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J*********l
发帖数: 1185 | 1 【 以下文字转载自 MedicalCareer 讨论区 】
发信人: Jessiesgirl (喏念婆), 信区: MedicalCareer
标 题: [bssd]娃这是asthma吗？
发信站: BBS 未名空间站 (Mon Jun 17 23:36:13 2013, 美东)
娃persist ent wheezing差不多俩月了
病史如下，娃17months，有eczema，但是outgrow 了。fulltime in daycare
3月有咳嗽，流浓鼻涕。偶尔听到wheezing。和儿医提到wheezing，她说不要太容易给
娃贴标签。上抗生素10天，效果明显。
4月中搬家后，收拾院子。娃经常在边上玩。
娃开始明显wheezing，同时runny nose， cough。尤其是哭闹后明显。
5月初看儿医。当时在诊所做inhale albuterol。o2 sat 97%. 治疗前的o2 sat 没查，
娃哭闹厉害。儿医说，wheezing在albuterol 后有改善。开抗生素10天，和albuterol
液体。
10天后，runny nose 有改善。wheezing 继续。
6月初看儿医。albuterol 和 steroid inhaler。一周后，没反映。继续wheezing，周
一轻度发烧。
上周二看儿医，口服prednisone，steroid inhaler，albuterol inhaler。娃还是
wheezing。
同时cxr ，sinus xray。无异常。
这周四有appointment看儿医。
已经refer了看allergy specialist，但是人家特忙，要等。
还有哪些检查可以做呢？ | J*********l
发帖数: 1185 | | J*********l
发帖数: 1185 | 3 连接有问题。
Flexible bronchoscopy as a valuable tool in the evaluation of persistent
wheezing in children.
Erkan Cakir, Refika Hamutcu Ersu, Zeynep Seda Uyan, Sedat Oktem, Bulent
Karadag, Okan Yapar, Ozge Pamukcu, Fazilet Karakoc, Elif Dagli
Division of Pediatric Pulmonology, Marmara University, Istanbul, Turkey.
International journal of pediatric otorhinolaryngology (impact factor: 0.85)
. 10/2009; 73(12):1666-8. DOI:10.1016/j.ijporl.2009.08.016
Source: PubMed
ABSTRACT Persistent wheezing is a common problem in early childhood and
leads to a diagnostic dilemma, excessive investigations, drug administration
and additional cost.
To determine the efficacy and the safety of FOB in children with persistent
wheezing despite bronchodilator and inhaled steroid therapy.
Patients with persistent wheezing that lasted at least 6 weeks and did not
respond to bronchodilator and inhaled steroid therapy and to whom flexible
bronchoscopy was performed were included to the study.
Between 1997 and 2009; 113 patients were enrolled to the study. Sixty-three
percent of the children were male. Median age was 14 months at presentation
and median duration of symptoms was 5 months. Bronchoscopy revealed
pathological findings in 48% of the patients. Thirty-eight patients had
malacia disorders, 14 had foreign body aspiration and two had external
compression of airways which were later diagnosed as vascular ring. Major
and minor complications were not seen in 92% of the patients while transient
hypoxia was seen in 6%, stridor in 1% and tachycardia in 1% of the patients.
Flexible bronchoscopy provided rapid and definitive diagnosis for our
patients with persistent wheezing without any major complications. This
study is one of the largest studies concerning persistent wheezing. Early
bronchoscopic evaluation can reduce cost by providing rapid and accurate
diagnosis and preventing unnecessary investigations and drug administration.
Flexible bronchoscopy is a safe procedure and should be considered in the
evaluation of children with persistent wheezing. |
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