10.09.2020

Acute bronchitis clinic. Acute bronchitis. Options for the flow of acute bronchitis


Bronchitis is the disease of the respiratory tract, characterized by an inflammatory process in the mucous membrane of the bronchi.

The classification is produced by various criteria.

For the flow of form:

  1. (The disease usually lasts 2-3 weeks, after which the recovery comes).
  2. (This form characterizes acute bronchitis, which proceeds more than 3 weeks).
  3. (The diagnosis is set, if the patient has a sign of bronchitis for 2 years of observation for at least 3 months per year).
  4. The recurrent (criterion of diagnosis is such: during the year at least 2 infectious inflammatory lesions of the bronchial tree are diagnosed).

On the independence of the development of bronchitis are primary and secondary:

  • The primary disease is a state in which any pathological factor initially acts on the mucous membrane of the bronchial tree, causing its inflammation. That is, primary bronchitis is an independent pathological process that begins in bronchi and is limited to them. This option is found in clinical practice extremely rare.
  • The secondary damage to the bronchi is a manifestation or complication of another disease occurring in the respiratory tract (for example, flu, cough) or in other organs and organism systems. Secondary bronchitis against the background of other diseases of the respiratory tract - this is the pathology, which is most often found in the practice of a doctor.

The causes of inflammation are:

  1. Infection.
  2. Allergy.
  3. Physico-chemical factors (for example, inhalation of air, which contains annoying chemical compounds).

Important! Usually the damage to the bronchial tree is caused by the effects of viruses. Among them are the most common influenza viruses, adenoviruses, respiratory syncytial virus, rhinoviruses.

A bacterial or fungal agent can join viral infection as the process. Much less often, bacteria or mushrooms act as the root cause of bronchitis. Sometimes chlamydia and mycoplasma becomes causative agents.

Physical, chemical, allergic agents act as independent reasons or factors predisposing to the accession of infection.

According to the presence of signs of narrowing the lumen of the bronchi, obstructive and unstructive bronchitis is distinguished.

In terms of lesion, bronchitis happens:

  • proximal (the base of the bronchial tree is affected);
  • distal (inflammation proceeds in bronchi with a small diameter; this disease is called "").

Depending on the degree of propagation, allocate:

  • limited;
  • common;
  • diffuse.

By type of inflammatory manifestations, bronchitis happens:

  1. Catarial.
  2. Serous-purulent.
  3. Hemorrhagic.
  4. Peptic.
  5. Necrotic.

Clinic

The beginning of the infectious version of the disease under consideration is usually manifested by the SMI symptoms. Rubber appears, sore throat, general weakness, chills, a slight increase in body temperature. The cough first is dry, without a wet branch. It is enhanced with in-depth breathing, which accompanies, for example, emotional conversation, laughter. No rarely observed pain in the field of trachea. . It acquires a productive character, that is, the wet begins to flip.

A characteristic feature is noisy, whistling breath and participation in the breathing of auxiliary muscles.

The degree of increase in body temperature depends on the cause that caused the development of bronchitis, the specific form of the disease and the individual characteristics of the body.

Diagnostics

Basic diagnostic signs:

  • cough;
  • shortness of breath with difficulty exhalation (with obstructive forms of illness and with bronchipolitis);
  • signs detected when listening to the phoneneoscope: hard breathing, dry and solid-caliber wet wheels.

Important! Radiography of the chest organs is required to eliminate pneumonia. With bronchitis, a bilateral gain of the pulmonary pattern and the pattern of lung roots can be occurring. If there is a narrowing of the bronchi lumen, the increase in the transparency of pulmonary fields, flattening and low recovery of the diaphragm domes, the horizontal of the rib lines is determined.

Also explore the function of external respiration. There may be disturbed violations on obstructive type.

With severe chronic flow, there are sometimes diagnostic procedures such as bronchography and bronchoscopy.

From laboratory research appoints:

  1. General urine analysis.
  2. Microscopic range of sputum (including research for the presence of the pathogen of tuberculosis).
  3. Sowing sputum on the microflora.
  4. Biochemical analysis.

Differential diagnosis

Depending on the signs of the disease, the differential diagnosis can be carried out with such pathology as:

  • pneumonia;
  • fibergation;
  • bronchi foreign body and others.

Treatment program

Medical measures are usually carried out in an outpatient mode. Hospitalization is shown only to people with the unfavorable strength of bronchitis or those who have severe concomitant pathology. Treatment of bronchitis complex.

Important! The purpose of antibiotics or antiviral drugs is performed only by testimony.

