中国儿童保健杂志 ›› 2019, Vol. 27 ›› Issue (12): 1374-1377.DOI: 10.11852/zgetbjzz2019-0093

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青岛地区儿童慢性湿性咳嗽病因学研究和治疗管理

王丽燕, 孙广荣, 刘田田, 王晓丽   

  1. 青岛市妇女儿童医院儿童咳喘门诊,山东 青岛 266000
  • 收稿日期:2019-01-23 修回日期:2019-05-15 发布日期:2019-12-10 出版日期:2019-12-10
  • 通讯作者: 孙广荣,E-mail:sgr7526@163.com
  • 作者简介:王丽燕(1977-),女,山东人,副主任医师,硕士学位,主要研究方向为儿内科咳喘专业

Etiological study and therapeutic management of children with chronic wet cough in Qingdao area

WANG Li-yan,SUN Guang-rong,LIU Tian-tian,WANG Xiao-li   

  1. Cough and Asthma Clinic for Children,Women and Children's Hospital of Qingdao,Qingdao,Shandong 266000,China
  • Received:2019-01-23 Revised:2019-05-15 Online:2019-12-10 Published:2019-12-10
  • Contact: SUN Guang-rong,E-mail:sgr7526@163.com

摘要: 目的 了解青岛地区儿童慢性湿性咳嗽病因构成、临床特征和治疗管理,为儿童慢性湿性咳嗽诊断和治疗建立规范化、标准化流程提供临床依据。方法 依据中华医学会2013年修订的《中国儿童慢性咳嗽诊断与治疗指南》标准,选择2017年7月-2018年7月青岛市妇女儿童医院咳喘门诊和病房诊断为慢性湿性咳嗽的726例合格病例的各项数据进行统计分析,了解青岛地区儿童慢性湿性咳嗽病因构成比及治疗情况。结果 1)726例病例中前5位病因分别为上气道咳嗽综合征(UACS,47.1%)、呼吸道感染后咳嗽(PIC,24.7%)、迁延性细菌性支气管炎(PBB,7.85%)、哮喘并感染(占6.74%)、胃食管反流(GERC,5.23%)。2)不同年龄儿童病因构成比不同,各病因咳嗽发作时间、痰液外观和细胞学分析不同。3)主要诊断修正率中多病因修正率高达55.55%,治疗以联合治疗为主,首诊3~4种药物联合治疗占45.31%。结论 1)青岛地区儿童慢性湿性咳嗽病因构成与慢性咳嗽病因构成不同。2)缺乏规范的治疗管理,修正诊断比例仍较高,提醒临床医生应重视临床疗效观察,注意多病因和病因不明的病例,根据观察、等待、随访的原则,及时修正诊断,调整用药,规范治疗。

关键词: 青岛地区, 慢性湿性咳嗽, 治疗管理, 儿童

Abstract: Objective To understand the etiology,clinical features and therapeutic management of children with chronic wet cough in Qingdao area,in order to provide clinical basis for standardization and normalization of the diagnosis and treatment of chronic wet cough. Methods According to the 2013 Guidelines for diagnosis and treatment of chronic cough in children revised by Chinese Medical Association,726 children diagnosed with chronic wet cough in Cough and Asthma Clinic of Qingdao Women and Children's Hospital were selected from July 2017 to July 2018.The data were statistically analyzed and the constituent ratio of causes and treatment of chronic cough were obtained. Results 1) The leading 5 causes of chronic wet cough in 726 children included upper airway cough syndrome(UACS,47.1%),post-infectious cough(PIC,24.7%),protracted bacterial bronchitis(PBB,7.85%),asthma with infection(6.74%) and gastroesophageal reflux cough(GERC,5.23%).2) The etiological composition in children at different age groups was different,and the onset time,appearance of sputum and cytological analysis were different.3) The correction rate of main diagnosis and multiple causes was as high as 55.55%,mainly with combined treatment.Combined treatment of 3 to 4 drugs in the first visit accounted for 45.31%. Conclusions 1) The etiology of chronic wet cough in children in Qingdao is different from that of chronic cough.2) Because of the lack of standardized management and high proportion of modified diagnosis,more attention should be paid to the clinical efficacy of chronic wet cough.In addition,for cases with more causes and unknown etiology,it is necessary for clinical staff to give more concern,revise the diagnosis and adjust the medication timely according to the principles of observation and follow-up.

Key words: Qingdao area, chronic wet cough, therapeutic management, children

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