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目的评价婴幼儿用乙酰甲胆碱进行人工支气管激发试验(即通过肺部听诊判断结果)的安全性。方法对2010年1月至2013年2月在绵阳市中心医院门诊及住院部就诊的1108例慢性咳嗽婴幼儿采用乙酰甲胆碱进行支气管激发试验,观察试验中患儿呼吸、心率、动脉血氧饱和度、咳嗽情况及肺部哮鸣音等。结果婴幼儿乙酰甲胆碱人工支气管激发试验总阳性率为80.3%,激发后患儿心率、呼吸频率较激发前有所增快,氧饱和度较前有所下降,82.31%患儿无症状;17.69%的患儿有一过性症状,其中咳嗽占15.52%,喘息占1.53%,声音嘶哑占0.63%,经用沙丁胺醇后15 min内患儿呼吸、心率、氧饱和度均恢复到检查前水平,上述症状及肺部哮鸣音均消失,在激发试验中无一例患儿氧饱和度<85%、呼吸窘迫及哮喘重度以上发作。结论婴幼儿乙酰甲胆碱人工支气管激发试验是一种安全可靠简单的检查方法,在婴幼儿慢性咳嗽病因诊断中具有非常重要的作用,在不具备婴幼儿潮气肺功能设备或患儿家属不愿使用水合氯醛镇静时可考虑使用。
Objective To evaluate the safety of infants and young children using methacholine for artificial bronchial provocation test (that is, judging by the results of pulmonary auscultation). Methods From January 2010 to February 2013 in Mianyang Central Hospital outpatient and inpatient department of 1108 cases of chronic cough infants and children using methacholine bronchial provocation test to observe the test of children with breathing, heart rate, arterial oxygen Saturation, cough and lung wheeze and so on. Results The positive rate of methacholine artificial bronchial provocation in infants and young children was 80.3%. After being stimulated, the heart rate and respiratory rate of children were increased faster than those before challenge, the oxygen saturation decreased slightly compared with the former, and 82.31% of children were asymptomatic. 17.69% had transient symptoms, of which 15.52% were cough, 1.53% were wheezing, 0.63% were hoarseness, and the respiration, heart rate and oxygen saturation within 15 min after salbutamol were recovered to pre-test levels, None of the above symptoms and lung wheeze disappeared in the provocation test with oxygen saturation <85%, respiratory distress and asthma attacks. Conclusion The infant methacholine artificial bronchial provocation test is a safe, reliable and simple method of examination. It plays a very important role in the etiological diagnosis of chronic cough in infants and young children. In the absence of infantile moisture and pulmonary function equipment or the families of children unwilling Use chloral hydrate sedation can be considered.