長庚兒童過敏氣喘中心

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　網友李沅達(男生)

[ 請問我女兒是氣喘還是氣管過敏？ ] 2021/5/2 上午 05:43:06　　

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醫生好，我女兒五歲，在讀小班時因一次感冒誘發過敏咳嚴重，治療期間，有吃日舒三天，其他是症狀治療，有把病治好，感冒症狀為整天急性咳嗽，咳到無法入睡，症狀治療都無效，直到當醫師第二次看診開日舒，當下第一天吃日舒咳嗽有緩解，吃完三天有慢慢好直至咳嗽都沒咳。

之後每當感冒，咳嗽都滿嚴重，夜咳到無法入睡，症狀治療改善不大，看2、3次都是吃抗生素慢慢緩解咳嗽。期間醫院有照X光，發現肺部發炎輕微，沒有黃痰、黃鼻涕。

後面幾次感冒，醫生判斷女兒應當是氣喘（她沒有喘，每當感冒都是以嚴重咳嗽居多，沒有呼吸困難沒有喘鳴就是一直咳嗽），起初開立欣流。

但是女兒感冒都有治好，吃欣流效用好像沒有很明顯，很規律的發現，女兒若是感冒 > 嚴重咳嗽 > 抗生素 >慢慢好

前三個月有中一次疑似呼吸道融合病毒感冒，發高燒五天住院，感冒症狀都有，咳嗽最嚴重，一樣整天咳，咳到無法入睡，沒有呼吸困難、喘鳴，吃日舒3天改善不大，醫院，6小時吸一次噴霧式支氣管擴張劑，住五天才慢慢改善病情。

後面開立輔舒酮早晚二吸保養搭配欣流、勝克敏液，至今到前一週又感冒，發燒三天，一樣咳嗽嚴重，吃日舒有改善，後面咳嗽一直沒好，有開口服類固醇（必爾生）吃七天慢慢改善。

1、請問醫生，我女兒這樣是氣喘嗎？（疑問）
2、為何都是吃抗生素才有改善咳嗽，明明沒有黃痰黃鼻涕
3、以後遇到感冒，咳嗽嚴重，該如何給她緩解咳嗽？
4、保養用藥需要吃到欣流和輔舒酮、勝克敏液3種嗎？

感覺跟我認知到氣喘的病人不一樣，我弟弟有氣喘，發作時喘鳴聲很明顯，但是去醫院急診時吸支氣管擴張劑很明顯就馬上緩解，但是我女兒，每逢感冒咳嗽嚴重都束手無策那種無力感。

站長于丞亞醫師(女生)回覆 2021/10/5 上午 12:55:53

關心孩子的父母您好:
氣喘的典型症狀包含喘鳴、呼吸急促、胸悶、及咳嗽，且症狀發生的頻率及嚴重度會隨時間與情境有所變化，例如病毒感染、過敏原 (如塵蟎、花粉、蟑螂)及運動等。氣喘的診斷除了臨床症狀的觀察，在可配合指令的學童，肺功能檢查也是客觀衡量的工具之一，而喘鳴聲音的大小通常在診斷氣喘的幫助不大，建議媽媽可以與您的兒童過敏科醫生討論是否開立尖峰呼氣流速計監測臨床症狀，以及是否需安排額外的肺功能檢查。根據媽媽的描述，妹妹在急性感染過後都有咳嗽不易復原的問題，這種狀況下，氣喘是在臨床上常見的鑑別診斷之一，其他診斷包含了鼻涕倒流、慢性鼻竇炎、胃食道逆流...等，皆需配合不同的理學或影像學判讀。
氣喘急性發作可在上呼吸道感染後出現，可先嘗試吸入劑型速效支氣管擴張劑1-2下，每20分鐘給予1次，共3次，每3-4小時使用吸入劑型速效支氣管擴張劑1-2下約1-2天，並回診請兒童過敏科醫師評估藥物的調整。在氣喘保養藥物的選擇需看病童急性發作的頻率與嚴重程度決定，可記錄妹妹近期是否有半夜間及醒來時咳嗽發生頻率上升或是加重等狀況。建議可以與您的兒童過敏科醫師討論最近的發病情況，進行藥物的調整喔！

網友黃順瑜(男生)回覆

2023/9/15 下午 09:57:57

狀况和我兒子一樣，請問你怎麼處理?
可討論一下?

網友9000(不明)回覆

2024/11/2 下午 06:16:48

https://bph.poxet.tw
https://www.poxet.tw

　網友張家豪(男生)

[ 6歲童半夜驚醒疑似喘不過氣 ] 2024/9/10 上午 07:51:32　　

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小朋友有驗出過敏，有吃一陣子的勝克敏及欣流，後來狀況好轉後，就沒在吃了，但是最近晚上小朋友會驚醒，一直哭鬧，疑似喘不過氣，約3-4分鐘後就又能安然入睡。目前頻率每晚約發生一次。請問這是什麼症狀呢？

　網友8788(男生) [ https://bph.poxet.tw ] 2024/7/4 下午 10:19:52　　

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　網友Tilly(女生)

[ 夜咳 ] 2024/3/30 上午 07:56:31　　

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小孩最近晚上入睡後約11點-1點之間會咳嗽，咳嗽的時候有點痰音還會磨牙，之前看過醫生有過敏體質，平時睡前有喝勝克敏，冬天也有在吃欣流，但最近明明有些回溫了怎麼半夜還會咳嗽（有開冷氣27度），前天晚上有試過喝喘解液，那個晚上似乎就沒咳，所以這樣是不是氣管過敏還是鼻涕倒流！？
請問喘解液能像勝克敏一樣只喝睡前嗎？
喘解液喝多了會導致氣管敏感的機率增加嗎
霧化

　網友蕭蕭(女生) [ 孩子咳嗽帶痰，嚴重鼻塞 ] 2024/2/7 上午 09:11:59　　

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