Çocuklarda Kronik Öksürüğe Yaklaşım

Abstract

Öksürük çocuklarda çok sık rastlanan bir yakınma olup, ailelerde ciddi anksiyeteye neden olabilmektedir. Özellikle kış aylarında hekimlere başvuru sebeplerinin büyük bir kısmını öksürük şikâyeti oluşturmaktadır. Öksürüğün basit bir üst solunum yolu enfeksiyonundan acil cerrahi girişim gerektiren yabancı cisim aspirasyonuna kadar pek çok nedeni vardır. Kronik öksürük, ACCP (American College of Chest Physicians) kılavuzuna göre 4 haftadan; BTS (British Thoracic Society) kılavuzuna göre 8 haftadan uzun süren inatçı ve aralıksız öksürük olarak tanımlanmıştır. Kronik öksürüğe yaklaşımda hastadan alınacak ayrıntılı bir öykü ve hastaya yapılacak sistemsel bir fizik muayene tanının temel taşıdır. Tüm hastalar akciğer grafisi ve yapılabiliyorsa solunum fonksiyon testi ile değerlendirilmeli, bunlara göre spesifik bulguların varlığında nedene yönelik tetkik ve tedavi planlanmalıdır. Spesifik bir neden bulunamadığında ise dikkatli izlem ve periyodik değerlendirme ile takip edilmesi güncel önerilerdir. Bu derlemede kronik öksürüklü çocuklara yaklaşım güncel bilgiler ışığında özetlenmiştir.

Keywords

• çocuk
• kronik öksürük
• öksürük
• tanısal yaklaşım

Approach to Chronic Cough in Children

Abstract

Cough is a very common complaint in children and can cause serious anxiety in families. Especially in the winter months, cough is a major reason for visits to physicians. There are many causes of cough, ranging from a simple upper respiratory tract infection to foreign body aspiration requiring emergency surgical intervention. Chronic cough is defined as a persistent and unremitting cough lasting longer than 4 weeks according to the ACCP (American College of Chest Physicians) guidelines and longer than 8 weeks according to the BTS (British Thoracic Society) guidelines. In the approach to chronic cough, a detailed history and a systematic physical examination are the cornerstones of the diagnosis. All patients should be evaluated with chest radiography and pulmonary function test if available, and in the presence of specific findings, investigations and treatment should be planned for the cause. In the absence of a specific cause, careful follow up and periodic evaluation are the current recommendations. This review summarizes the approach to children with chronic cough in light of current knowledge.

Keywords

• children
• chronic cough
• cough
• diagnostic algorithm

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