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12岁以下儿童的哮喘：初始评估和诊断

Authors
Gregory Sawicki, MD, MPH
Kenan Haver, MD
Section Editors
Robert A Wood, MD
Gregory Redding, MD
Deputy Editor
Elizabeth TePas, MD, MS
Translators
彭东红, 副主任医师，副教授

引言

哮喘是一个全球范围的重大健康问题，且是很多国家中最常见的儿童期慢性疾病之一[1,2]。不同国家的哮喘患病率有所不同，从1%到18%不等。例如，在美国，哮喘影响了700多万儿童[3]。哮喘的确诊需要仔细进行病史采集、体格检查和诊断性检查。必须仔细考虑喘鸣的鉴别诊断，特别是对于婴儿和幼儿，因为此类患者不能检测可逆性气流受限。

儿童哮喘的初始评估和诊断将总结在此。儿童哮喘的流行病学、病理学及病理生理学；儿童哮喘严重程度的评估/控制及监测；以及儿童哮喘的治疗将单独讨论。 (参见“12岁以下儿童的哮喘：定义、流行病学和病理生理学”和“12岁以下儿童哮喘的初始治疗和监测控制”和“12岁以下儿童的哮喘：使用控制药物治疗持续哮喘”和“12岁以下儿童哮喘：急性症状的急救治疗”)

病史

疑似哮喘儿童的病史集中于是否存在症状、典型症状的形式、诱发因素或条件(即，特应性)以及哮喘的危险因素(表 1)。

对于为了疾病监测而就诊的确诊哮喘儿童，应获得的其他病史包括：既往及当前的治疗(应用哮喘控制药物和快速缓解药物)、暴露于触发因素的情况、卫生保健服务[急诊科(emergency department, ED)、医院、非计划就诊]的利用情况、学校出勤情况和学习成绩，以及参与体育活动的情况。回顾哮喘问卷调查表(例如哮喘控制测试)可能提供额外的有用信息。 (参见“12岁以下儿童哮喘的初始治疗和监测控制”，关于‘控制的评估’一节)

哮喘急性发作就诊儿童的评估将单独讨论。 (参见“儿童哮喘急性发作的急诊科治疗”)

                                  

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