bronchitis
Introduction
Introduction to bronchitis Bronchitis refers to chronic, non-specific inflammation of the trachea, bronchial mucosa, and surrounding tissues. The main cause of bronchitis is the repeated infection of viruses and bacteria to form chronic non-specific inflammation of the bronchi. When the temperature drops, the small blood vessels in the respiratory tract, ischemia, and the decline of defense function are conducive to disease, chronic stimuli such as smoke dust and pollution of the atmosphere can also occur. Smoking causes bronchospasm, mucosal variation, ciliary movement, increased mucus secretion, and infection. Factors also have a certain relationship. Acute bronchitis starts faster, begins with a dry cough, and later coughs or purulent sputum. Often accompanied by swelling or pain after the sternum. Systemic symptoms such as fever are better in 3 to 5 days, but the symptoms of cough and cough often last for 2 to 3 weeks. Chronic bronchitis is characterized by long-term, repeated and progressively increased cough as a prominent symptom with cough. Cough symptoms are related to infection or not, when it is light and heavy. It can also be accompanied by wheezing and the course of the disease is delayed. basic knowledge The proportion of illness: 0.07% Susceptible people: no specific population Mode of infection: non-infectious Complications: obstructive emphysema, bronchial pneumonia, bronchiectasis
Cause
Cause of bronchitis
Infection (15%):
Repeated infection with viruses and bacteria forms chronic non-specific inflammation of the bronchi. More common are syncytial virus, parainfluenza virus, influenza virus, adenovirus, rhinovirus and Mycoplasma pneumoniae. In most cases, bacterial infections can occur concurrently with viral infections.
Climate factors (15%):
When the temperature drops suddenly, the bronchial mucosa congestion and edema, sputum obstruction and bronchial lumen stenosis can produce bronchitis symptoms such as asthma. In addition, small blood vessels in the respiratory tract, ischemia, decreased defense function, etc. are also prone to disease.
Physical and chemical factors (15%):
Chronic stimuli such as smoke dust and polluted atmosphere can also occur.
Smoking (25%):
Smoking causes bronchospasm, mucosal variability, decreased ciliary movement, and increased mucus secretion.
Allergic factors (15%):
People with allergic constitutions have a certain chance of developing bronchitis.
Prevention
Bronchitis prevention
Daily prevention of bronchitis:
1. Actively control infection: In the acute phase, follow the doctor's advice and choose effective antibiotic treatment. Commonly used drugs are: compound sulfamethoxazole, a strong toxin, erythromycin, penicillin and so on. When the treatment is ineffective, drugs that have not been used or used by the patient, such as medimycin, spiramycin, and cephalosporin, may also be selected. After the acute infection control, the antibiotics should be stopped in time to avoid side effects caused by long-term application.
2, smoking cessation: patients with chronic bronchitis not only must first quit smoking, but also to avoid passive smoking, because the chemicals in the smoke such as tar, nicotine, hydrogen cyanide, etc., can act on the autonomic nerves, causing bronchospasm, thereby increasing the respiratory tract Resistance; in addition, it can also damage the bronchial mucosal epithelial cells and their cilia, increase the secretion of bronchial mucosa, reduce the purification function of the lungs, easily cause the reproduction of pathogenic bacteria in the lungs and bronchi, leading to the occurrence of chronic bronchitis.
3. Promote sputum sputum: Patients with acute phase use antitussive and expectorant drugs while using antibacterial drugs. For patients who are frail and unable to cough, or patients with more sputum, should be based on sputum, it is not appropriate to use strong antitussives, so as not to inhibit central nervous system aggravation of respiratory tract inflammation, leading to worsening of the disease. Help critically ill patients change their position at regular intervals, gently massage the chest and back of the patient to promote the discharge of sputum.
4, maintain a good family environment, indoor air circulation is fresh, have a certain humidity, control and eliminate all kinds of harmful gases and smoke, quit smoking habits, pay attention to keep warm. The indoor air is supplemented with negative ions. The small particle size and high activity air anion can effectively enhance the ciliary movement of the tracheal mucosa epithelium, affect the activity of the respiratory enzymes in the epithelial villi, improve the secretion function of the alveoli and the ventilation and ventilation functions of the lungs, thereby effectively alleviating bronchitis.
