儿童慢性上气道咳嗽综合征病因及诊断方法探讨

目的探讨儿童慢性上气道咳嗽综合征（UACS）的病因及诊断方法。方法对135例诊断为UACS患儿的病因、临床特点及对治疗反应进行分析。结果135例UACS患儿中3例失访,132例慢性上气道咳嗽综合征患儿病因明确（97.78%）,其中慢性鼻炎67例（49.63%）,鼻窦炎42例（31.11%）,变应性鼻炎22例（16.30%）,腺样体肥大7例（5.19%）,解剖结构异常所致鼻炎1例（0.74%）。主要临床特点是咳嗽135例（100%）,抠鼻孔102例（75.56%）,清喉94例（69.63%）、流涕89例（65.93%）,鼻塞或打鼾78例（57.78%）,打喷嚏71例（52.59%）、咽痒68例（50.37%）、咽部感分泌物下流或异物感63例（46.67%）,张口呼吸45例（33.33%）。治疗12周症状基本消失128例（94.81%）,显效3例（2.22%）,总有效率97.04%（131/135）。结论儿童UACS最常见的三个病因是慢性鼻炎、鼻窦炎及变应性鼻炎,咳嗽是其主要症状,通过详细询问咳嗽特点及其伴随症状,尤其是鼻部症状、检查鼻咽部,97.78%都能明确诊断,经特异积极治疗,绝大部分疗效好。

Clinical research of causes and diagnosis of chronic upper airway cough syndrome in children

Objective To discuss the causes and diagnosis of chronic upper airway cough syndrome in children.Methods Cause,clinical characteristics and therapeutic effects of 135 cases with chronic upper airway cough syndrome were analyzed.Results In 135 children with chronic upper airway cough syndrome,3 cases were out of followed,132 chronic cases cause were out of.Rhinitis,nasosinusitis,allergic rhinitis,adenoid hypertrophy,anatomic abnormalities were 67 cases（49.63%）,42 cases（31.11%）,22 cases（16.30%）,7 cases（5.19%）and 1 case（0.74%）respectively.Main characteristics and symptoms with chronic upper airway cough syndrome included cough（135 cases,100%）,pick nose（102 cases 75.56%）,hem（94 cases,69.63%）,rhinorrhea（89 cases,65.93%）,nasal congestion snore（78 cases,57.78%）,sneeze（71 cases,52.59%）,itch in pharynx（68 cases,50.37%）,secretion flowed down or felt foreign matter on pharynx（63 cases,46.67%）and breath with mouth（45 cases,33.33%）.Among the patients investigated,128 cases（94.81%）were cured in 12 weeks,3 cases（2.22%）were effective,the total effective rate was 97.04%（131/135）.Conclusion Chronic rhinitis,nasosinusitis,allergic rhinitis are common three causes of chronic upper airway cough syndrome in childhood,chronic cough is the main symptom,As high as 97.78%（132/135）children with chronic upper airway cough syndrome can be diagnosed through careful inquiring the characteristics of cough and its accompanied symptoms and examining nose-pharynx.The therapeutic effect is satisfactory on chronic upper airway cough syndrome.