临床误诊误治2024，Vol.37Issue(7)：21-24,4.DOI:10.3969/j.issn.1002-3429.2024.07.005
儿童慢性咳嗽病因及误诊原因分析
Analysis of Etiology and Causes of Misdiagnosis of Chronic Cough in Children
摘要
Abstract
Objective To analyze the etiology of chronic cough in children and the causes of misdiagnosis of chronic cough in children.Methods A total of 53 children with misdiagnosed chronic cough admitted from January 2018 to January 2022 were selected,and the case data were analyzed.Results Of the 53 patients,32 were males and 21 were females.They were aged 7-12 years,and the course of disease was 4-28 months.There were 15 patients with allergic rhinitis and sinusitis,and 12 patients with family history of asthma.All 53 patients presented with different degrees of cough as the main complaint,including 31 patients with night irritant cough,20 patients with daytime episodic cough,and 2 patients with both daytime and night cough.There were 12 patients with discomfort under xiphoid process,burning sensation behind sternum,acid reflux and belching,and 15 patients with postnasal drip or frequent throat clearing.There was misdiagnosis of chronic bronchitis in 31 patients and chronic pharyngitis in 22 patients.Treatment was given including cough relief,phlegm reduction,and anti-infection treatment,but the symptoms did not improve significantly.In 26 patients,cough variant asthma was confirmed by pulmonary function examination,bronchial stimulation test and induced sputum examination.Fifteen patients had postnasal drip or frequent throat clearing in daily life,and had a history of allergic rhinitis and sinusitis.After nasopharyngoscopy,mu-cus attached to the posterior pharyngeal wall was found,which was confirmed as upper airway cough syndrome.In 12 patients with cough accompanied by burning sensation,acid reflux,and belching,reflux esophagitis was found by gastroscopy and gas-troesophageal reflux cough was confirmed.Misdiagnosis lasted 3 to 20 months.After diagnosis,53 cases were treated corre-spondingly with good prognosis.Conclusion The etiology of chronic cough in children is complex.Clinicians should be fa-miliar with the multi-system manifestations,etiology and diagnostic procedures of chronic cough in children,conduct detailed medical history and medication history,carefully perform physical examination,pay attention to the nature of cough,circadian rhythm of cough,and factors causing cough,carefully analyze the etiology,and conduct timely and relevant specific examina-tions,thereby making definite diagnosis and treatment early,and improving the quality of life of children.关键词
慢性咳嗽/儿童/胃食管反流性咳嗽/误诊/慢性支气管炎/慢性咽炎/病因/鉴别诊断Key words
Chronic cough/Children/Gastroesophageal reflux cough/Misdiagnosis/Chronic bronchitis/Chronic pharyngitis/Etiology/Differential diagnosis分类
临床医学引用本文复制引用
田君平,张钰,申永旺,陈欣..儿童慢性咳嗽病因及误诊原因分析[J].临床误诊误治,2024,37(7):21-24,4.基金项目
河北省2019年度医学科学研究课题(20191752) （20191752）
