中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2012年
6期
607-609
,共3页
吴峰%吴海桂%吴思仿%陈必达%周五铁%林伟明
吳峰%吳海桂%吳思倣%陳必達%週五鐵%林偉明
오봉%오해계%오사방%진필체%주오철%림위명
慢性咳嗽%经验性治疗%病因导向的诊断流程
慢性咳嗽%經驗性治療%病因導嚮的診斷流程
만성해수%경험성치료%병인도향적진단류정
Chronic cough%Empirical treatment%Cause-oriented diagnostic process
目的 分析我院慢性咳嗽患者的病因分布情况,探讨便于临床应用的慢性咳嗽诊治方法.方法 按照入选标准进行初步询问病史和体格检查,按慢性咳嗽病因导向的诊断流程,在缺乏部分辅助检查或患者不配合检查时结合经验性治疗,并进行疗效及病因分析.结果 79例患者接受随访,拟诊咳嗽变异型哮喘(CVA)28例,治疗有效而确诊23例；拟诊嗜酸性粒细胞支气管炎(EB) 12例,治疗有效而确诊9例；拟诊上气道咳嗽综合征(UACS)22例,治疗有效而确诊14例；拟诊变应性咳嗽(AC)10例,治疗有效而确诊9例；拟诊胃食管相关性咳嗽( GERC)7例,治疗有效而确诊4例.79例患者治疗总有效率为74.7％ (59/79).结论 以病因导向的诊断流程和经验性治疗相结合策略诊治慢性咳嗽成功率高,并能掌握慢性咳嗽的临床特征及病因,值得临床推广.
目的 分析我院慢性咳嗽患者的病因分佈情況,探討便于臨床應用的慢性咳嗽診治方法.方法 按照入選標準進行初步詢問病史和體格檢查,按慢性咳嗽病因導嚮的診斷流程,在缺乏部分輔助檢查或患者不配閤檢查時結閤經驗性治療,併進行療效及病因分析.結果 79例患者接受隨訪,擬診咳嗽變異型哮喘(CVA)28例,治療有效而確診23例；擬診嗜痠性粒細胞支氣管炎(EB) 12例,治療有效而確診9例；擬診上氣道咳嗽綜閤徵(UACS)22例,治療有效而確診14例；擬診變應性咳嗽(AC)10例,治療有效而確診9例；擬診胃食管相關性咳嗽( GERC)7例,治療有效而確診4例.79例患者治療總有效率為74.7％ (59/79).結論 以病因導嚮的診斷流程和經驗性治療相結閤策略診治慢性咳嗽成功率高,併能掌握慢性咳嗽的臨床特徵及病因,值得臨床推廣.
목적 분석아원만성해수환자적병인분포정황,탐토편우림상응용적만성해수진치방법.방법 안조입선표준진행초보순문병사화체격검사,안만성해수병인도향적진단류정,재결핍부분보조검사혹환자불배합검사시결합경험성치료,병진행료효급병인분석.결과 79례환자접수수방,의진해수변이형효천(CVA)28례,치료유효이학진23례；의진기산성립세포지기관염(EB) 12례,치료유효이학진9례；의진상기도해수종합정(UACS)22례,치료유효이학진14례；의진변응성해수(AC)10례,치료유효이학진9례；의진위식관상관성해수( GERC)7례,치료유효이학진4례.79례환자치료총유효솔위74.7％ (59/79).결론 이병인도향적진단류정화경험성치료상결합책략진치만성해수성공솔고,병능장악만성해수적림상특정급병인,치득림상추엄.
Objective To understand the frequency distribution of causes to facilitate the diagnosis and treatment of chronic cough.Methods Patients were recruited according to the inclusion criteria:chronic cough more than 8 weeks;normal X-ray appearance;coughing symptoms as the main or only symptom.Disease history was referred and physical examination was conducted,according to the diagnosis criteria of chronic cough causeoriented processes.If laboratory examination results are missing for a patient,empirical treatment will be combined as a treatment for this patient.Finally,the curative effect and the cause of disease will be analyzed.Results Seventy-nine patients were followed up.Twenty-eight,12,22,10,and 7 patients respectively were suspected of having CVA,EB,UACS,AC and GERC,among whom,23,9,14,9 and 4 were confirmed for their diagnosis,and 84.1％,75.0％,63.6％,90.0％,and 57.1％ of them received effective targeted therapies,accounting for 29.1％,11.4％,24.1％,11.4％,and 6.3％ respectively of all patients.The overall response rate was 74.7％.Conclusion The diagnosis and treatment of chronic cough with combinational cause-oriented diagnostic process and empirical therapy produce high effective rate with low cost.In addition,it could help understand the local frequency distribution of causes of chronic cough.It may be worth wide clinical application.
