Kovesi Tom, Giles Brenda Louise, Pasterkamp Hans
Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario;
Paediatr Child Health. 2012 Aug;17(7):e46-64.
Asthma is a serious health problem for First Nations and Inuit children. In children younger than one year of age, asthma needs to be distinguished from viral bronchiolitis, which is unusually common in Canadian Aboriginal children. In children younger than six years of age, the diagnosis depends on the presence of typical symptoms, the absence of atypical features and the documentation of response to therapy - particularly a rapid, transient response to bronchodilators. In older children, the presence of reversible airway obstruction should be determined using spirometry whenever feasible to confirm the diagnosis. Environmental triggers should be evaluated and corrected whenever possible. Regular use of inhaled steroids is the most important measure for maintaining good asthma control in children with asthma. Clients and their families should receive asthma education. Control should be regularly reassessed at follow-up visits in health centres, with therapy adjusted to the lowest level capable of maintaining good control.
哮喘是加拿大原住民和因纽特儿童面临的一个严重健康问题。对于一岁以下的儿童，哮喘需要与病毒性细支气管炎相区分，后者在加拿大原住民儿童中异常常见。对于六岁以下的儿童，诊断取决于典型症状的存在、非典型特征的缺失以及对治疗反应的记录——尤其是对支气管扩张剂的快速、短暂反应。对于年龄较大的儿童，只要可行，应使用肺活量测定法确定是否存在可逆性气道阻塞以确诊。应尽可能评估并纠正环境触发因素。对于患有哮喘的儿童，定期使用吸入性类固醇是维持良好哮喘控制的最重要措施。患者及其家人应接受哮喘教育。在健康中心的随访中应定期重新评估控制情况，并将治疗调整至能够维持良好控制的最低水平。
