cough at night
Introduction
Introduction Cough is a common symptom of respiratory diseases and a protective reflex action of the body. With cough, the secretions or foreign bodies in the respiratory tract can be excreted. However, frequent and severe cough can affect rest and sleep, endangering health and losing its protective significance.
Cause
Cause
Cough is the main symptom of respiratory diseases, such as cough and innocence or sputum is rarely dry cough, common in the early stage of acute pharyngitis and bronchitis; acute sudden cough, more common in bronchial foreign bodies; long-term chronic cough, more common in Chronic bronchitis, tuberculosis, etc.
The adverse effect of cough is that it can spread the tracheal lesions to the adjacent small bronchi, which makes the condition worse. In addition, persistent and severe cough can affect rest, but also easy to consume physical strength, and can cause damage to the elastic tissue of the alveolar wall and induce emphysema.
Examine
an examination
Related inspection
Pulmonary function test lung imaging mycoplasma pneumoniae complement fixation test airway resistance (R) airway allergy test
First, medical history
The nature of the symptoms and cough is helpful in suggesting a diagnostic clue.
1, cough with high fever: cough with high fever call patients, consider more acute infectious diseases, acute exudative pleurisy or empyema.
2, cough with chest pain: cough with invented chest pain should consider pleural disease, or lung and other organ diseases, such as lung cancer, pneumonia and pulmonary infarction.
3, cough with cough: cough with cough and jaundice more consider bronchitis, pneumonia, etc. If cough a large number of purulent patients more consider lung abscess, bronchiectasis, secondary infection of lung cysts. If you have cough with cough and jam, you should consider lung amebiasis and paragonimiasis.
4, cough accompanied by hemoptysis: hemoptysis should consider bronchiectasis or cavitary tuberculosis, a small amount of hemoptysis or blood in the sputum to consider lung cancer, tuberculosis and so on.
Second, physical examination
First check the position of the trachea, chronic pleurisy or chronic empyema, chronic tuberculosis, atelectasis and other diseases of the trachea to the affected side, pneumothorax or a large number of pleural effusion when the trachea pushes to the healthy side, the superior vena cava syndrome prompts mediastinal swelling or Ditch tumor, supraclavicular lymph node enlargement should consider bronchial lung cancer, the occurrence of subcutaneous emphysema in the neck is often caused by tension pneumothorax or mediastinal emphysema; excessive side resuscitation on the lung side is more common in pneumothorax, excessive repercussions on both sides are more obstructive Emphysema, phlegm sounds in the upper part of the lung should pay attention to tuberculosis, turbidity in the lower part consider pleural effusion or lung consolidation, auscultation of bilateral dry voices consider chronic bronchitis, and any part of the lungs hear localized scented rales There are indications of pulmonary inflammation or cavities, and the presence of moderately moist rales in the limited lung field is considered to have the possibility of bronchial dilatation; patients with pulmonary emphysema signs who have significant heartbeat should consider the presence of pulmonary heart disease.
Third, laboratory inspection
Understanding the amount, color, smell and nature of cockroaches is diagnostic. In the sputum, bronchial tube type, lung stone, and sulfur granules were found to help pneumococcal pneumonia, tuberculosis, and pulmonary actinomycosis. Microscopic examination revealed Kusmanian spirochetes, and Xialan crystals were helpful for patients with bronchial asthma. The parasite eggs found in the sputum can be diagnosed with paragonimiasis. The head of the echinococcosis of the cysticercosis can be diagnosed with cysticercosis, and the amoebic trophozoite can be diagnosed for the diagnosis of pulmonary amebiasis. (Smear, culture, animal inoculation) is important for tuberculosis, pulmonary fungal disease, etc. It is found that cancer cells can identify the diagnosis of bronchogenic lung cancer; tuberculosis test has a certain significance for children with lymph node tuberculosis.
Fourth, other inspections
Because the lungs have a good natural contrast, ordinary X-ray films can detect most of the lung lesions, and sometimes the nature can be determined according to the location, extent and shape of the lesion, such as pneumonia, lung abscess, pulmonary cyst, tuberculosis, lung cancer. , pneumoconiosis, etc. For deep lesions, X-ray tomography was used. CT. MRI examination showed that the superiority of CT scan was that there was no image overlap in the cross-sectional image, and the lesions that could not be displayed by X-ray were found.
Bronchography can directly diagnose the location and shape of bronchiectasis, and can also be diagnosed with bronchial lung cancer. Patients with delirium should be diagnosed with barium meal examination. Bronchoscopy can diagnose endobronchial foreign bodies, endobronchial tuberculosis, and bronchial tumors; mediastinoscopy can help diagnose mediastinal tumors and detect mediastinal lymphadenopathy. Scanning is now positive in pulmonary inflammatory lesions and sarcoidosis, so it cannot be used as a means of monitoring lung cancer and pneumonia and sarcoidosis.
Diagnosis
Differential diagnosis
1. Acute cough: refers to cough within 3 weeks, which is the most common symptom in respiratory clinics. Causes include viruses, mycoplasmas or bacteria including acute bronchitis, pneumonia, respiratory infections, tuberculosis, and tracheal foreign bodies.
2, subacute cough: duration of more than 3 weeks, cough within 8 weeks is called subacute cough, the reason is more complicated.
3, chronic cough: lasts more than 8 weeks, can last for several years or even for decades. The causes of chronic cough are more complicated, including cough variant asthma (allergic bronchitis), upper respiratory cough syndrome (allergic rhino-bronchitis), gastroesophageal reflux, eosinophilic bronchitis, chronic bronchitis, etc. . Among them, cough variant asthma and upper respiratory cough syndrome are the most common.
