Craig Finella, Henderson Ellen M, Bluebond-Langner Myra
aThe Louis Dundas Centre for Children's Palliative Care, Great Ormond Street Hospital for Children NHS Foundation Trust bThe Louis Dundas Centre for Children's Palliative Care, UCL-Institute of Child Health, London, UK cRutgers University, Camden, New Jersey, USA.
Curr Opin Support Palliat Care. 2015 Sep;9(3):217-26. doi: 10.1097/SPC.0000000000000154.
Respiratory symptoms in children with life-limiting and life-threatening conditions are common, distressing and have a lasting impact, yet there is a paucity of evidence to guide clinicians in their management. This article makes a series of recommendations for the management of the most frequent and distressing respiratory symptoms encountered in paediatrics (dyspnoea, cough, haemoptysis and retained secretions) with attention to the evidence from research.
There are very few paediatric studies exploring any aspect of respiratory symptoms in paediatric palliative care, so much of the evidence base has been drawn from adult studies, few of which have been published in the past 12-18 months.
In the absence of well designed paediatric studies we need to judiciously apply what we can extrapolate from adult studies to each child we are treating; selecting interventions and approaches carefully, adjusting them when there is no evidence of individual benefit.
患有危及生命和有生命危险疾病的儿童出现呼吸道症状很常见，令人痛苦且具有持久影响，但指导临床医生进行管理的证据却很匮乏。本文针对儿科中最常见且令人痛苦的呼吸道症状（呼吸困难、咳嗽、咯血和分泌物潴留）的管理提出了一系列建议，并关注了研究证据。
很少有儿科研究探讨儿科姑息治疗中呼吸道症状的任何方面，因此大部分证据基础来自成人研究，其中在过去12 - 18个月内发表的很少。
在缺乏精心设计的儿科研究的情况下，我们需要明智地将从成人研究中推断出的内容应用于我们治疗的每个儿童；谨慎选择干预措施和方法，在没有个体受益证据时进行调整。
