小儿慢性咳嗽诊断与鉴别诊断

慢性咳嗽是指咳嗽症状至少持续3周,以咳嗽为主要表现,胸部X线检查无明显病变。通过临床表现和相关检查可对慢性咳嗽进行诊断和鉴别诊断。引起小儿慢性咳嗽的三大病因是咳嗽变异性哮喘(CVA)、鼻窦炎及鼻后滴流综合征(PNDs)和胃食管反流(GER)性疾病,而在小儿还须注意呼吸道感染因素和先天性肺发育畸形。近年来国内外研究表明,嗜酸细胞性支气管炎(EB)亦是慢性咳嗽的重要原因。此外,还应注意支气管扩张、支气管异物、药物性咳嗽及精神性咳嗽。

Diagnosis and differential diagnosis of chronic cough in children

Chronic cough is defined as continuous cough persisted for three weeks or more.The clinical feature is chronic cough,without any significant X-ray pathologic changes.The diagnosis and differential diagnosis of chronic cough can be made with monitoring the clinical manifestations and doing some laboratory examination.Cough variant asthma,post nasal drip sydrome and gastroesophageal reflux are the three main causes of chronic cough.For children,more attention should be paid to rule out respiratory tract infection and congenital lung dysplasia.Recently,the study at home and abroad also suggested that eosinophilic bronchitis were also an important cause of chronic cough.In addition,bronchiectasis,bronchial foreign body,drug-induced cough and pasychologic cough should be considered when making diferential diagnosis.