摘要
目的调查分析上海市综合医院慢性咳嗽儿童诊治及生活质量现况。方法选取2019年1月—2019年12月,在上海市三家综合医院就诊的758例慢性咳嗽患儿进行病因诊断,定期随访并根据病情变化修正诊断。通过莱塞斯特咳嗽量表(LCQ)和自制问卷调查慢性咳嗽儿童生活质量现况。结果各病因不同年龄段患儿的诊断修正率不同,学龄前儿童呼吸道感染后咳嗽的诊断修正率最高(38.0%)。用药方面首诊以白三烯受体拮抗剂、抗组胺药、抗生素等3-4种药物联合治疗最多见,后期减少至1-2种药物;抗生素的使用,在四种病因中的分布不同,差异均有统计学意义(χ^(2)=42.486,P<0.05;χ2=34.315,P<0.05;χ^(2)=24.774,P<0.05;χ^(2)=8.722,P<0.05)。慢性咳嗽儿童的生活质量普遍下降,无论是LCQ量表还是自制问卷均显示,上气道咳嗽综合征合并咳嗽变异性哮喘对生活质量影响最大。结论定期随访、反复评估在慢性咳嗽的诊治过程中至关重要,注重和家长沟通解释病情,缓解焦虑情绪,避免过度用药。
Objective To investigate and analyze the current status of diagnosis and treatment and quality of life in children with chronic cough in Shanghai comprehensive hospitals.Methods From January 2019 to December 2019,758 children with chronic cough who were treated in three comprehensive hospitals in Shanghai were selected for etiological diagnosis,followed up regularly and the diagnosis was revised according to changes in the condition.The current quality-life of children with chronic cough was investigated through the Leicester Cough Scale(LCQ)and a self-made questionnaire.Results The diagnosis correction rate of children in different age groups was different for each etiology,and the diagnosis correction rate of cough after respiratory infection in preschool children was the highest(38.0%).In terms of medication,the first diagnosis was with leukotriene receptor antagonists,antihistamines,antibiotics and other 3-4 drug combination treatments,and the latter was reduced to 1-2 drugs.The distribution of antibiotics in the four causes was different,and the difference was statistically significant(χ^(2)=42.486,P<0.05;χ2=34.315,P<0.05;χ^(2)=24.774,P<0.05;χ^(2)=8.722,P<0.05).The quality of life of children with chronic cough generally declined.Both the LCQ scale and the self-made questionnaire showed that upper airway cough syndrome combined with cough variant asthma had the greatest impact on quality life.Conclusion Regular follow-up and repeated evaluation are essential in the diagnosis and treatment of chronic cough.It is important to communicate with parents to explain the condition,relieve anxiety,and avoid excessive medication.
作者
沈华琴
张皓
吴志敏
李恒涛
张妍涵
丁丽凤
盛秋明
SHEN Hua-qin;ZHANG Hao;WU Zhi-min;LI Heng-tao;ZHANG Yan-han;DING Li-feng;SHENG Qiu-ming(Zhoupu Hospital Affiliated to Shanghai Healthy Medical College,Shanghai 201318,China;Shanghai Children Medical Center Affiliated to Medical College of Shanghai Jiaotong University,Shanghai 200127,China;East Branch of the Sixth People’s Hospital Affiliated to Shanghai Healthy Medical College,Shanghai 201306,China;Fengcheng Hospital of Shanghai Fengxian District,Shanghai 201411,China)
出处
《临床肺科杂志》
2021年第10期1486-1490,1496,共6页
Journal of Clinical Pulmonary Medicine
基金
上海市医学引导类(中、西医)科技支撑项目(No.19401931800)
上海市卫生健康委员会中西医结合专项(No.ZHYY-ZXYJHZX-202022)
上海市浦东新区卫生健康委员会卫生科技项目(No.PW2019A-36)。
关键词
咳嗽
儿童
治疗
生活质量
cough
children
treatment
quality of life
