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目的就儿童咳嗽变异性哮喘56例误诊进行分析。方法选择2010~2012年本院呼吸科收治的56例患儿,本组患儿经确诊后,给予丙酸倍氯米松气雾剂(必可酮)+沙丁胺醇气雾剂+酮替芬联合吸入疗法,酮替芬口服6~12个月,必可酮使用6~12个月,沙丁胺醇使用1~4个月。结果本组患儿在确诊前,曾被误诊为7例(12.5%)间质性肺炎,3例(5.4%)支原体肺炎,18例(32.1%)反复上呼吸道感染,28例(50.0%)支气管炎。35例(62.5%)在治疗1周内咳嗽消失,16例(28.6%)在治疗1~2周内消失,5例(8.9%)在治疗3~4周内消失。随访1年,6例(10.7%)复发1~2次,10例(17.9%)擅自停药而复发,40例(71.4%)无复发。结论临床医师应提高对儿童咳嗽变异性哮喘疾病的认识,在诊断时,务必要全面分析患儿的病情,且对病史进行详细询问,对于怀疑患有该疾病的患儿应及时做肺功能检查和变应原试验。早期试用抗过敏药物和支气管扩张剂对患儿进行诊断性治疗。
Objective To analyze the misdiagnosis of 56 children with cough variant asthma. Methods Fifty-six children admitted to our Department of Respiratory Medicine from 2010 to 2012 were selected. Patients in this group were diagnosed with beclometasone dipropionate aerosol (aerosol) and salbutamol aerosol combined with ketotifen Therapy, ketotifen orally 6 to 12 months, will be available ketone for 6 to 12 months, salbutamol used for 1 to 4 months. Results Before diagnosis, the patients were misdiagnosed as 7 cases (12.5%) interstitial pneumonia, 3 cases (5.4%) mycoplasma pneumonia, 18 cases (32.1%) repeated upper respiratory tract infection, 28 cases (50.0% bronchitis. Thirty-five patients (62.5%) lost their cough within 1 week of treatment, 16 (28.6%) disappeared within 1 to 2 weeks and 5 (8.9%) disappeared within 3 to 4 weeks of treatment. Followed up for 1 year, 6 cases (10.7%) recurred 1-2 times, 10 cases (17.9%) relapsed without authorization and 40 cases (71.4%) had no recurrence. Conclusions Clinicians should raise awareness of cough variant asthma in children. At the time of diagnosis, it is imperative to analyze the illness of the children comprehensively and to inquire the history of the disease in detail. For children suspected of having the disease, pulmonary function tests should be performed promptly And allergen test. Early trial of anti-allergy drugs and bronchodilators in children with diagnostic treatment.