儿童细菌性气管炎：治疗和预防
- Author
- Charles R Woods, MD, MS
Charles R Woods, MD, MS
- Professor of Pediatrics
- University of Louisville School of Medicine
- Section Editors
- Glenn C Isaacson, MD, FAAP
Glenn C Isaacson, MD, FAAP
- Section Editor — Pediatric Otolaryngology
- Professor, Departments of Otolaryngology, Head and Neck Surgery and Pediatrics
- Lewis Katz School of Medicine at Temple University
- Sheldon L Kaplan, MD
Sheldon L Kaplan, MD
- Editor-in-Chief — Pediatrics
- Section Editor — Pediatric Infectious Diseases
- Professor and Vice Chairman for Clinical Affairs
- Baylor College of Medicine
- Deputy Editor
- Carrie Armsby, MD, MPH
Carrie Armsby, MD, MPH
- Senior Deputy Editor — UpToDate
- Deputy Editor — Pediatrics
- University of Massachusetts School of Medicine
- Translators
- 乔晓红, 副主任医师
乔晓红, 副主任医师
- 上海市同济医院儿科
引言
本专题将总结儿童细菌性气管炎的治疗和预防。儿童细菌性气管炎的临床特征和诊断，以及儿童气管造口导管和气管插管相关的气管感染将单独讨论。 (参见“儿童细菌性气管炎的临床特征及诊断”和“儿童气管造口导管和气管插管相关的气管支气管炎”)
定义
细菌性气管炎是气管软组织的一种侵袭性、渗出性细菌感染[1]。描述这一疾病的其他术语包括：“细菌性哮吼”、“膜性哮吼”、“假膜性哮吼”、“急性喉气管支气管炎”和“膜性喉气管支气管炎”[2]。 (参见“儿童细菌性气管炎的临床特征及诊断”，关于‘术语’一节)
治疗概述
细菌性气管炎治疗的基础是气道维持、液体复苏(需要时)，以及给予适当的抗生素。一些儿童需要通过内镜对气道进行急诊或尽快评估。这一操作一般最好是在手术室、重症监护病房或相当条件设施的环境中进行[3]。 (参见“儿童细菌性气管炎的临床特征及诊断”，关于‘内镜’一节和“儿童急性上气道阻塞的紧急评估”)
一般来说，对于细菌性气管炎患儿，即使不需要气管插管，也应收入儿科重症监护病房，以便能够监测其潜在的疾病进展。已报道有少数患者在未入住重症监护病房的情况下获得了成功的治疗(一项大型病例系列研究中这一比例约为10%)[3]。
气道管理
概述 — 气道维持是细菌性气管炎治疗的主要部分。初始气道管理是根据临床评估确定的呼吸窘迫程度进行的。对于具有完全或几近完全气道阻塞征象的患者，气道控制应该在诊断性评估之前进行。
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