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儿童喘鸣的评估

Authors
Diana R Quintero, MD
Khoulood Fakhoury, MD
Section Editor
Gregory Redding, MD
Deputy Editor
Alison G Hoppin, MD
Translators
罗征秀, 副主任医师，副教授

引言

追溯词源，英语名词性单词“喘鸣(stridor)”来源于拉丁语动词“stridere”，意思是发出刺耳或尖锐(嘎吱嘎吱)的声音。相称地，如今喘鸣一词的主要用法之一是指呼吸时发出的一个高调的、单声道声音，这种声音的最佳闻及部位是颈前区。喘鸣的这些特点使它和典型的(复调)哮鸣音区分开来。

喘鸣是因狭窄气道的气流振荡所致，它的出现提示大气道严重堵塞。喘鸣发声可用伯努利定律解释，即随着气流速度增加，气流内压力下降。在一个装置中，当气流被迫通过狭窄的管道时，局部区域的低压对狭窄的远端产生真空效应。狭窄气道远端局部低压引起气道壁塌陷和振动，从而产生喘鸣的特征性吱吱声[1-5]。

喘鸣是儿科人群中经常遇到的主诉症状，是需要立即对其进行评估的一个重要体格检查发现。喘鸣的病理生理学、鉴别诊断和临床治疗将总结在此。其他常见主诉呼吸道症状，包括哮鸣音和咳嗽，同急性上呼吸道梗阻的紧急评估和治疗一样，参见其他专题。 (参见“婴儿和儿童喘鸣的评估方法”和“儿童慢性咳嗽的诊疗方法”和“儿童急性上气道阻塞的紧急评估”)

解剖学和病因学

解剖学上，上呼吸道可分两个区域，胸腔外和胸腔内：

胸腔外部分 — 此区域包括胸廓入口以上的气道，而这部分气道分为两个解剖区域：

                    

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Literature review current through: 2017-07 . | This topic last updated: 2017-02-10.
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