Department of Pediatrics and Pediatric Emergency, University Hospital Policlinico-Vittorio Emanuele, Catania, Italy.
Eur Rev Med Pharmacol Sci. 2011 Jun;15(6):711-6.
Asthma is one of the most common chronic diseases, leading to an increased rate of hospitalization.
The aim of this report is to review the current concepts and treatment of asthmatic children, focusing our attention on the treatment of children in a Department of Pediatric Emergency.
Frequent respiratory infections, personal or familial allergy, disease severity and young age are important factors leading to hospitalization. However, regular clinical follow-up and use of inhaled corticosteroids, the IgE levels and O2 saturation may reduce the probability of hospitalization during asthma attacks. The diagnosis of asthma in children is based on recognizing a characteristic pattern of episodic respiratory symptoms and signs, in the absence of an alternative explanation for them. The presence of these factors increases the probability that a child with respiratory symptoms will have asthma. These factors include age at presentation; sex; severity and frequency of previous wheezing episodes; coexistence of atopic disease; family history of atopy; and abnormal lung function.
Asthma is a chronic condition that often remains uncontrolled for reasons that may be related to the disease process itself, the management decisions of clinicians, the patient's perceptions of disease control or self-management behaviors, the cost of medications, or a combination of all of these factors. To this end, patients with asthma should be educated not to accept a certain level of symptoms or activity limitations as an inevitable consequence of asthma. Both the levels of current impairment and the future risks (of asthma exacerbations or adverse medication effects) should be used to inform decisions about appropriate levels of asthma therapy, and physicians should be aware of the new medication recommendations.
哮喘是最常见的慢性疾病之一,导致住院率增加。
本报告旨在综述哮喘儿童的当前概念和治疗方法,重点关注儿科急诊部门中儿童的治疗。
频繁的呼吸道感染、个人或家族过敏史、疾病严重程度和年龄较小是导致住院的重要因素。然而,定期进行临床随访和使用吸入皮质类固醇、IgE 水平和 O2 饱和度可降低哮喘发作期间住院的可能性。儿童哮喘的诊断基于识别间歇性呼吸症状和体征的特征模式,而这些症状和体征没有其他解释。存在这些因素会增加具有呼吸道症状的儿童患有哮喘的可能性。这些因素包括发病时的年龄;性别;先前喘息发作的严重程度和频率;特应性疾病的共存;特应性家族史;以及肺功能异常。
哮喘是一种慢性疾病,常常因可能与疾病本身、临床医生的管理决策、患者对疾病控制或自我管理行为的认知、药物成本或这些因素的组合有关的原因而得不到控制。为此,哮喘患者应接受教育,不要接受一定程度的症状或活动受限是哮喘的必然结果。应根据当前的损害程度和未来的风险(哮喘恶化或药物不良反应的风险)来告知适当的哮喘治疗水平的决策,医生应了解新的药物治疗建议。