發(fā)布時間：2018-07-03 00:48

  本文選題：兒童 + 慢性咳嗽　； 參考：《大連醫(yī)科大學》2012年碩士論文

【摘要】：目的了解慢性咳嗽患兒三種常見病因分布、觀察不同病因的肺功能改變，探討兒童慢性咳嗽三種常見病因不同年齡組病因分布的狀況、肺通氣功能受累及氣道可逆性阻塞的特點，為兒童慢性咳嗽三種常見病因的診斷及鑒別診斷提供一定的依據(jù)。 方法采用前瞻性、連續(xù)采樣的方法，選擇符合兒童慢性咳嗽納入標準的2009年3月至2012年2月在大連市兒童醫(yī)院慢性咳嗽門診就診的患兒，年齡在3-12歲，除外急性咳嗽、特異性咳嗽、有基礎疾病的慢性咳嗽以及根據(jù)我院目前診治條件尚不能給予明確診斷的患兒，根據(jù)不同病因的臨床特點和診斷線索，按照慢性咳嗽的診斷流程，予以輔助檢查、診斷性治療及定期隨訪，進行診斷或修正診斷，對明確診斷的CVA、RI and PIC和UACS的三組患兒，按不同年齡組分析三種常見病因的分布，用力依賴性肺通氣功能、支氣管舒張試驗的變化及比較。 結果 1.慢性咳嗽患兒三種常見病因分別為CVA、RI and PIC、UACS；100例中有105例次病因診斷明確，，單一病因95例，占95%，二重病因5例，占5%。 2.兒童慢性咳嗽患者病因分布 2.1105例次的慢性咳嗽患兒三種常見病因CVA、RI and PIC、UACS構成比依次為44%、29%、27%，以CVA組最高。 2.2不同年齡組三種常見病因的構成比不同，CVA在慢性咳嗽學齡前組與學齡組所占百分比均位于首位，RI and PIC在學齡前組高于UACS，而UACS則在學齡組居多。 3.用力依賴性肺通氣功能的改變 3.1三種常見病因肺通氣功能障礙陽性患兒的病因構成 105例次慢性咳嗽患兒肺通氣功能大致正常者52例次，占49%，通氣功能障礙者53例次，占51%；通氣功能障礙的慢性咳嗽患兒三種常見病因CVA、RI andPIC、UACS構成比依次為55%、24%、21%，以CVA患兒居多。 3.2三種常見病因肺通氣功能障礙陽性率的比較 105例次慢性咳嗽患兒中CVA組、RI and PIC組、UACS組肺通氣功能障礙陽性率依次為63.0%、43.3%和37.9%，以CVA組陽性率最高；經卡方檢驗，χ2=19.9，P＜0.001，提示三種常見病因肺通氣功能障礙陽性率存在差異，有統(tǒng)計學意義。 3.3支氣管舒張試驗陽性患兒的病因構成 78例次慢性咳嗽患兒支氣管舒張試驗陰性結果有64例次，占69.24%，陽性結果有24例次，占30.76%；支氣管舒張試驗陽性患兒的三種常見病因CVA、RI andPIC、UACS構成比依次為55%、24%、21%，以CVA最高。 3.4三種常見病因支氣管舒張試驗陽性率的比較 78例次慢性咳嗽患兒進行支氣管舒張試驗，CVA、RI and PIC、UACS氣管舒張試驗陽性率依次為53%、18%、12.5%，以CVA陽性率最高；經卡方檢驗，χ2=22.3，P＜0.001，提示三種常見病因支氣管舒張試驗陽性率存在差異，有統(tǒng)計學意義。 結論 1.3-12歲兒童慢性咳嗽的三種常見病因的構成依次為CVA、RI and PIC、UACS。 2.兒童慢性咳嗽病因構成以CVA為主；除CVA學齡前組患兒以RI and PIC居多，而學齡組以UACS居多。 3.兒童慢性咳嗽三種常見病因肺通氣功能障礙的陽性率不同，CVA、RI andPIC、UACS依次為63.0%、43.3%、37.9%，以CVA最高。 4.兒童慢性咳嗽三種常見病因支氣管舒張試驗陽性率不同，CVA、RI and PIC、UACS依次為：53%、18%、12.5%；CVA的陽性率最高，而RI and PIC、UACS的陽性率低，而陰性率較高。
[Abstract]:Objective to understand the three common causes of chronic cough in children, observe the changes in the pulmonary function of different causes, explore the distribution of the causes of the three common causes of chronic cough in children, the pulmonary ventilation function and the reversible airway obstruction, and provide the diagnosis and differential diagnosis of three common causes of chronic cough in children. The basis of the decision.
Methods a prospective, continuous sampling method was used to select children with chronic cough in Dalian children's Hospital from March 2009 to February 2012. The age was 3-12 years old, with the exception of acute coughing, specific cough, chronic cough with basic diseases, and the condition of current diagnosis and treatment in our hospital. According to the clinical characteristics and diagnostic clues of different pathogeny, according to the clinical characteristics and diagnostic clues of different causes, the diagnosis of chronic cough, diagnostic treatment and regular follow-up, diagnosis or correction, three groups of patients with clear diagnosis of CVA, RI and PIC and UACS, were used to analyze the distribution of the three common causes by different age groups. Changes and comparisons of lung function and bronchodilation test.
Result
1. the three common causes of children with chronic cough were CVA, RI and PIC, UACS, and 105 of the 100 cases were diagnosed, 95, 95%, and 5, accounting for 5%..
Etiological Distribution of 2. children with chronic cough
