crepitus
Introduction
Introduction pronunciation: a very fine and uniform voice. Similar to the sound produced when a bunch of hair is twisted around the ear. It is characterized by short sound, finely divided, intermittent, equal and uniform. This is because the alveoli are infected and there is exudate, and the alveoli are glued together, but not completely. When the inhalation, the adhered alveoli are suddenly spread by the gas, or the bronchiole mucosa is swollen and adhered by the sticky secretions. When the inhalation, the adhered parts are separated again, and the special cracking sound produced is the squeaking sound. It usually appears at the end of inhalation, or at the apex of inspiration. The part where pronunciation often occurs is the posterior lower part of the lung.
Cause
Cause
The pronunciation of sputum often indicates the pathological changes of the lung parenchyma, such as alveolar inflammation, which is seen in the hyperemia and dissipative phases of pulmonary lobar pneumonia and tuberculosis. The initial stage of pulmonary congestion and pulmonary edema. The lungs are inflated, but the alveoli are not completely blocked. In addition, it is also seen in bronchiolitis.
When subcutaneous emphysema can also smell sputum, palpation can touch the sensation of hair, which is a characteristic sign of subcutaneous emphysema.
In the case of gas gangrene, there is a snoring sound in the skin around the wound, which is one of the signs of gas gangrene.
The pronunciation of can be seen in a variety of situations, and the specific meaning needs to be combined with clinical comprehensive judgment.
Examine
an examination
Related inspection
Pulmonary function test lung examination lung and pleural percussion
The diagnosis is mainly based on clinical manifestations, wound secretion examination and X-ray examination. For example, after injury or surgery, the wound has unusual pain, local swelling is rapidly increased, the skin around the wound is sputum, and there are severe symptoms of systemic poisoning such as pulse. Accelerated, irritated and progressive anemia, that is, the possibility of gas gangrene should be considered. There are a large number of Gram-positive bacilli in the smears of the secretions in the wound. X-ray examination of gas between the wound muscles is the three important basis for the diagnosis of gas gangrene. Anaerobic bacterial culture and pathological biopsy can confirm the diagnosis, but it takes a certain time, so you can not wait for the results, so as not to delay treatment.
Diagnosis
Differential diagnosis
Identification of gas gangrene
1. Bacillus cellulitis: The infection is confined to the subcutaneous cellulite and spreads rapidly along the fascia gap, but does not invade the muscle. Generally, the onset is slow, and the incubation period is 3 to 5 days. Although it also begins with wound pain, there are also sputum sounds around the wound, but local pain and systemic symptoms are mild, skin is rarely discolored, and edema is very light.
2. Anaerobic streptococcal cellulitis: The onset is slow, and symptoms usually appear 3 days after injury. Toxemia, pain, local swelling and skin changes are mild. There are emphysema and sputum sounds, but emphysema is limited to subcutaneous tissue and fascia. There is general inflammatory performance around the wound. The exudate was serous and the smear was checked for streptococci.
3. Escherichia coli cellulitis: interstitial emphysema can occur, and there are symptoms of toxic blood such as high fever and phlegm. However, local swelling develops slowly, and the pus has the characteristic of pus infected by E. coli, that is, the pus is thin and serous. A pus smear test can be found in Gram-negative bacilli.
