Department of Pediatrics, University College of Medical Sciences (University of Delhi) and GTB Hospital, Delhi 110 095, India.
Indian Pediatr. 2010 Jan;47(1):56-60. doi: 10.1007/s13312-010-0014-5.
Wheezing in acute respiratory infections is a rule rather than exception. A large proportion of children (up to 75%) having pneumonia or severe pneumonia as per WHO definitions have associated wheezing. The current strategies to diagnose and manage wheeze in the community need to be updated, as audible wheeze is present in only less than one third of wheezy children, and can not be relied upon solely. A history of previous episodes of respiratory distress has a high sensitivity to diagnose wheezy disorders. In a significant proportion of children, the respiratory rate comes back to normal and the chest indrawing disappear after two to three cycles of inhaled bronchodilator medications. Operational research is needed to evaluate the feasibility of including management of wheezing in the community based ARI management programs.
急性呼吸道感染出现喘鸣是普遍现象而非例外。有很大一部分儿童（多达 75%）患有肺炎或世卫组织定义的严重肺炎，同时伴有喘鸣。当前社区中诊断和管理喘鸣的策略需要更新，因为可闻及喘鸣的儿童不到三分之一，不能完全依赖可闻及喘鸣来诊断。既往发作性呼吸困难的病史对诊断喘鸣性疾病具有很高的敏感性。在相当一部分儿童中，在吸入支气管扩张剂药物 2 到 3 个循环后，呼吸频率恢复正常，胸部凹陷消失。需要进行运营研究来评估将喘鸣管理纳入社区内急性呼吸道感染管理方案的可行性。
