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12岁以下儿童哮喘：急性症状的急救治疗

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

急救药物主要用于缓解急性哮喘症状时发生的支气管收缩，但一些药物可能还有其他作用。快速缓解药物包括：短效β受体激动剂(short-acting beta agonist, SABA)、抗胆碱能支气管扩张剂(如，异丙托溴铵)和短期使用全身性糖皮质激素。

用于12岁以下儿童快速缓解哮喘症状的药物将总结在此。以下推荐意见是根据2007年出版的美国国家哮喘教育和预防计划(National Asthma Education and Prevention Program, NAEPP)专家组的指南制定[1]，这与出版的其他主要哮喘指南类似[2,3]。

儿童急性哮喘发作的管理将会单独详细讨论。 (参见“儿童哮喘急性发作的急诊科治疗”和“儿童哮喘急性发作：住院患者处理”)

快速缓解药物的预防性使用，如在预期的触发因素(如，运动和变应原暴露)前使用SABA，也将单独详细讨论。 (参见“β受体激动剂用于哮喘：急性给药及预防性应用”，关于‘运动诱导哮喘中的应用’一节和“运动诱发的支气管收缩”和“β受体激动剂用于哮喘：急性给药及预防性应用”，关于‘预防变应原诱发的哮喘’一节)

短效β受体激动剂

诸如沙丁胺醇和左沙丁胺醇这样的短效β受体激动剂(SABA)，仍是治疗儿童哮喘的主要药物[1]。SABA可舒张气道平滑肌，使气流迅速增加。这些药物通常能够快速缓解急性哮喘症状(如，咳嗽、喘鸣、胸闷和呼吸急促)，药物起效的时间为5-15分钟，并在约50分钟开始达到峰值，作用可持续3-6小时。因此，按需使用这些药物是间歇性哮喘患者急性症状的一线治疗(图 1A和图 1B)，也是哮喘急性发作患者的一线治疗。 (参见“β受体激动剂用于哮喘：急性给药及预防性应用”和“儿童哮喘急性发作的急诊科治疗”和“儿童哮喘急性发作：住院患者处理”)

               

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Literature review current through: 2017-07 . | This topic last updated: 2016-10-28.
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