慢性孤立性咳嗽患儿50例病因和诊断程序

Causes and diagnostic procedure of 50 children with chronic solitary cough

目的探讨慢性孤立性咳嗽的病因诊断及其程序。方法从首都医科大学附属北京儿童医院2003年10月至2004年8月在门诊就诊的58例慢性咳嗽患儿中,首先筛选慢性孤立性咳嗽病例,进一步根据咳嗽特征、辅助检查、治疗反应等确定慢性孤立性咳嗽的病因。结果在58例慢性咳嗽的患儿中,筛选出慢性孤立性咳嗽50例,其中鼻后滴流综合征20例(8例慢性副鼻窦炎,6例慢性过敏性鼻炎,6例感染后鼻炎)、咳嗽变异性哮喘17例、感染后咳嗽5例、心理性咳嗽4例、原发性胃食道反流1例、嗜酸粒细胞性支气管炎2例、未明原因1例。结论儿童慢性孤立性咳嗽的病因有鼻后滴流综合征、咳嗽变异性哮喘、感染后咳嗽、心理性咳嗽等。根据咳嗽特征、辅助检查、治疗反应等能确定绝大多数慢性孤立性咳嗽的病因。

Objective To discuss the causes and diagnostic procedure of chronic solitary cough in children. Methods We chose 58 children with chronic cough who visited Beijing Children＇s Hospital Affiliated to Capital University of Medical Sciences from Oct. 2003 to Aug. 2004. Diagnostic procedures of two steps were used. Firstly, we differentiated chronic solitary cough from chronic cough. Secondly, we analysed the causes of chronic solitary cough. Results Fifty cases of chronic solitary cough were identified from 58 children with chronic cough. Among them ,20 cases had postnasal drop syndrome, 17 cough variant asthma,5 postinfection cough ,4 psychogenic cough, 1 primary gastroesophageal reflux disease,2 eosinophilic brochitis and 1 unclear cause. Conclusion The causes of chronic solitary cough in children included postnasal drop syndrome,cough variant asthma, postinfection cough, psychogenic cough and primary gastroesophageal reflux disease. Diagnostic methods of two steps can identify the causes of almost all chronic solitary cough in children.