Powell C V, Stokell R A
Department of Emergency Medicine, Royal Children's Hospital, Victoria.
Aust Fam Physician. 2000 Oct;29(10):915-9.
The hospital management of croup has altered significantly over the last decade, with current data suggesting that all children with croup who demonstrate an increase in difficulty breathing should be treated with corticosteroids, and children with more severe croup should be treated with nebulised adrenaline.
To discuss the assessment of croup severity, the recent changes in treatment and to make suggestions for the management of croup in general practice.
Children with mild croup require reassurance. There is no evidence that steroids have a place in management in this group. A single dose of prednisolone is appropriate for children with stridor at rest, but no recession and they can be managed in the general practice setting provided they can be reviewed within 2-4 hours. Failure to improve after treatment with steroids means hospital referral. Children with more severe croup require hospital assessment and possible admission.
在过去十年中，哮吼的医院管理方式发生了显著变化，目前的数据表明，所有出现呼吸困难加重的哮吼患儿均应接受皮质类固醇治疗，而病情较重的哮吼患儿应接受雾化肾上腺素治疗。
讨论哮吼严重程度的评估、近期治疗方法的变化，并对全科医疗中哮吼的管理提出建议。
轻度哮吼患儿需要安抚。没有证据表明类固醇在该组患儿的管理中有作用。对于安静时出现喘鸣但无呼吸凹陷的患儿，单次服用泼尼松龙是合适的，并且如果能在2 - 4小时内进行复查，他们可以在全科医疗环境中进行管理。使用类固醇治疗后无改善意味着需转诊至医院。病情较重的哮吼患儿需要住院评估并可能住院治疗。