2.1105 cases of chronic cough children three common causes CVA, RI and PIC, UACS constituent ratio was 44%, 29%, 27%, the highest in CVA group.
2.2 the proportion of the three common causes in different age groups was different. The percentage of CVA in the preschool group and the school age group in the chronic cough was the first, and the RI and PIC was higher than the UACS in the preschool age group, while the UACS in the school age group was most.
The changes of 3. forced dependent pulmonary ventilation
3.1 etiology of three common causes of positive pulmonary ventilation dysfunction
The lung ventilation function of 105 children with chronic cough was 52 times, 49% and 51% for ventilatory dysfunction. Three common causes of chronic cough in children with ventilation dysfunction CVA, RI andPIC, and UACS constituent ratio were 55%, 24%, 21%, with the majority of children with CVA.
3.2 comparison of positive rates of three common causes of pulmonary ventilation dysfunction
In the group CVA and the RI and PIC group, the positive rate of pulmonary ventilation dysfunction in group UACS was 63%, 43.3% and 37.9% in group UACS, and the positive rate in group CVA was the highest. The positive rate of three common causes of lung ventilation dysfunction was statistically significant by chi square test, chi square and P < 0.001.
Etiology of 3.3 children with positive bronchial dilation test
The negative results of bronchial diastolic test in 78 children with chronic cough were 64 cases, accounting for 69.24%, and the positive results were 24 times, accounting for 30.76%. The three common causes of children with positive bronchial diastolic test were CVA, RI andPIC, and the UACS constituent ratio was 55%, 24%, 21%, with the highest CVA.
3.4 comparison of positive rates of three common causes of bronchodilation test
78 cases of children with chronic cough were tested for bronchodilation, CVA, RI and PIC, and the positive rate of UACS tracheal diastolic test was 53%, 18%, 12.5%, and the positive rate of CVA was the highest. By chi square test, chi square, P < 0.001, suggesting that the positive rates of bronchial diastolic test were different in three common causes, with statistical significance.
conclusion
The three common causes of chronic cough in children aged 1.3-12 were CVA, RI and PIC and UACS..
2. the etiology of chronic cough in children was mainly CVA, while in CVA preschool group, RI and PIC was the majority, while school-age group was mostly UACS.
3. there were three common causes of chronic cough in children. The positive rates of pulmonary ventilation dysfunction were different. CVA, RI andPIC and UACS were 63%, 43.3%, 37.9%, respectively, and the highest was CVA.
4. the positive rates of bronchial diastolic test in three common causes of chronic cough in children were different, CVA, RI and PIC, UACS were 53%, 18%, 12.5%, and the positive rate of CVA was the highest, while RI and PIC, UACS positive rate was low, but negative rate was higher.
【學位授予單位】：大連醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2012
【分類號】：R725.6

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