 mg/kg,two times a day,the cough disppeared in 14 days.Conclusion:Cough variant asthma should be excluded when children have chronic cough,cough variant asthma is diagnosised clearly,the standardized treatment should be done according to the rule of asthma therapy, and reduce the incidence of asthma. 　　[Key words] Cough variant asthma;Child;Chronic cough 　　 　　咳嗽变异性哮喘(CVA)以慢性咳嗽为唯一或主要的临床表现,表现为顽固性咳嗽,夜间和(或)清晨加重,持续时间较长,抗生素治疗无效,严重影响患儿的生活质量,给家长造成了极大的困扰,并导致药物的滥用,且发病率有逐年上升的趋势。近年来,CVA作为哮喘的一种特殊类型已得到普遍认可,其本质是气道慢性炎症、气道反应性增高及一定程度的气道重构。本文选择本院62例咳嗽变异性哮喘患儿,分析其