5, strengthen physical exercise, enhance physical fitness, improve the resistance of the respiratory tract, strengthen physical exercise to improve their physical fitness, you must choose health care exercises, Tai Chi, Wu Qin Xiu and other projects according to their physical fitness, adhere to exercise, can improve the body's disease resistance, The amount of activity is based on no obvious urgency, rapid heartbeat and excessive fatigue. Patients with chronic bronchitis should exercise appropriate physical exercise during the remission period to improve the body's immunity and the ability of the heart and lungs to reserve. Of course, it is not enough to strengthen exercise alone. It is necessary to cooperate with some commonly used medical devices in China, asthma treatment, and the function of regulating and improving organs of the organs. The asthma treatment belt is a medical device with a quasi-size, based on the theory of Chinese medicine meridian acupuncture. The use of high-tech materials NdFeB magnets, acting on the human body, the two veins, the hand Taiyin lung, the hand Shaoyin heart, and the heart Yu, Feishu, Suizhong, Dazhui and other acupoints to fundamentally regulate the function of the organs. To achieve the purpose of regulating the air, promoting blood circulation, promoting lung and asthma, reducing inflammation and analgesia. Preventing upper respiratory tract infections and avoiding the inhalation of harmful substances and allergens can prevent or reduce the occurrence of this disease.
6. In the climate change and cold season, pay attention to timely add and subtract clothes to avoid catching colds and prevent influenza. Pay attention to the changes in the condition and master the law of the disease so that measures can be taken in advance. If the patient has difficulty breathing, lips, nails purple, lower limbs edema, delirium, lethargy, should be promptly sent to hospital for treatment.
Health guidance for bronchitis:
1. Actively carry out sports activities, strengthen physical exercise, and improve disease resistance. Such as carrying out cold-resistant exercises, walking or practicing Qigong, insisting on cold water baths, etc. Improve environmental sanitation, prevent air pollution, and quit smoking.
2. Prevent and treat colds in a timely manner. Because the cold is the cause of an acute attack. At the same time, radical infection of rhinitis, pharyngitis, chronic tonsillitis and other upper respiratory tract infections are important for preventing the onset of this disease. Pay attention to increase or decrease clothes, beware of invasion of external evils, pay attention to indoor air circulation, and pay attention to taking birth.
3, self-massage: take Sanli, Yingxiang, the sun, Baihui points gently press the , perennial. Pay attention to diet and diet, eat more fresh vegetables and fruits such as radish, pear, melon, watermelon, etc., to raise lungs and clear away heat. Spicy food, spicy food, and other irritating foods.
Complication
Bronchitis complications Complications obstructive emphysema bronchial pneumonia bronchodilation
1, obstructive emphysema: is the most common complication of chronic bronchitis, the patient's alveolar wall fibrous tissue diffuse hyperplasia. In addition, stenosis and sputum obstruction, poor exhalation, it can occur obstructive emphysema.
2, bronchial pneumonia: chronic bronchial inflammation spread to the lung tissue around the bronchi, patients with chills, fever, increased cough, increased sputum, and purulent. The total number of white blood cells and neutrophils increased. X-ray examination, the two lungs have spotted or small pieces of shadow.
3, bronchiectasis: recurrent chronic bronchitis, bronchial mucosa congestion, edema, ulcer formation, fibrous tissue proliferation of the wall, more or less deformation of the lumen, dilatation or stenosis. The expansion part is mostly columnar. Bronchiectasis formed after pertussis, measles or pneumonia is often columnar or saclike, and is more severe than chronic bronchitis.
Symptom
Bronchitis symptoms Common symptoms Cough, bronchial purulent secretions, increased wheezing, exhalation, difficulty, cough, wheezing, repeated infection, shortness of breath
Acute bronchitis symptoms:
Acute bronchitis starts faster, begins with a dry cough, and later coughs or purulent sputum. Often accompanied by swelling or pain after the sternum. Systemic symptoms such as fever are better in 3 to 5 days, but the symptoms of cough and cough often last for 2 to 3 weeks. Chronic bronchitis is characterized by long-term, repeated and progressively increased cough as a prominent symptom with cough. Cough symptoms are related to infection or not, when it is light and heavy. It can also be accompanied by wheezing and the course of the disease is delayed.
Chronic bronchitis symptoms :
1, cough: long-term, repeated, gradually worsening cough is the outstanding performance of this disease. The mild ones only occur in the winter and spring seasons, especially before and after getting up in the morning, and there is less cough during the day. Cough reduces or disappears during summer and autumn. In severe cases, the cough in the four seasons, the winter and spring intensified, coughing day and night, especially in the morning and evening.
2, cough: the general sputum is white mucus foam, more in the morning, often because of the sticky and not easy to pull out. Symptoms rapidly increase after infection or cold, increased sputum, increased viscosity, or yellow purulent sputum or wheezing. Occasionally because of a cough and blood in the sputum.
