McGarvey L P, Heaney L G, MacMahon J
Department of Respiratory Medicine, Belfast City Hospital, Northern Ireland.
Int J Clin Pract. 1998 Apr-May;52(3):158-61.
Respiratory physicians often encounter patients with chronic cough. The evaluation and outcome of such patients by centres with established diagnostic protocols has been well described. By contrast, little is known about patients referred to general respiratory clinics where no such protocol exists. We describe the findings of a retrospective survey of all new patient referrals with chronic cough to a general respiratory clinic over a 12-month period. A diagnosis of asthma or chronic airflow obstruction was made in 43% of patients. Gastro-oesophageal reflux and postnasal drip syndrome, together accounting for over 60% of diagnoses in specialist clinics, were infrequently identified in our study (4% and 2% respectively). At follow-up, 43% of patients reported persistent symptoms, contrasting the excellent treatment response reported by specialist clinics. In general respiratory clinics where a specific diagnostic protocol is not in place, these differences in diagnosis and outcome may be due to inadequate investigation or may reflect a different patient population.
呼吸内科医生经常会遇到慢性咳嗽患者。已有成熟诊断方案的中心对这类患者的评估及结果已有详尽描述。相比之下，对于转诊至没有此类方案的普通呼吸科诊所的患者情况却知之甚少。我们描述了一项对某普通呼吸科诊所12个月期间所有因慢性咳嗽前来就诊的新患者进行回顾性调查的结果。43%的患者被诊断为哮喘或慢性气流阻塞。胃食管反流和鼻后滴漏综合征在专科诊所的诊断中占比超过60%，而在我们的研究中却很少被发现（分别为4%和2%）。随访时，43%的患者报告仍有持续症状，这与专科诊所报告的良好治疗反应形成对比。在没有特定诊断方案的普通呼吸科诊所，诊断和结果的这些差异可能是由于检查不充分，也可能反映了不同的患者群体。
