Meharry Medical College, Nashville, TN 37208, USA.
Am Fam Physician. 2011 May 1;83(9):1067-73.
Croup is a common illness responsible for up to 15 percent of emergency department visits due to respiratory disease in children in the United States. Croup symptoms usually start like an upper respiratory tract infection, with low-grade fever and coryza followed by a barking cough and various degrees of respiratory distress. In most children, the symptoms subside quickly with resolution of the cough within two days. Croup is often caused by viruses, with parainfluenza virus (types 1 to 3) as the most common. However, physicians should consider other diagnoses, including bacterial tracheitis, epiglottitis, foreign body aspiration, peritonsillar abscess, retropharyngeal abscess, and angioedema. Humidification therapy has not been proven beneficial. A single dose of dexamethasone (0.15 to 0.60 mg per kg usually given orally) is recommended in all patients with croup, including those with mild disease. Nebulized epinephrine is an accepted treatment in patients with moderate to severe croup. Most episodes of croup are mild, with only 1 to 8 percent of patients with croup requiring hospital admission and less than 3 percent of admitted patients requiring intubation.
喉炎是一种常见疾病，在美国，儿童因呼吸道疾病而到急诊就诊的病例中，喉炎约占 15%。喉炎的症状通常类似于上呼吸道感染，伴有低度发热和鼻咽炎，随后出现犬吠样咳嗽和不同程度的呼吸窘迫。在大多数儿童中，咳嗽在两天内缓解后，症状迅速消退。喉炎通常由病毒引起，其中副流感病毒（1 型至 3 型）最为常见。然而，医生应考虑其他诊断，包括细菌性气管炎、会厌炎、异物吸入、扁桃体周围脓肿、咽后脓肿和血管性水肿。湿化疗法的益处尚未得到证实。建议所有喉炎患者（包括轻症患者）使用地塞米松（通常口服 0.15 至 0.60 毫克/公斤）单剂量治疗。对于中重度喉炎患者，雾化肾上腺素是一种公认的治疗方法。大多数喉炎发作较轻，只有 1%至 8%的喉炎患者需要住院治疗，不到 3%的住院患者需要插管。
