儿童慢性气道炎症相关性疾病缓解期治疗与康复管理专家共识

doi:10.12372/jcp.2022.22e1089

摘要/Abstract

中华医学会儿科学分会儿科呼吸学组中国医师协会儿科医师分会儿童呼吸学组. 儿童慢性气道炎症相关性疾病缓解期治疗与康复管理专家共识[J]. 临床儿科杂志, 2022, 40(10): 770-781.

. Expert consensus on the treatment and rehabilitation management of chronic airway inflammation-related diseases in children[J]. Journal of Clinical Pediatrics, 2022, 40(10): 770-781.

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参考文献 89

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分类	代表药物	作用机制	应用范围
糖皮质激素	ICS：布地奈德（BUD）、二丙酸倍氯米松（BDP）、丙酸氟替卡松（FP）	抑制炎症递质、细胞因子释放及调节机体免疫,发挥抗炎作用^[9]	哮喘、CVA、NAEB、AC、BO
	口服糖皮质激素（oral corticosteroids,OCS）：泼尼松、甲基泼尼松龙		哮喘重度持续、BO
	鼻喷糖皮质激素：莫米松、BUD和FP鼻喷剂		AR
ICS-LABA	布地奈德-福莫特罗、氟替卡松-沙美特罗	协同抗炎、平喘^[4]	哮喘、CVA
LTRA	孟鲁司特钠	竞争性结合半胱氨酰白三烯受体、阻断半胱氨酰白三烯的活性^[10]	哮喘、CVA、AR、BO
抗组胺药	氯雷他定、西替利嗪	抑制组胺释放以减少血管渗出和组织水肿	AR、AC
抗胆碱能药	噻托溴铵、异丙托溴铵	舒张支气管^[11]	哮喘
祛痰类药物	N-乙酰半胱氨酸、氨溴素	增强气道纤毛运动、分解痰液中的黏性成分、减少痰液黏性等^[12]	痰液黏稠、分泌异常、排痰功能欠佳者
大环内酯类抗菌药物	阿奇霉素、红霉素	抑制中性粒细胞及巨噬细胞的功能与活性,减少其在气道的聚集^[13]	BO

分类	具体评估内容
病史评估	现病史、既往史、共患病等
检查评估	血常规和生化指标、FeNO、心电图、影像学、电子支气管镜等
功能评估	肺功能、咳嗽峰流速、最大吸气压（maximal inspiratory pressure,MIP）、最大呼气压（maximal expiratory pressure,MEP）、跨膈压、膈肌超声、心肺功能试验、6 min步行试验、徒手肌力检查、等长测力计、等张肌力检查、吞咽功能评估
问卷评估^{[86⇓⇓-89]}	视觉模拟评分（visual analogue scale,VAS）¹⁾、咳嗽特异性生活质量问卷（cough specific quality of life questionnaire,CQLQ）²⁾、莱斯特咳嗽问卷（leicester cough questionnaire,LCQ）³⁾、Borg量表⁴⁾、发育和健康状况评定量表(青少儿版)(development and well being assessment,DAWBA)⁵⁾、匹兹堡睡眠质量指数量表（Pittsburgh sleep quality index,PSQI）⁶⁾、儿童营养风险筛查工具（screening toolfor risk on nutritional status and growth,STRONGkid）⁷⁾

疾病	营养管理	运动康复	呼吸训练	健康教育	心理干预	自我管理	学校管理	物理康复治疗
疾病	营养管理	运动康复	呼吸训练	健康教育	心理干预	自我管理	学校管理	手法排痰	ACBT
哮喘	++	++	++	++	++	++	++	+	+
CVA	+	++	+	++	++	++	++	-	+
AR	+	+	+	++	++	++	++	-	-
PIBO	++	++	++	++	++	++	++	++	++
NAEB	+	+	+	++	++	++	++	+	+
AC	++	+	+	++	++	++	++	-	-

儿童慢性气道炎症相关性疾病缓解期治疗与康复管理专家共识

Expert consensus on the treatment and rehabilitation management of chronic airway inflammation-related diseases in children

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