3, asthma: when combined with respiratory infection, due to congestion and edema of the bronchial mucosa, sputum obstruction and bronchial stenosis, can produce asthma (wheeze) symptoms. The patient's throat wheezes while breathing, and there is a wheezing sound in the lungs during auscultation. This type of wheezing is a clinical manifestation of asthmatic bronchitis; however, its seizures are not like typical bronchial asthma.
4, repeated infections: in the cold season or sudden changes in temperature, prone to repeated respiratory infections. At this time, the patient's asthma increased, the amount of sputum increased significantly and was purulent, accompanied by general malaise, chills, fever and so on. Wet sounds appear in the lungs, and blood leukocyte counts are increased. Repeated respiratory infections are particularly prone to worsening the condition of older patients and must be given full attention.
Examine
Examination of bronchitis
1, white blood cell classification count: the total number of white blood cells and the difference count in the remission period patients are more normal. The total number of white blood cells and neutrophils can be elevated during acute attack with bacterial infection. Blood eosinophils may increase in patients with asthma.
2, sputum examination: the appearance of sputum in the acute attack is mostly purulent. Smear examination showed a large number of neutrophils, and more eosinophils were seen in patients with asthma. The growth of sputum culture can be seen in Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis.
3, lung function check: forced expiratory volume in one second and forced exhalation in one second, the ratio of forced vital capacity did not change significantly in the early stage. When airflow is blocked, the ratio of forced expiratory volume (FEV 1) and FEV 1 to vital capacity (VC) or forced vital capacity (FVC) is reduced (<70%). When the small airway is blocked, the flow rate of the maximum expiratory flow rate-capacity curve at 75% and 50% lung capacity can be significantly reduced. The closed volume can be increased.
4, X-ray examination: no obvious change in the early stage. Repeated acute authors showed that the texture of the two lungs was thickened and disordered, showing a reticular or strip-like and spotted shadow, and the following lung fields were obvious. This is due to thickening of the bronchial wall, infiltration or fibrosis of bronchial or alveolar interstitial inflammatory cells.
Diagnosis
Bronchitis diagnosis and identification
Diagnostic criteria
(1) Cough, cough or wheezing, which occurs for 3 months per year for 2 consecutive years or more.
(2) The incidence is less than 3 months per year, and a clear objective examination basis (such as X-ray, respiratory function measurement, etc.) can also be diagnosed.
(3) Can exclude other heart and lung diseases (such as tuberculosis, asthma, bronchiectasis, lung cancer, heart disease, etc.).
Differential diagnosis
(1) Bronchial asthma: Wheezing chronic bronchitis should be differentiated from bronchial asthma. Asthma often occurs suddenly in childhood or youth, and generally has no history of chronic cough and cough, characterized by paroxysmal asthma. Both lungs are full of wheezing during the attack, and can be asymptomatic after remission. There is often a history of personal or family allergic diseases. Wheezing chronic bronchitis is more common in middle and old age. Cough, cough accompanied by wheezing and wheezing are the main clinical manifestations. Symptoms can be relieved after infection control, but wheezing can be heard in the lungs. Typical cases are not difficult to distinguish, but it is difficult to distinguish between asthma with chronic bronchitis and/or emphysema.
(2) Bronchiectasis: It has the characteristics of recurrent episodes of cough and cough. There are a lot of purulent sputum in the case of infection, or there are multiple and less hemoptysis history. The lungs are mainly wet mouth rales, mostly located on one side and fixed in the lower lungs, and may have clubbing fingers (toes). X-ray examination of the common lower lung texture is rough or curled. Bronchography or CT examination can be identified.
(3) tuberculosis: tuberculosis patients often have symptoms of tuberculosis or local symptoms (such as fever, fatigue, night sweats, weight loss, hemoptysis, etc.). The diagnosis can be confirmed by X-ray examination and sputum tuberculosis examination.
(4) Lung cancer: patients are often over 40 years old, especially with a history of smoking for many years, irritating cough, frequent recurrent or persistent blood stasis, or changes in the nature of chronic cough. X-ray examination can be found with blocky shadows or nodular shadows, or obstructive pneumonia, treated with antibiotics, failed to completely dissipate, should consider the possibility of lung cancer. Examination of exfoliated cells and transbronchial biopsy can generally confirm the diagnosis.
(5) Silicosis and other pneumoconiosis: a history of exposure to dust and occupational diseases. X-ray examination showed sputum nodules, enlarged hilar shadows, and increased lung texture.
