van Nierop J C, van Aalderen W M, Brinkhorst G, Oosterkamp R F, de Jongste J C
Emma Kinderzickenhuis AMC, afd. Kinderlongziekten, Amsterdam.
Ned Tijdschr Geneeskd. 1997 Mar 15;141(11):520-4.
The diagnostic phase in a child with acute asthma should be short and comprise a brief history-taking, inspection and auscultation of the thorax, transcutaneous oxygen measurement and, if possible, peak flow measurement. Blood picture. sputum culture and chest X-ray may be included in the diagnostics if indicated. The primary treatment consists of administration of bronchodilators (beta-2 sympathicomimetics) by inhalation, using a spacer. Repeated inhalation of salbutamol and ipratropium may be necessary. In case of inadequate improvement (spraying necessary every 3 hours for 24-48 hours), hospitalization and systemic administration of corticosteroids are indicated. Other reasons for hospitalization are a transcutaneous oxygen saturation lower than 91%, complications such as subcutaneous emphysema and pneumothorax, exhaustion of child or parents, and rapid aggravation of the clinical picture with rising Pco2 and falling pH in capillary or arterial blood.
对于患有急性哮喘的儿童，诊断阶段应简短，包括简要的病史采集、胸部检查和听诊、经皮氧测量，以及如有可能进行峰值流速测量。如有指征，诊断还可包括血常规、痰培养和胸部X光检查。初始治疗包括使用储雾罐通过吸入方式给予支气管扩张剂（β-2拟交感神经药）。可能需要重复吸入沙丁胺醇和异丙托溴铵。如果改善不充分（24至48小时内每3小时就需要喷雾），则需住院并全身使用皮质类固醇。住院的其他指征包括经皮氧饱和度低于91%、皮下气肿和气胸等并发症、儿童或家长疲惫，以及临床症状迅速加重，伴有毛细血管或动脉血中Pco2升高和pH值下降。
