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目的探讨儿童难治性哮喘的病因、治疗与转归。方法回顾性分析106例难治性哮喘患儿的临床资料。结果91例确诊为支气管哮喘(85.8%),15例为其他因素引起的反复咳喘(14.2%)。难治性哮喘的病因分别是依从性差(16.5%)、吸入技术不正确(17.6%)、并存的疾病未得到重视和治疗(41.8%)、不良环境刺激和过敏原因素(13.2%)、反复呼吸道感染(7.7%),与运动、服用阿斯匹林、情绪低落有关各1例。根据病因采取针对性治疗后85例(93.4%)患儿得到控制。结论哮喘并存过敏性鼻炎、鼻窦炎、腺样体炎以及依从性差、吸入技术不正确是导致儿童难治性哮喘的主要原因,装修房屋致室内环境污染、饲养宠物已成为新的元凶。
Objective To investigate the etiology, treatment and prognosis of refractory asthma in children. Methods The clinical data of 106 children with refractory asthma were retrospectively analyzed. Results 91 cases were diagnosed as bronchial asthma (85.8%), 15 cases of other factors caused by repeated cough (14.2%). The causes of refractory asthma were poor compliance (16.5%), improper inhalation technique (17.6%), coexisting diseases without attention and treatment (41.8%), adverse environmental stimuli and allergen factors (13.2%), repeated Respiratory infections (7.7%), with exercise, taking aspirin, depression in 1 case. Eighty-five (93.4%) children were controlled according to the cause of targeted therapy. Conclusions The coexistence of allergic rhinitis, sinusitis and adenoiditis in asthma, poor compliance and inhalation technique are the main causes of intractable asthma in children. Renovation of houses causes indoor environmental pollution and keeping pets has become the new culprit.