Pediatric bronchitis
Introduction
Introduction to Pediatric Bronchitis Pediatric bronchitis refers to bronchial inflammation. Pediatric bronchiolitis mainly occurs in the small bronchi of the lungs, that is, the bronchioles. Therefore, the disease is called "bronchiolitis", usually caused by the common cold, influenza and other viruses. Complications caused by infection may also be caused by bacterial infections, which is an acute upper respiratory tract infection common in children. basic knowledge Probability ratio: 50% probability of illness in infants and young children Susceptible people: children Mode of infection: non-infectious Complications: emphysema, pulmonary heart disease
Cause
Causes of bronchitis in children
Climate (15%):
Cold is often an important cause and cause of bronchitis in children. The onset and acute exacerbation of bronchitis in children are common in the cold winter season, especially when the climate changes suddenly.
Physical and chemical factors (20%):
Such as irritating smoke, dust, air pollution (such as sulfur dioxide, nitrogen dioxide, chlorine, ozone, etc.) chronic stimulation, often one of the predisposing factors for children with bronchitis.
Infection factor (25%):
Infection is an important factor in the development of childhood bronchitis, mainly viral and bacterial infections. Rhinovirus, mucus virus, adenovirus and respiratory syncytial virus are more common.
Autonomic dysfunction (12%):
When the parasympathetic response of the respiratory tract is increased, weak stimuli that do not work for normal people can cause bronchoconstriction, increased secretions, and cough, cough, and asthma.
Allergic factors (10%):
Pediatric bronchitis patients often have a history of allergies.
Physical and chemical reactions (10%):
Inhalation of dust, irritating gases, supercooled air or sulfur dioxide, nitrogen dioxide, ammonia, chlorine and other smoke can stimulate the tracheal-bronchial mucosa.
Prevention
Pediatric bronchitis prevention
1, first of all to pay attention to the child's hot and cold, do not wear too hot, let him have a suitable cold-resistant exercise. The temperature is high, don't just think about the coldness of the child, but more importantly, always pay attention not to let the child get hot, so that the sweaty clothes are more likely to catch a cold.
2, if the child has a cold, try to give some medicine as soon as possible, do not delay the condition. Pediatric pediatrics believes that pediatric morbidity is easy and changes rapidly. After a child has a cold, taking the medicine one hour earlier and taking it one hour later, the results are completely different. Parents who have been in contact with children for a long time must learn to observe whether the child has an abnormal condition of a cold, and should promptly deal with it if there is an abnormality.
Complication
Pediatric bronchitis complications Complications emphysema pulmonary heart disease
1. Bronchial pneumonia: children may have high fever, hypoxia, dyspnea, acute respiratory failure, and even complications such as atelectasis, emphysema, empyema, pneumothorax, lung abscess, pericarditis, sepsis, etc. life.
2. Bronchiectasis: When pediatric bronchitis is not treated properly, it can be converted into chronic bronchial purulent inflammation, destroying the bronchial wall, deforming and expanding the bronchial wall, destroying the wall tissue, and losing the original natural defense ability of the bronchus. Cough efficiency and sputum function provide conditions for further infection. After a long time, the vicious circle has further expanded, and the condition has worsened and it is difficult to cure. The child may have intermittent intermittent fever, a large amount of purulent or hemoptysis. Further development can lead to pulmonary heart disease.
3. Chronic bronchitis, emphysema, pulmonary heart disease: If pediatric bronchitis can not be completely cured, repeated attacks, it will turn into chronic bronchitis, and then further develop into emphysema, pulmonary heart disease. Children can be repeatedly ill, long-term cough, sputum, wheezing, labor shortness of breath, palpitation, cyanosis, edema, long-term cure.
Symptom
Bronchitis symptoms in children Common symptoms Small bronchospasm dyspnea respiratory failure lung texture thickening sneezing
(1) Children who are more common in children under 1 year old, especially those who are under 6 months old.
(B) can occur all year round, but more common in winter and spring.
(3) The onset is more urgent, there are symptoms of early flu, such as coughing, sneezing, coughing increases after 1 to 2 days, episodes of dyspnea, wheezing, pale complexion, cyanosis of the lips, three concave signs, early wheezing of lung signs The sound is dominant, followed by a wet sound. Symptoms can be associated with congestive heart failure, respiratory failure, hypoxic encephalopathy, and water and electrolyte disorders. The general body temperature does not exceed 38.5 ° C, the course of disease is 1 to 2 weeks.
(4) The white blood cells are mostly normal or slightly increased. Blood gas analysis showed hypoxemia and a decrease or increase in arterial blood carbon dioxide partial pressure. Chest x-rays have a thickened lung texture, increased lung transparency, or small patches of shadow and atelectasis. Conditions can be used for rapid diagnosis of respiratory secretion virus to identify the type of virus.
Examine
Pediatric bronchitis examination
X-ray examination: no abnormalities in the early stage. Repeated attacks of the lesions, causing thickening of the bronchial wall, infiltration or fibrosis of bronchial or alveolar interstitial inflammatory cells, showing that the texture of the two lungs is thickened and disordered, showing a reticular or strip-like, speckled shadow, and the following lung fields are more obvious. .
Diagnosis
Diagnosis and diagnosis of bronchitis in children
clinical diagnosis
(1) Clinical manifestations
1. There are fever, aversion to cold, headache, and dry throat.
2. The main symptoms are cough and cough.
(2) Main types
1. The initial stage of acute bronchitis is dry cough, and the amount of sputum gradually increases, gradually becoming mucopurulent purulent sputum.
2. Chronic bronchitis is mainly caused by persistent cough. It is not cured for many months, and it is aggravated in the morning and evening, especially at night. The amount of sputum is more or less, so that coughing is faster. Symptoms, the shape is lighter in summer, and it is prone to acute attacks in winter, which makes the condition worse. The author of the anti-recurrence, the body is thin and weak. Can be complicated by atelectasis, emphysema, bronchiectasis and so on.
(3) Physical and chemical testing
1. The early breath sounds can be thick and thick, and the blisters can be heard on both sides.
2. X-ray examination: There is no special discovery in the acute. Chronic people may have corresponding chronic inflammatory changes.
Differential diagnosis
(1) Those with milder conditions should be identified with upper respiratory tract infections.
(B) bronchial foreign body: When there is airway obstruction with infection, its respiratory symptoms are similar to acute bronchitis, should pay attention to ask whether there is a history of respiratory foreign body inhalation, after treatment, the effect is not good, prolonged unhealed, repeated attacks. Chest X-ray showed obstruction such as atelectasis and emphysema.
(C) hilar bronchial lymph node tuberculosis: according to the history of tuberculosis exposure, tuberculin test and chest X-ray examination.
(D) bronchiolitis: more common in infants less than 6 months, there are obvious acute episodes of asthma and breathing difficulties. The body temperature is not high, the lungs are not obvious when the asthma attacks, and the fine wet rales can be heard after the relief.
(5) Bronchial pneumonia: When the symptoms of acute bronchitis are heavier, it should be differentiated from bronchial pneumonia.
