cough in children
Introduction
Introduction to pediatric cough Cough is a defensive reflex movement that prevents the inhalation of foreign bodies, prevents the accumulation of bronchial secretions, and removes secretions to prevent secondary infection of the respiratory tract. Any cause of acute and chronic inflammation of the respiratory tract can cause cough. According to the course of the disease can be divided into acute cough, subacute cough and chronic cough: 1, acute cough: refers to the course of less than 2 weeks, more common in the upper respiratory tract or lower respiratory tract infection and acute asthma attack; 2, subacute cough: refers to the course of disease More than 2 weeks and less than 4 weeks, except for respiratory infections can be seen in bacterial sinusitis and asthma; 3, chronic cough: cough symptoms lasting > 4 weeks called chronic cough. The principle of treatment of chronic cough in children is to clarify the cause and treat the cause. If the cause is unknown, empirical symptomatic treatment may be performed to achieve effective control. If the symptoms of cough are not relieved after treatment, it should be reassessed. Antitussive drugs should not be used in infants. basic knowledge The proportion of illness: 1.3% Susceptible people: children Mode of infection: non-infectious Complications: Chronic pharyngitis Acute epiglottis Diphtheria Acute laryngitis Acute bronchitis in children Chronic bronchitis Bronchiectasis Pulmonary tuberculosis Pneumonia Lung abscess Measles Pertussis Pulmonary edema
Cause
Causes of cough in children
Pathogenic microbial infection (40%):
Many pathogenic microorganisms, such as bacteria and viruses such as B. pertussis, Mycobacterium tuberculosis, respiratory infections caused by Mycoplasma pneumoniae, Chlamydia, etc., are the most common causes of chronic cough in children, and are more common in preschool children under 5 years of age. If the treatment is not timely, the spread of bacteria or viruses will cause pneumonia, the cough will continue to increase, and there will be different degrees of fever. Children with poor constitution or severe illness may have shock or death. This type of cough is irritating dry cough, or with a small amount of white sticky, and may have hoarseness, etc., and the treatment is mainly anti-infective.
Tracheal foreign body (20%):
Tracheal foreign body is a chronic cough from 1 to 3 years old. This type of cough usually manifests as paroxysmal severe cough, and there may be performances such as decreased breath sounds, wheezing, and suffocation. It may also be manifested as chronic cough with obstructive lungs. Swollen or atelectasis. Pillows can be used to support the baby's back and head with a pillow to prevent the secretion of sticky droplets from falling into the throat and causing suffocation.
Prevention
Pediatric cough prevention
1, anti-cough first sense. Preventing coughs and preventing colds is very important, so children should pay attention to exercise, improve their ability to prevent evil, and avoid exogenous feelings to prevent aggravation.
2, life should be conditioning. For children to strengthen life conditioning, diet is appropriate, to ensure sleep, the living environment should be quiet, the air should be fresh.
3. Less to public places. Try not to bring your child to a public place and less contact with coughing patients.
4. Eat pears and radishes. Appropriate consumption of pears and radishes has a certain preventive effect on cough.
5, children's hands and feet warm is a suitable sign for dressing, cold hands and feet because of less clothing, sweating on the back and neck means more clothes. Parents can add and remove clothes at any time according to the child's hands and feet, and avoid sweating and wind, and reduce the occurrence of colds.
6, to ensure that children eat three meals a day, eat less snacks, cold and sticky food. For the general fever, cough sick children to eat a delicious, light, nutritious diet; winter must give a hot diet, noodles, noodle soup is very good. Fever and sweating body fluid consumption, drink plenty of water, juice, and eat more fruits. The diet should be regular, and the vegetarian diet should be well matched to ensure the nutritional supply. Nutrition is guaranteed, the body will naturally be strong, and the resistance will be greatly enhanced.
7, the room should be clean, quiet, air circulation. The child can't sleep without having to force the child to sleep, and can sit and play. Do not take a bath when your child is sick, because bathing will make the blood circulation strong and easy to get cold again. Many children will also increase their secretions because of taking a bath. Only after a week of illness, when the child's cough is getting better, for example, just coughing in the morning, appetite, good spirits, playing, not having a fever, before going to sleep. Take a bath and sleep well, then you can wash it every other day.
Complication
Pediatric cough complications Complications Chronic pharyngitis acute epiglottis diphtheria acute laryngitis children acute bronchitis chronic bronchitis bronchiectasis tuberculosis pneumonia abscess measles pertussis pulmonary edema
First, respiratory infection
1. Bacterial or viral infections, such as acute upper respiratory tract inflammation, chronic sinusitis, chronic pharyngitis, posterior pharyngeal abscess, acute epiglottis, diphtheria, acute laryngitis, laryngotracheal bronchitis, acute bronchitis, chronic bronchitis, bronchi Expansion, tuberculosis, endobronchial tuberculosis, acute bronchiolitis, pneumonia, lung abscess, measles, whooping cough are complications of cough in children, so it should be taken seriously.
2. Mold infection: Cough in children can cause infection of Candida albicans in the respiratory tract.
3. Parasitic diseases: children with cough can be complicated by parasitic diseases, pulmonary hydatid cysts, paragonimiasis, malaria, amoeba, and worms and worms.
