Usta Guc Belgin, Asilsoy Suna, Durmaz Cemile
Department of Pediatric Allergy, Konya Education and Research Hospital, Konya, Turkey.
Clin Respir J. 2014 Jul;8(3):330-7. doi: 10.1111/crj.12076. Epub 2014 Feb 10.
Chronic cough is a common problem of various etiologies. While diagnosis may relatively be easy in the presence of some specific findings, it tends to be rather difficult when there are no clear symptoms. Therefore, practical guidelines are needed for management of patients with chronic cough. We aimed to evaluate assessment and management of chronic cough in children according to the British Thoracic Society guidelines published in 2008.
Patients with chronic cough lasting longer than 8 weeks between 5 and 16 years old were evaluated. Pulmonary function test and chest radiography were performed on all patients. Further workup was conducted on those requiring further investigation. Patients were re-evaluated at 2- to 4-week intervals, and we followed our patients for 18 months until cough resolved.
One hundred fifty six patients (52.5% female) aged 5-16 (8.42 ± 2.6) years were included. Of the 156 patients, 19.2% (n = 30) were diagnosed with postnasal drip syndrome plus asthma; 18.6% (n = 29) with postnasal drip syndrome; 12.2% (n = 19) with asthma; 12.2% (n = 19) with protracted bacterial bronchitis; and 11.5% (n = 18) with nonspecific isolated cough, 9.6% (n = 15) with cough variant asthma, 5.7% (n = 9) with psychogenic cough and 3.2% (n = 5) with gastroesophageal reflux disease.
Postnasal drip syndrome and asthma was the most common cause of chronic cough. Asthma-associated findings were found in some of the patients diagnosed with postnasal drip syndrome. It has been observed that there could be more than one particular cause for cough concerning some patients. The gastroesophageal reflux disease was not a common primary cause of chronic cough in children.
慢性咳嗽是由多种病因引起的常见问题。虽然在存在某些特定表现时诊断可能相对容易,但在没有明确症状时往往相当困难。因此,需要实用的指南来管理慢性咳嗽患者。我们旨在根据2008年英国胸科学会发布的指南评估儿童慢性咳嗽的评估和管理。
对5至16岁慢性咳嗽持续超过8周的患者进行评估。对所有患者进行肺功能测试和胸部X光检查。对需要进一步检查的患者进行进一步检查。患者每隔2至4周重新评估一次,我们对患者进行了18个月的随访,直到咳嗽消失。
纳入了156例年龄在5至16岁(8.42±2.6)的患者,其中女性占52.5%。在这156例患者中,19.2%(n = 30)被诊断为鼻后滴漏综合征合并哮喘;18.6%(n = 29)为鼻后滴漏综合征;12.2%(n = 19)为哮喘;12.2%(n = 19)为迁延性细菌性支气管炎;11.5%(n = 18)为非特异性孤立性咳嗽,9.6%(n = 15)为咳嗽变异性哮喘,5.7%(n = 9)为心因性咳嗽,3.2%(n = 5)为胃食管反流病。
鼻后滴漏综合征和哮喘是慢性咳嗽最常见的原因。在一些被诊断为鼻后滴漏综合征的患者中发现了与哮喘相关的表现。据观察,一些患者的咳嗽可能有不止一个特定原因。胃食管反流病不是儿童慢性咳嗽的常见主要原因。