2019版儿童支气管哮喘诊断与防治指南.ppt

2016版儿童支气管哮喘诊断与防治指南;《儿童支气管哮喘诊断和防治指南》发表于2008年后…;对哮喘定义的表述进行了适当修订 重点对儿童哮喘的临床表现特点进行了描述 明确了儿童哮喘的年龄划分（≥6岁和6岁） 根据我国儿科学定义的儿童年龄分期 与GINA等级保持一致（5 years and younger) 重视6岁哮喘高危患儿的早期识别和早期干预 新增了难治性哮喘的章节 新制定了儿童哮喘管理流程图 对特殊检查手段在诊断中的价值进行了简要阐述 更新了变应原特异性免疫治疗（AIT）相关内容 强调了儿童哮喘个体化治疗的重要性 增加了参考文献（60篇）;儿童支气管哮喘哮喘的定义 诊断和评估;新指南哮喘定义;;临床特点;6岁以下儿童喘息分型;按症状表现形式： 发作性喘息：常与上呼吸道感染相关，发作控制后症状可完全缓解，发作间歇期无症状。 多诱因性喘息：可由??种触发因素诱发，喘息发作的间歇期也有症状(如夜间睡眠过程中、运动、大笑或哭闹时)。;6岁儿童喘息特点;Darveaux JI, et al. J Allergy Clin Immunol Pract 2014;2:658-63;婴幼儿喘息及肺功能变化;哮喘的诊断;哮喘的诊断;＜６岁儿童哮喘的诊断评估;＜６岁儿童哮喘的诊断评估;哮喘预测指数Modified asthma predictive index, mAPI;哮喘预测工具Asthma Prediction Tool;哮喘预测工具Asthma prediction tool;;哮喘诊断和病情监测评估的相关检查;;哮喘诊断和病情监测评估的相关检查;19分或以下，说明哮喘控制情况不佳。;Childhood Asthma Control Test, C－ACT for children 4 to 11 years;1、During the past 4 weeks, how often was your child bothered by breathing problems, such as wheezing, coughing, or shortness of breath? Not at all once or twice once every week 2 or 3 times a week 4 or more times a week 2、During the past 4 weeks, to what extent did your child’s breathing problems,such as wheezing, cough, or shortness of breath, interfere with his or her abilityto play, go to school, or engage in usual activities that a child should be doing athis or her age? Not at all slightly moderately quite a lot extremely 3、During the past 4 weeks, how often did your child’s breathing problems (wheezing, coughing, shortness of breath) wake him or her up at night? Not at all once or twice once every week 2 or 3 times a week 4 or more times a week 4、During the past 3 months, how often did you need to treat your child’s breathing problems with rescue or quick-relief medications? Not at all once or twice once every week 2 or 3 times a week 4 or more times a week 5、During the past 12 months, how often did your child need to take oralcorticosteroids for breathing problems not controlled by other medications? Never