儿童慢性咳嗽384例病因分析及随访.docxVIP

儿童慢性咳嗽384例病因分析及随访 　　【摘要】目的:了解儿童非特异性慢性咳嗽的病因,分析不同年龄组儿童慢性咳嗽病因特点。方法:根据中华医学会儿科分会呼吸学组与中华儿科杂志制定的《儿童慢性咳嗽诊断与治疗指南》的标准,对2009年3月至2010年6月在潍坊医学院附属人民医院儿内科门诊就诊共384例慢性咳嗽儿童,按照指南的诊断流程询问病史、体格检查、辅助检查,在初步确定病因后,针对病因进行特异性治疗,分别于初诊后半个月、1个月、3个月随访,根据治疗效果确定病因诊断,进而统计不同年龄组病因。结果:随访后384例患儿确诊病因例数及构成比由高到低依次为:呼吸道感染和感染后咳嗽180例(46.9%),cva+上气道咳嗽综合征(uacs)84例(21.9%),咳嗽变异性哮喘(cva)61例(15.8%),uacs50例(13.0%),随访结束时原因仍不明者5例(1.3%),心因性咳嗽4例(1.1%),年龄组病因:≤3岁组:呼吸道感染和感染后咳嗽72.2%(52/72);cva+uacs23.6%(17/72);3～6岁组中呼吸道感染和感染后咳嗽占53.9%,(109/202);≥6岁组各病因间差异无统计学意义(p0.05)。不同年龄组间病因构成比差异有统计学意义(p0.05)。结论:引起儿童非特异性慢性咳嗽前4位病因依次为呼吸道感染和感染后咳嗽,cva+uacs,cva,uacs,不同年龄组儿童慢性咳嗽的病因构成比不同。 　　【关键词】儿童;咳嗽 　　analysisofetiologicalagentsinchildrenwithnon-specificchroniccough:afollow-up-study 　　licuiqingduanquanji 　　【abstract】objective:toinvestigatetheetiologyofchildrenwithnon-specificchroniccoughandanalyzethecharacteristicsofetiologyduringthefollowup.methods:diagnosiscriteriaweredefinedforchildrenwithnon-specificchroniccoughthatwereformulatedbythesubspecialtygroup,societyofpediatrics,chinesemedicalassociationandchinesejournalofpediatricsin2008.totally384patientsinwhomcoughwasthemainortheonlysymptom,lasting4weeks,presentingtooutpatientclinicofpaediatricsofweifangpeople’shospitalbetweenmarch2009andjune2010wererecruitedintothisstudy.basedontheguidelines,diagnosiswasmadeaftertakinghistory,physicalexaminationandassistantexamination.afteretiologicaltreatment,thepatientswerefollowedupduringthesecondweek,thefourthweekandtwelfthweek.etiologicaldiagnosiswasconfirmedifcoughwasresolvedafterspecifictherapy.ifcoughwasnotresolved,thediagnosiswasrecheckedandanewtherapywasapplied.results:totally180(46.9%)wasdiagnosedpostinfectioncough,84(21.9%)wascvaandupperairwaycoughsyndrome(uacs),61(15.8%)patientsreceivedfinaldiagnosisofcoughvariantasthma(cva),50(13%)ofuacs.indifferentagegroups,theproportionofincidenceofetiologicalagentsisstatisticallydistinct.inthe≤3yearsoldgroup,52(72.2%)waspostinfectioncough;17patients(23.6%)werediagnosedcva+uacs;in3-6yearsgroup,