小儿慢性咳嗽176例病因的临床诊断与分析

目的：探讨小儿慢性咳嗽的病因及其特征，为临床医生对病因正确治疗提供科学依据。方法：收集2002年2月-2008年6月期间因慢性咳嗽为主诉的儿科门诊及住院的患儿176例。询问详细的病史，体格检查，相关辅助检查和治疗后的反馈诊断等进行病因诊断与临床分析。结果：本组慢性咳嗽上呼吸道炎症40例占22．8％（40／176），咳嗽变异哮喘32例占18．18％（32／176），支原体感染27例占15．34％（27／176），鼻后滴漏综合症25例占14．21％（25／176），过敏性咳嗽19例占10．80％（19／176），胃食管反流19例占10．80％（19／176），神经性咳嗽4例占2．27％（4／176），支气管异物3例占1．71％（3／176），病因未明7例占3．98％（7／176），而经过针对病因的个性化治疗，大部分患儿咳嗽症状明显减轻或消失。结论：小儿慢性咳嗽病因未明有其特点，以哮喘相关性咳嗽．上呼吸道炎症为其主因。详细地询问病史是其诊断的关键。

Clinical Diagnosis and Analysis of 176 Cases of Chronic Cough in Children

Objective： To investigate the cause of chronic cough in children and its characteristics, as the cause for clinicians to make the right treatment to provide a scientific basis. Methods： Collecting as a result of chronic cough chief of pediatric out-patient and hospitalization of children with 176 cases in a period of Feb, 2002 to June, 2008. Asked over the details of history, physical examination, examination and treatment related to post-diagnosis, such as feedback for diagnosis and clinical analysis. Results： Chronic cough, accounting for 40 cases of respiratory tract inflammation 22.8% （40/176）, 32 cases of cough variant asthma accounted for 18.18% （32/176）, 27 cases ofmycoplasma infections accounted for 15.34% （27/176）, nose Postnasal drip syndrome in 25 cases accounted for 14.21% （25/176）, 19 cases of allergic cough accounted for 10.80% （19/176）, 19 cases of gastro-esophageal reflux accounted for 10.80% （19/176）, nervous cough accounted for 4 cases 2.27% （4 / 176）, 3 cases of bronchial foreign bodies accounted for 1.71% （3 / 176）, 7 cases of unknown etiology accounted for 3.98% （7 / 176）, and after a cause for personalized treatment, most children with cough symptoms were reduced or disappeared. Conclusion： The cause of chronic cough in children has its own unknown characteristics, and related to asthma, cough, upper respiratory tract inflammation as the main reasons for its tract inflammation, so inquired in detail about their medical history is the key to diagnosis.