Capital Allergy & Respiratory Disease Center, Sacramento, California.
Division of Allergy, Immunology and Pulmonary Medicine, Washington University School of Medicine and St Louis Children's Hospital, St Louis, Missouri.
Ann Allergy Asthma Immunol. 2018 Jun;120(6):559-579.e11. doi: 10.1016/j.anai.2018.04.002. Epub 2018 Apr 10.
Current asthma guidelines recommend a control-based approach to management involving assessment of impairment and risk followed by implementation of treatment strategies individualized according to the patient's needs and preferences. However, for children with asthma, achieving control can be elusive. Although tools are available to help children (and families) track and manage day-to-day symptoms, when and how to implement a longer-term step-up in care is less clear. Furthermore, treatment is challenged by the 3 age groups of childhood-adolescence (12-18 years old), school age (6-11 years old), and young children (≤5 years old)-and what works for 1 age group might not be the best approach for another. The Pediatric Asthma Yardstick provides an in-depth assessment of when and how to step-up therapy for the child with not well or poorly controlled asthma. Development of this tool follows others in the Yardstick series, presenting patient profiles and step-up strategies based on current guidance documents, but modified according to newer data and the authors' combined clinical experience. The objective is to provide clinicians who treat children with asthma practical and clinically relevant recommendations for each step-up and each intervention, with the intent of helping practitioners better treat their pediatric patients with asthma, particularly those who do not always respond to recommended therapies.
当前的哮喘指南建议采用基于控制的方法进行管理，包括评估损害和风险，然后根据患者的需求和偏好制定个体化的治疗策略。然而，对于哮喘儿童来说，实现控制可能并不容易。虽然有一些工具可以帮助儿童（和家庭）跟踪和管理日常症状，但何时以及如何实施更长期的护理升级并不明确。此外，治疗还受到儿童-青少年（12-18 岁）、学龄期（6-11 岁）和幼儿（≤5 岁）这 3 个年龄组的挑战，适用于一个年龄组的方法可能不适用于另一个年龄组。《儿科哮喘尺度》深入评估了如何为控制不佳或控制不良的哮喘儿童升级治疗。该工具的开发遵循 Yardstick 系列中的其他工具，根据当前的指导文件呈现患者概况和升级策略，但根据新数据和作者的综合临床经验进行了修改。其目的是为治疗哮喘儿童的临床医生提供实用且与临床相关的建议，以便于为他们提供每个升级和每个干预措施的建议，从而帮助医生更好地治疗患有哮喘的儿科患者，尤其是那些对推荐疗法反应不佳的患者。
