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儿童急性呼吸窘迫:哮吼与急性哮喘

Acute Respiratory Distress in Children: Croup and Acute Asthma.

作者信息

Sharma B S, Shekhawat Dhananjay S, Sharma Prity, Meena Chetan, Mohan Hari

机构信息

Department of Pediatric Medicine, S.M.S. Medical College, Jaipur, Rajasthan, 302004, India,

出版信息

Indian J Pediatr. 2015 Jul;82(7):629-36. doi: 10.1007/s12098-014-1559-4. Epub 2014 Sep 26.

Abstract

Acute respiratory distress is one of the most common reason for emergency visits in children under 5 y of age. An accurate understanding of the epidemiology of these diseases, identification of risk factors and etiology is critical for successful treatment and prevention of related mortality. The cause of acute respiratory distress varies in etiology, and hence is amenable to different treatment modalities. Depending on the predominant symptoms and signs, a child presenting to the clinician can be divided into six groups, viz., stridor; cough, fever and difficulty in breathing or fast breathing; wheezing; mediastinal shift with severe respiratory distress; slow or irregular breathing in absence of any pulmonary sign; and respiratory distress with cardiac findings. A detailed history followed by a thorough clinical examination and laboratory evaluation assisted by imaging modalities if indicated, helps to establish the exact cause of respiratory distress in the child. Early recognition and prompt institution of appropriate management or referral can significantly improve the outcome of this illness. This article offers clinicians a brief update on the general management guidelines of respiratory distress in pediatric patients. Specific treatment depends on the exact cause, however croup and acute severe asthma have been discussed in this article.

摘要

急性呼吸窘迫是5岁以下儿童急诊就诊的最常见原因之一。准确了解这些疾病的流行病学、识别危险因素和病因对于成功治疗和预防相关死亡至关重要。急性呼吸窘迫的病因各不相同,因此适合不同的治疗方式。根据主要症状和体征,前来就诊的儿童可分为六组,即喘鸣;咳嗽、发热及呼吸困难或呼吸急促;喘息;伴有严重呼吸窘迫的纵隔移位;无任何肺部体征的呼吸缓慢或不规则;以及伴有心脏表现的呼吸窘迫。详细的病史,随后进行全面的临床检查,并在必要时借助影像学手段进行实验室评估,有助于确定儿童呼吸窘迫的确切病因。早期识别并及时采取适当的管理措施或转诊可显著改善该病的预后。本文为临床医生提供了儿科患者呼吸窘迫一般管理指南的简要更新。具体治疗取决于确切病因,本文已对喉炎和急性重症哮喘进行了讨论。

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