Clinical Diagnosis and Treatment Strategy of Children's Bronchial Asthma——Suggestions of Shanghai Pudong New Area / Fengxian District Expert

doi:10.12114/j.issn.1007-9572.2020.00.130

Chinese General Practice ›› 2020, Vol. 23 ›› Issue (6): 633-643.DOI: 10.12114/j.issn.1007-9572.2020.00.130

Special Issue: 儿科最新文章合辑

• Monographic Research • Next Articles

Clinical Diagnosis and Treatment Strategy of Children's Bronchial Asthma——Suggestions of Shanghai Pudong New Area / Fengxian District Expert　

1.Shanghai Children's Medical Center，Shanghai Jiao Tong University School of Medicine，Shanghai 200127，China
2.Renji Hospital，Shanghai Jiao Tong University School of Medicine，Shanghai 201112，China
3.Shanghai Oriental Hospital，Shanghai 200120，China
4.Shanghai Seventh People's Hospital，Shanghai 200137，China
5.Shanghai Pudong Hospital，Shanghai 201399，China
6.Shanghai Fengxian Hospital，Shanghai 201400，China
7.Fengcheng Hospital，Fengxian District，Shanghai 201411，China
8.Shanghai Sixth People's Hospital，Shanghai 201306，China
9.Shanghai Pudong New Area People's Hospital，Shanghai 201299，China
10.Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine，Shanghai 201203，China
11.Shanghai Fengxian District Central Hospital，Shanghai 201400，China
12.Shanghai Pudong New Area Punan Hospital，Shanghai 200125，China
13.Shanghai Pudong New Area Gongli Hospital，Shanghai 200135，China
14.Shanghai Pudong New District Zhoupu Hospital，Shanghai 201318，China
15.Beicai Community Health Service Center，Pudong New Area，Shanghai 201204，China
16.Tangqiao Community Health Service Center，Pudong New Area，Shanghai 200127，China
17.Heqing Community Health Service Center，Pudong New Area，Shanghai 201201，China
18.Jinyang Community Health Service Center，Pudong New Area，Shanghai 200136，China
19.Xidu Sub Center，Community Health Service Center，Nanqiao Town，Fengxian District，Shanghai 210401，China
20. Lianyang Community Health Service Center，Pudong New Area，Shanghai 200134，China
21.Weifang Community Health Service Center，Pudong New Area，Shanghai 200122，China
*Corresponding author：YIN Yong，Chief physician，Master supervisor；E-mail：yinyong9999@163.com
ZHAO Liebin，Chief physician，Master supervisor；E-mail：zhaoliebin@scmc.com.cn

Published:2020-02-20 Online:2020-02-20

基层儿童支气管哮喘临床诊治策略——上海市浦东新区/奉贤区专家建议（附同行评议）

1.200127上海市，上海交通大学医学院附属上海儿童医学中心　2.201112上海市，上海交通大学医学院附属仁济医院　3.200120上海市东方医院　4.200137上海市第七人民医院　5.201399上海市浦东医院　6.201400上海市奉贤区中医院　7.201411上海市奉贤区奉城医院　8.201306上海市第六人民医院　9.201299上海市浦东新区人民医院　10.201203上海市，上海中医药大学附属曙光医院　11.201400上海市奉贤区中心医院　12.200125上海市浦东新区浦南医院　13.200135上海市浦东新区公利医院　14.201318上海市浦东新区周浦医院　15.201204上海市浦东新区北蔡社区卫生服务中心　16.200127上海市浦东新区塘桥社区卫生服务中心　17.201201上海市浦东新区合庆社区卫生服务中心　18.200136上海市浦东新区金杨社区卫生服务中心　19.210401上海市奉贤区南桥镇社区卫生服务中心西渡分中心　20.200134上海市浦东新区联洋社区卫生服务中心　21.200122上海市浦东新区潍坊社区卫生服务中心
*通信作者：殷勇，主任医师，硕士生导师；E-mail：yinyong9999@163.com
赵列宾，主任医师，硕士生导师；E-mail：zhaoliebin@scmc.com.cn

