old man coughing
Introduction
Introduction It is well known that cough is a protective reflex that removes sputum, ensures a smooth airway, and is also beneficial for the removal of pathogenic microorganisms. However, severe and frequent coughing in the elderly may lead to accidents.
Cause
Cause
First, causing fatigue fracture
We know that the completion of the coughing action requires the command of the brain center and the participation of multiple muscles. In this process, the chest, abdomen and diaphragm muscles should be violently contracted, especially the respiratory muscles of the chest. They are attached to the ribs, and the ribs are pulled when contracted. Frequent frequent coughing can cause fatigue fractures of the ribs. This situation is more common in the elderly due to decreased bone density.
Second, leading to the formation of pneumothorax
When coughing, the intrapulmonary pressure and intrathoracic pressure will increase rapidly. For ordinary people, it seems that there is no danger, but patients with senile diseases such as bronchitis, tuberculosis, pneumoconiosis, emphysema, etc., due to the invasion of chronic diseases, stingy The stenosis of the tract is narrow, the resistance is increased, the alveoli are dilated, and the cough is easily broken when the cough is severe, so that the air enters the closed pleural cavity and forms a pneumothorax. In the latter, the intrathoracic pressure is further increased continuously, and the expansion of the lobes is limited. The patient may have a series of symptoms of dyspnea such as hernia and chest tightness.
Third, the intrapulmonary pressure and intrathoracic pressure caused by transient cough and sputum in the brain will also hinder venous return, reduce cardiac output, lower blood pressure, and cause loss of consciousness due to temporary ischemia of the brain. This disease also occurs in patients with chronic obstructive pulmonary diseases such as emphysema and silicosis. Of course, severe cough causes hemoptysis, nosebleeds, and even cerebral hemorrhage.
Fourth, increase the organ drooping
Abdominal muscle contraction during severe cough can also cause intra-abdominal pressure to rise. Prolonged intra-abdominal pressure will accelerate the formation of sagging organs, such as sagging of the stomach, spleen sag, prolapse of the nucleus, etc., and may also lead to the formation of hernia. For older women, urinary incontinence, uterine prolapse, etc. can occur when a severe cough occurs.
Examine
an examination
Related inspection
Tuberculin intradermal test chest radiograph
Diagnosis can be made based on clinical manifestations.
Diagnosis
Differential diagnosis
Differential diagnosis of severe cough in the elderly:
Many diseases are associated with cough symptoms, and diseases that need to be differentiated from cough variant asthma include COPD, chronic bronchitis, cough caused by gastroesophageal reflux, recurrent respiratory tract infections (RRTI), typical asthma, and postnasal drip synthesis. Disease (PNDS), endobronchial tuberculosis, and angiotensin-converting enzyme inhibitor-induced cough, which are common causes of chronic cough, and need to be carefully excluded in the diagnosis of cough variant asthma. In addition, chronic heart failure, esophageal hiatal hernia, hypertension, airway inflammation, tumors, foreign bodies, and smoke stimuli, anxiety, etc. can lead to chronic cough.
