重庆医科大学：《儿科学》课程教学资源（PPT课件）Respiratory Disorders

Respiratory Disorders Dr enmei lju Division of respiratory diseases Children's Hospital CUMS

Respiratory Disorders Dr Enmei Liu Division of Respiratory Diseases Children’s Hospital CUMS

Respiratory disorders are important as They account for 50% of consultations with general practitioners for acute illness in young children and one- third of consultations in older children Respiratory illness leads to 20-35% of acute paediatric admissions to hospital a They are the fifth most common cause of death in children ages between one and 14 years in the uK Asthma is the most common chronic illness of childhood in the UK and the most frequent single cause for emergency hospital admission Cystic fibrosis is the most common lethal inherited disorder in Caucasians

Respiratory disorders are important as ◼ They account for 50% of consultations with general practitioners for acute illness in young children and one-third of consultations in older children ◼ Respiratory illness leads to 20-35% of acute paediatric admissions to hospital ◼ They are the fifth most common cause of death in children ages between one and 14 years in the UK ◼ Asthma is the most common chronic illness of childhood in the UK and the most frequent single cause for emergency hospital admission ◼ Cystic fibrosis is the most common lethal inherited disorder in Caucasians

Respiratory infections most frequent infections of childhood The pre-school child has on average 6-8 respiratory infections a year. Most are mild, self-limiting illness but some such as bronchiolitis or epiglottitis, are potentially life-threatening

Respiratory infections ◼ most frequent infections of childhood. ◼ The pre-school child has on average 6-8 respiratory infections a year. ◼ Most are mild, self-limiting illness but some, such as bronchiolitis or epiglottitis, are potentially life-threatening

Pathogens Viruses: cause 80-90%/ of childhood respiratory infections. The most important are the respiratory syncycial virus(rsv, rhinoviruses, parainfluenza influenza and adenovirus, an individual virus can cause several different patterns of illness, e.g. RSV can cause bronchiolitis, croup, pneumonia or a common cold. The important bacterial respiratory pathogens are Streptococcus pneumoniae and other streptococci Haemophilus infiuenzae bordetella pertussis which cause whooping cough, and mycoplasma pneumoniae. Mycobacterium tuberculosis remains an important pathogen. Some pathogens cause predictable epidemics, such as RSV bronchiolitis every winter, whereas others, e.g. pneumococcus, show little seasonal variation

Pathogens ◼ Viruses: cause 80-90% of childhood respiratory infections. The most important are the respiratory syncycial virus (RSV), rhinoviruses, parainfluenza, influenza and adenovirus. An individual virus can cause several different patterns of illness, e.g. RSV can cause bronchiolitis, croup, pneumonia or a common cold. ◼ The important bacterial respiratory pathogens are Streptococcus pneumoniae and other streptococci, Haemophilus influenzae, Bordetella pertussis which cause whooping cough, and mycoplasma pneumoniae. Mycobacterium tuberculosis remains an important pathogen. Some pathogens cause predictable epidemics, such as RSV bronchiolitis every winter, whereas others, e.g. pneumococcus, show little seasonal variation

Host and environmental factors Poor socio-economic status(such as overcrowded damp housing and poor nutrition) arger family size ■ Maternal smoking Boys more than girls Prematurity-especially infants who have required artificial ventilation Congenital abnormalities of the heart or lungs Rarely, immune deficiency either congenital e.g. agammaglobulinaemia, or acquired, e. g. malignant disease or hiv infection

Host and environmental factors ◼ Poor socio-economic status (such as overcrowded, damp housing and poor nutrition) ◼ Larger family size ◼ Maternal smoking ◼ Boys more than girls ◼ Prematurity-especially infants who have required artificial ventilation ◼ Congenital abnormalities of the heart or lungs ◼ Rarely, immune deficiency, either congenital, e.g.agmmaglobulinaemia, or acquired, e.g. malignant disease or HIV infection

The childs age The child s age influences the prevalence and severity of infections It is in infancy that serious respiratory ilIness requiring hospital admission is the most common and the risk of death is great There is an increased frequency of infections when the child or older siblings start nursery or school. Repeated upper respiratory tract infections are rarely an indication of underlying disease

The child’s age ◼ The child’s age influences the prevalence and severity of infections. ◼ It is in infancy that serious respiratory illness requiring hospital admission is the most common and the risk of death is great. ◼ There is an increased frequency of infections when the child or older siblings start nursery or school. Repeated upper respiratory tract infections are rarely an indication of underlying disease

Classification of respiratory Infections Upper respiratory tract infection a Laryngeal/tracheal infection Bronchitis Brochiolitis a Pneumonia

Classification of respiratory infections ◼ Upper respiratory tract infection ◼ Laryngeal/tracheal infection ◼ Bronchitis ◼ Brochiolitis ◼ Pneumonia

Upper respiratory tract infection (URTI 80%of respiratory infections involve only the nose, throat ears and sinuses a The term urti embraces a number of different conditions common cold(coryza) sore throat(pharyngitis including tonsillitis) a acute otitis media a sinusitis

Upper respiratory tract infection (URTI) ◼ 80% of respiratory infections involve only the nose, throat, ears and sinuses ◼ The term URTI embraces a number of different conditions: ◼ common cold (coryza) ◼ sore throat (pharyngitis, including tonsillitis) ◼ acute otitis media ◼ sinusitis

Clinical presentation The most common presentation is a child with a combination of a painful throat, fever, nasal blockage and discharge and earache Cough is troublesome in many cases

Clinical Presentation ◼ The most common presentation is a child with a combination of a painful throat, fever, nasal blockage and discharge and earache. ◼ Cough is troublesome in many cases

URTIs may cause Difficulty in feeding in infants as their noses are blocked and this obstructs breathing Febrile convulsions Precipitation of acute asthma In infants hospital admission may be required exclude a more serious infection

URTIs may cause ◼ Difficulty in feeding in infants as their noses are blocked and this obstructs breathing ◼ Febrile convulsions ◼ Precipitation of acute asthma ◼ In infants, hospital admission may be required exclude a more serious infection