Lulla S, Newcomb R W
J Pediatr. 1980 Sep;97(3):346-50. doi: 10.1016/s0022-3476(80)80179-x.
We studies the records of 242 consecutive visits paid by 85 children for emergency treatment of asthma, using a standard format that included history, physical signs, peak expiratory flow rates, and responses to treatments. The decision for admission was made in 23% of the episodes. It was based on the degree of airway obstruction, as reflected in physical signs and depression of PEFR, remaining after treatment. The risk of hospital admission was directly related to duration of symptoms prior to the visit, to the extent of signs of airway obstruction on arrival, and to response to the first epinephrine injection. In 39 instances, children were sent home only to return within two days because symptoms recurred. Review of data from their initial visits did not allow us to predict most of these returns. These data may serve as an aid to composing criteria useful for managing episodes of asthma in children. They support the utility of pulmonary function data in discriminating between episodes that can and those that cannot be managed safely as outpatients.
我们研究了85名儿童因哮喘急诊而连续进行的242次就诊记录，采用了一种标准格式，其中包括病史、体征、呼气峰值流速以及对治疗的反应。在23%的病例中做出了住院决定。这是基于治疗后体征和呼气峰值流速降低所反映的气道阻塞程度。住院风险与就诊前症状持续时间、到达时气道阻塞体征的程度以及对首次肾上腺素注射的反应直接相关。在39例病例中，儿童被送回家，但因症状复发在两天内又返回。回顾他们初次就诊的数据并不能让我们预测大多数这些复诊情况。这些数据可能有助于制定对管理儿童哮喘发作有用的标准。它们支持肺功能数据在区分可以作为门诊患者安全管理的发作和不能作为门诊患者安全管理的发作方面的效用。
