背景:慢性咳嗽是各种病因的常见问题。虽然在存在一些具体发现的情况下,诊断可能相对容易,当没有明确的症状时,它往往相当困难。因此,对于慢性咳嗽患者的治疗,需要有实用的指南.我们旨在根据2008年发布的英国胸科学会指南评估儿童慢性咳嗽的评估和管理。
方法:对5至16岁之间持续超过8周的慢性咳嗽患者进行评估。对所有患者进行肺功能检查和胸部X线检查。对需要进一步调查的人员进行了进一步的检查。每隔2至4周对患者进行重新评估,我们跟踪病人18个月,直到咳嗽消退。
结果:纳入156例患者(52.5%为女性),年龄在5-16(8.42±2.6)岁。在156名患者中,19.2%(n=30)被诊断为鼻后滴注综合征加哮喘;18.6%(n=29)鼻后滴注综合征;12.2%(n=19)患有哮喘;12.2%(n=19)患有持续性细菌性支气管炎;11.5%(n=18)患有非特异性孤立性咳嗽,9.6%(n=15)患有咳嗽变异性哮喘,5.7%(n=9)患有心理性咳嗽,3.2%(n=5)患有胃食管反流病。
结论:鼻后滴漏综合征和哮喘是慢性咳嗽的最常见原因。在一些被诊断为鼻后滴漏综合征的患者中发现了与哮喘相关的发现。已经观察到,关于一些患者,可能存在多于一个的咳嗽的特定原因。胃食管反流病不是儿童慢性咳嗽的常见主要原因。
BACKGROUND: Chronic cough is a common problem of various etiologies. While diagnosis may relatively be easy in the presence of some specific findings, it tends to be rather difficult when there are no clear symptoms. Therefore, practical
guidelines are needed for management of patients with chronic cough. We aimed to evaluate assessment and management of chronic cough in children according to the British Thoracic Society
guidelines published in 2008.
METHODS: Patients with chronic cough lasting longer than 8 weeks between 5 and 16 years old were evaluated. Pulmonary function test and chest radiography were performed on all patients. Further workup was conducted on those requiring further investigation. Patients were re-evaluated at 2- to 4-week intervals, and we followed our patients for 18 months until cough resolved.
RESULTS: One hundred fifty six patients (52.5% female) aged 5-16 (8.42 ± 2.6) years were included. Of the 156 patients, 19.2% (n = 30) were diagnosed with postnasal drip syndrome plus asthma; 18.6% (n = 29) with postnasal drip syndrome; 12.2% (n = 19) with asthma; 12.2% (n = 19) with protracted bacterial bronchitis; and 11.5% (n = 18) with nonspecific isolated cough, 9.6% (n = 15) with cough variant asthma, 5.7% (n = 9) with psychogenic cough and 3.2% (n = 5) with gastroesophageal reflux disease.
CONCLUSIONS: Postnasal drip syndrome and asthma was the most common cause of chronic cough. Asthma-associated findings were found in some of the patients diagnosed with postnasal drip syndrome. It has been observed that there could be more than one particular cause for cough concerning some patients. The gastroesophageal reflux disease was not a common primary cause of chronic cough in children.