以胸闷为主的儿童支气管哮喘临床分析

A analysis of the children bronchial asthma

目的 为提高儿童哮喘的确诊率 ,减少漏诊率 ,充分认识儿童不典型哮喘的临床特点和早期症状。方法 调查 114例哮喘儿童 ,男 74例 ,女 40例 ,平均年龄 8.92岁。分析其首诊时的主要症状 ,监测 PEF值 ,并随访 2 4个月。结果 其中 49例有胸闷症状 ,占 43 % ,而首诊时不伴哮鸣音者 2 1例 ,全部伴有 Ig E升高 ,呼气流量峰值(PEF)降低。经给予支气管扩张剂和抗过敏治疗 ,均明显好转。随访 2 4个月有 16例最终出现哮鸣音 ,5例始终未出现。结论 胸闷是儿童哮喘的重要症状之一 ,其特点为反复发作 ,血 Ig E升高 ,PEF值下降 ,支气管扩张试验阳性 ,如有过敏史、家族史者更应重视。

Objective To get a clear understanding of the clinical manifestation of children asthma and its early symptoms,reduce the rate of misdiagnosis,and raise high the rate of diagnose.Methods To make an observation of 114 patients of children asthma for 24 months,with an average age of 8.92.Among them,there were 74 males and 40 females.To analyze their early symptoms,and to monitor their PEF.Results Among the 114 patients,49(43%) of them sufferd from chest distress,and 21 patients did not have wheezing when thery first came to the hospital.The rising IgE and falling PEF were common phenomena for all the 114 patients,who clearly became better after the use of bronchiectasis agent and anti allergy treatment.During the 24 months observation,only 16 of the 21 finally had wheezing,and 5 did not show wheezing till the very end.Conclusions According to the analysis above,we can tell that chest distress can be regarded as one of the main symptims of children asthma and it can be ignored easily.Its main characteristics are repeated chest distress,an unnecessary wheezing,a rising IgE,a falling PEF,an allerfy history,a family history and a positive result of bronchiectasis test.A timely diagnosis and treatment can prevent the patients' condition from worsenin.