Nelson Kyle A, Zorc Joseph J
The University of Pennsylvania School of Medicine, The Children's Hospital of Philadelphia, Department of Pediatrics, Philadelphia, PA 19104, USA.
Adolesc Med State Art Rev. 2010 Apr;21(1):21-33, vii.
Current management of acute asthma has been defined in clinical practice guidelines developed from systematic reviews and expert opinion. Initial treatment with inhaled high-dose beta-agonists and anticholinergics is recommended for severe exacerbations. Most patients treated in emergency departments should receive systemic corticosteroids. Adjunctive therapy for those not improving is less well-defined, but options include intravenous magnesium sulfate and heliox-driven nebulized beta-agonists. Poor adherence to preventive therapies and infrequent primary care follow-up are well documented among children and adolescents treated in emergency departments. These factors may contribute to disparities in outcomes for minority populations and are important considerations during acute care visits.
急性哮喘的当前管理已在基于系统评价和专家意见制定的临床实践指南中得以明确。对于严重加重的情况，建议初始治疗采用吸入高剂量β受体激动剂和抗胆碱能药物。在急诊科接受治疗的大多数患者应接受全身用皮质类固醇。对于病情无改善者的辅助治疗尚无明确定义，但可选择的治疗包括静脉注射硫酸镁和氦氧混合气驱动的雾化β受体激动剂。在急诊科接受治疗的儿童和青少年中，预防性治疗依从性差和初级保健随访不频繁的情况有充分记录。这些因素可能导致少数族裔人群在治疗结果上存在差异，并且在急诊就诊期间需重点考虑。
