Reisman J J, Canny G J, Levison H
Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada.
Ann Allergy. 1988 Sep;61(3):163-71.
Chronic cough is a fairly common pediatric complaint. Usually, it is secondary to irritation of the airways following a respiratory viral infection. In these cases, the cough tends to diminish over time. There may, however, be a subsequent development of bronchial hyperreactivity. Asthma is common in the pediatric population. From 50% to 90% of chronic coughers may have hyperreactive airways. In the absence of a pulmonary function laboratory to test for this, a trial of bronchodilator therapy is warranted. Other conditions discussed may also cause chronic cough and a thorough history and physical examination with some simple radiologic investigations can help pinpoint the cause. Specific therapy can then be used to manage the problem. In addition to specific therapy, care must be taken to explain to the parents and patient the physiology of the cough and why it is present. Anxieties and fears should be dealt with in a caring and direct manner. Occasionally, non-specific therapy is needed to allow the parents and child some rest and relief.
慢性咳嗽是儿科较为常见的主诉。通常，它继发于呼吸道病毒感染后气道受到刺激。在这些情况下，咳嗽往往会随着时间推移而减轻。然而，随后可能会出现支气管高反应性。哮喘在儿童群体中很常见。50%至90%的慢性咳嗽患儿可能有气道高反应性。在没有肺功能实验室进行检测的情况下，进行支气管扩张剂治疗试验是有必要的。所讨论的其他病症也可能导致慢性咳嗽，详细的病史、体格检查以及一些简单的影像学检查有助于查明病因。然后可采用特定疗法来处理该问题。除了特定疗法外，还必须向家长和患儿解释咳嗽的生理机制以及咳嗽存在的原因。应以关怀且直接的方式处理焦虑和恐惧情绪。偶尔，需要采用非特异性疗法让家长和孩子能得到一些休息并缓解症状。