Second, allergic diseases
Bronchial asthma, eosinophilic pulmonary infiltration, and cough in children can be complicated by allergic diseases.
Third, pulmonary dysfunction
Pediatric cough can be complicated by pulmonary congestion, pulmonary edema, and pulmonary infarction.
Fourth, mechanical or other factors
Inhalation of smoke or other irritating gases, hypertrophy of hypertrophy, inhalation of foreign bodies in the respiratory tract, esophageal fistula, pleural effusion, mediastinal tumor, cardiac hypertrophy, pericardial effusion, diaphragmatic stimulation, spasm, vagus nerve auricle stimulation (eg otitis externa , foreign body, eczema).
Fifth, mental children cough.
Sixth, other
Pulmonary cystic fibrosis, hemorrhagic pulmonary and renal syndrome, alveolar protein accumulation, alveolar microlithiasis, pulmonary hemosiderosis, leukemia or reticuloendothelial cell lung infiltration.
Symptom
Children with cough symptoms Common symptoms Children with severe cough, chronic cough, allergic cough
Exogenous cough is caused by wind, cold, heat, dryness and other external evils. It is characterized by acute onset, short course of disease, and frequent colds; internal cough and spleen have spleen deficiency, lung deficiency and kidney deficiency. It is characterized by a slow condition, a long course of disease, and repeated attacks. Children's cough is more serious than adults. Most people will cough. Parents will go to the doctor, take medicine, and hang water when they see a little cough. The result of the medication is that the child's appetite is poor, the appetite is not good, the nutrition can't keep up, and the child's resistance is poor, so that the child is more likely to catch a cold and cough, so the child is in a vicious circle, and the child often It grows thin, looks pale, and can even cause asthma. Therefore, when the child has cough symptoms, parents should first observe the cough, see if there are complications and systemic symptoms, and then decide whether to seek medical attention immediately.
(1) Cough that needs to be taken care of quickly
1. The child suddenly coughs very badly and has difficulty breathing. There may be foreign matter blocking the trachea. Some things that are easy to be swallowed are peanuts, pencil cases, pills, buttons, coins, etc. This kind of situation is very dangerous and should go to the hospital in time.
2. High fever, cough, wheezing and difficulty breathing, need to be sent to the hospital for emergency treatment.
3. Babies are prone to bronchiolitis, a form of pneumonia. The child's face is not good, often purple, or breathing faster, shoulder breathing, plus the lower part of the chest wall when inhaling, should also be sent to the hospital for treatment.
(2) Parents can observe first, do not rush to the hospital for coughing
1. Although there is a cough and fever, but the spirit is good, mostly cold or tonsillitis.
2. Cough after a cold, fever and cough.
3. Cough, phlegm, but not fever, good spirits.
4. Only coughing occurs in the morning.
5. A mild cough during stress or after exercise.
The above five cough parents do not have to worry too much, they can relieve symptoms and treat cough by diet therapy.
Examine
Pediatric cough examination
(1) too little blood around the examination
Bacterial infections are often associated with a total number of white blood cells and neutrophils, and viral infections tend to decrease. White blood cell counts and classification of lymphocyte examinations are significantly increased, and must be accused of considering whooping cough. In patients with eosinophilia, parasitic infections or allergic diseases must be considered.
(2) Continue chronic cough patients
The doctor must routinely check the stool for normal or concentrated methods.
(3) The sputum is not checked.
(4) Pathogen examination
The ear, nose, throat swab or secretions are cultured or virus separated, and conditions can be used for immunofluorescence evaluation. Suspected pertussis can be used for cough culture. When infants and young children are suspected of tuberculosis infection, they can take gastric juice to find tuberculosis or animal inoculation.
(5) too few serological tests
If necessary, the condensation test can be done, and the complement can be combined with the test or the neutral test.
(6) Tuberculin test.
(7) X-ray impatient check
The cough persists and cannot be explained by the history or physical examination. If the recurrence or the need for further drugs to determine the nature of the lesion, the chest X-ray examination, the parasitic sinus X-ray examination, and bronchography if necessary.
(8) bronchoscopy examination
If the cause of foreign body inhalation or repeated hemoptysis is unknown, it may be unsuitable for bronchoscopy. If the cause of the cough is unclear, it is necessary to have a pneumatic puncture or lung biopsy.
Diagnosis
Diagnosis and diagnosis of cough in children
diagnosis
Because cough is a non-specific symptom of many diseases, it is necessary to ask for detailed medical history, comprehensive physical examination, chest X-ray or CT, airway responsiveness measurement, pulmonary function, electrocardiogram, fiberoptic bronchoscopy and some special cases. Check to rule out other diseases that can cause chronic, intractable cough.
Differential diagnosis
Many diseases are associated with cough symptoms, and diseases that need to be differentiated from cough variant asthma include pneumonia, bronchiolitis, upper respiratory tract infection, recurrent respiratory tract infections (RRTI), childhood asthma, cough caused by gastroesophageal reflux, Post-nasal drip syndrome (PNDS), endobronchial tuberculosis, etc., which are common causes of chronic cough, and need to be carefully excluded in the diagnosis of cough variant asthma.
