在儿童中喘-社区获得的肺炎联合诊断:一个范围审查
Md Mahbubur Rashid1, Shamim Ahmed2, Louisa Owens1,3
1Faculty of Medicine, School of Clinical Medicine, UNSW, Sydney, Australia.
概括
这次审查发现,胸部X射线用于诊断儿童喘和社区获得性肺炎 (CAP) 是常见的. 抗生素经常在没有证实细菌感染的情况下使用,这凸显了对标准化临床指导方针的需求.
科学领域:
- 儿科肺病学 儿科肺病学
- 传染性疾病 传染性疾病
- 基于证据的医学基于证据的医学.
背景情况:
- 在儿童中喘和社区获得性肺炎 (CAP) 的联合诊断带来了诊断和管理的挑战.
- 现有的文献显示了这种特定儿科患者群体的诊断和治疗方法的变化.
研究的目的:
- 进行关于儿童 (2-18岁) 与喘和CAP同时发生的诊断和管理的文献范围审查.
- 确定这一患者群体的临床实践中的证据缺口和差异.
主要方法:
- 使用Arksey和O'Malley框架和PRISMA扩展进行了全面的范围审查.
- 从2003年到2023年6月,在五个主要数据库 (PubMed,CINAHL,Scopus,Web of Science,Embase) 进行了文献搜索.
- 分析了12个选定的摘要,参考了既定的指南 (GINA,IMCI,PIDS/IDSA).
主要成果:
- 胸部X射线在83.3%的研究中被用于确认喘-CAP联合诊断.
- 在实验室调查和感染病因检测方面存在显著差异 (41.7%的研究).
- 75%的病例中使用了抗微生物药物,通常没有报告细菌病因 (44.4%的治疗病例).
结论:
- 胸部X射线是儿童喘-CAP联合诊断的常见诊断工具.
- 抗生素的使用经常缺乏细菌感染的实验室确认,这表明潜在的过度使用.
- 需要标准化临床实践指南,以提高护理的一致性,减少管理儿科喘-CAP联合诊断的变化.
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