基金资助:
上海市科委生物医药项目（16411955100）；上海市卫生计生委重要薄弱学科——儿科学（2016ZB0104）；上海交通大学中国医院发展研究院重点项目（CHDI-2017-A-06）；上海浦东新区卫生和计划生育委员会卫生计生科研项目（PW2017E-1）；“科技创新行动计划”生物医药领域科技支撑项目（19441909000）

Abstract

Abstract: Asthma is the most common chronic respiratory inflammatory disease in childhood.As long as we grasp the indications of acute and chronic treatment and referral，primary medical and health institutions should be the best platform for asthma prevention and treatment.This suggestions refers to the recent domestic and foreign relevant industry standards，research data and management guidelines，and publishes more specific understanding and interpretation of clinical diagnosis and treatment strategies for children's bronchial asthma，and puts forward more operational requirements and programs for clinical practice.This suggestions is divided into seven parts：early screening of children's asthma，detection of children's asthma pulmonary function，recognition of children's allergic symptoms and detection of allergens，assessment tool of asthma control based on grass-roots hospital，treatment strategy of children's asthma in grass-roots hospital，recommended scheme of children's asthma maintenance period treatment and two-way referral standard and process.Based on the treatment goal of children's asthma，the whole process of diagnosis and treatment is improved combing，focusing on the "key points"，especially according to the "treatment time axis" to develop the corresponding treatment plan，can maximize the standardization and normalization of management，in order to provide a reference for the chronic disease management in primary medical and health institutions.

Key words: Asthma, Child, Diagnosis, Therapy, Clinical diagnosis and treatment strategy, Primary medical and health institutions, Expert consensus, Early screening, Pulmonary function, Allergy, Two-way referral

摘要： 儿童支气管哮喘（简称哮喘）是儿童时期最常见的慢性呼吸道炎症性疾病，只要把握好急慢分治和转诊指征，基层医疗卫生机构应是哮喘防治的最佳平台。本建议参考近期国内外相关行业标准、研究数据及管理指南，就儿童哮喘临床诊治策略发表更加具体的认识和解读，并对临床实践提出更具操作性的要求和方案。本建议分为儿童哮喘的早期筛查、儿童哮喘肺功能检查、儿童过敏症状的识别和过敏原检查、基于基层医疗卫生机构的哮喘控制评估工具、基层医疗卫生机构儿童哮喘治疗策略、儿童哮喘维持期治疗推荐方案和双向转诊标准及流程7个部分，围绕儿童哮喘的治疗目标，对诊疗过程进行梳理，重点掌握各项“关键点”，尤其是按照“治疗时间轴”制定相应的治疗方案，能最大限度地实现管理的标准化和规范化，以期为基层医疗卫生机构慢性病管理提供参考。

关键词: 哮喘, 儿童, 诊断, 治疗, 临床诊治策略, 基层医疗卫生机构, 专家意见, 早期筛查, 肺功能, 过敏, 双向转诊

YIN Yong,LU Yanming,QIAO Jing, et al. Clinical Diagnosis and Treatment Strategy of Children's Bronchial Asthma——Suggestions of Shanghai Pudong New Area / Fengxian District Expert　[J]. Chinese General Practice, 2020, 23(6): 633-643. DOI: 10.12114/j.issn.1007-9572.2020.00.130.
殷勇,卢燕鸣,乔荆等. 基层儿童支气管哮喘临床诊治策略——上海市浦东新区/奉贤区专家建议（附同行评议）[J]. 中国全科医学, 2020, 23(6): 633-643. DOI: 10.12114/j.issn.1007-9572.2020.00.130.

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Clinical Diagnosis and Treatment Strategy of Children's Bronchial Asthma——Suggestions of Shanghai Pudong New Area / Fengxian District Expert

基层儿童支气管哮喘临床诊治策略——上海市浦东新区/奉贤区专家建议（附同行评议）

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