  • organization of mode and nutrition. The bed mode during fever, subsequent - gentle. Diet in the midst of the disease should be predominantly milky plant. It is recommended to drink abundant (the volume should be 2 times higher than the age daily rate). It is necessary to drink more warm fluid in the form of tea with raspberries, lemon, mint, cranberry morse, infusion of rosehip;
  • symptomatic treatment;
  • vitaminotherapy;
  • physiotherapeutic treatment, healing physical education.

- This is a diffuse-inflammatory disease of the bronchi, affecting the mucous membrane or the entire thickness of the bronchi wall. Damage and inflammation of the bronchial tree can occur as an independent, isolated process (primary bronchitis) or develop as a complication against the background of existing chronic diseases and transferred infections (secondary bronchitis). Damage to the mucous epithelium of the bronchi violates the operational of the secret, the motor activity of the cilia and the process of cleansing the bronchi. Share and chronic bronchitis are separated, differing in etiology, pathogenesis and treatment.

MKB-10

J20 J40 J41 J42

General

Bronchitis - diffuse-inflammatory disease of the bronchi, affecting the mucous membrane or the entire thickness of the bronchi wall. Damage and inflammation of the bronchial tree can occur as an independent, isolated process (primary bronchitis) or develop as a complication against the background of existing chronic diseases and transferred infections (secondary bronchitis). Damage to the mucous epithelium of the bronchi violates the operational of the secret, the motor activity of the cilia and the process of cleansing the bronchi. Share and chronic bronchitis are separated, differing in etiology, pathogenesis and treatment.

Acute bronchitis

The acute flow of bronchitis is characteristic of many sharp respiratory infections (ORVI, ORZ). Most often, the cause of acute bronchitis are paragripping viruses, respiratory syncitial virus, adenoviruses, less often - influenza virus, measles, enteroviruses, rhinoviruses, mycoplasma, chlamydia and mixed viral-bacterial infections. Acute bronchitis rarely has a bacterial nature (pneumococci, staphylococci, streptococci, hemophilic stick, causative agent of a cough). The inflammatory process first affects the nasopharynx, almonds, trachea, gradually spreading to the lower respiratory tract - bronchi.

Viral infection can provoke the reproduction of the conditionally pathogenic microflora, exacerbating the catarrhal and infiltrative changes in the mucousa. The upper layers of the bronchi wall are affected: hyperemia and swelling of the mucous membrane arises, the pronounced infiltration of the submembraty layer arises, dystrophic changes and rejection of epithelial cells occur. For proper treatment Acute bronchitis has a favorable forecast, the structure and functions of the bronchi are completely restored and after 3 to 4 weeks. Acute bronchitis is very often observed in childhood: this fact is explained by the high susceptibility of children to respiratory infections. Regularly repeated bronchitis contribute to the transition of disease in chronic form.

Chronical bronchitis

Chronic bronchitis is a long-flowing inflammatory disease of the bronchi, progressive over time and causing structural changes and disruption of the functions of the bronchial tree. Chronic bronchitis proceeds with periods of exacerbations and remission, often has a hidden current. Recently, there has been an increase in the incidence of chronic bronchitis due to the deterioration of ecology (air pollution by harmful impurities), the widespread dissemination of bad habits (smoking), high level allergyization of the population. With the long-term effects of adverse factors on the mucous membrane of the respiratory tract, gradual changes are developing in the structure of the mucous membrane, increased range of sputum, violation of the drainage ability of bronchi, decreased by local immunity. In chronic bronchitis, hypertrophy of the gland glands arises, thickening of the mucous membrane. The progression of sclerotic changes in the Bronchi wall leads to the development of bronchiectasis deforming bronchitis. The change in the airconducting ability of the bronchi significantly disrupts the ventilation of the lungs.

Classification of bronchitis

Bronchites are classified for a number of signs:

By severity of the flow:
  • easy degree
  • middle degree
  • heavy degree
By clinical flow:

Acute bronchitis

Acute bronchitis, depending on the etiological factor, are:

  • infectious origin (viral, bacterial, viral-bacterial)
  • non-infectious origin (chemical and physical harmful factors, allergens)
  • mixed origin (combination of infection and action of physico-chemical factors)
  • unclean etiology

In the field of inflammatory lesion distinguish:

  • bronchites with a predominant damage to the bronchi middle and small caliber
  • broncholites

According to the mechanism of occurrence, primary and secondary sharp bronchitis are isolated. By the nature of inflammatory exudate, bronchitis distinguish: Catarial, purulent, catarrhal-purulent and atrophic.

Chronical bronchitis

Depending on the nature of inflammation, catarrhal chronic bronchitis and purulent chronic bronchitis are distinguished. By changing the function of external respiration, obstructive bronchitis and the unstructive shape of the disease are distinguished. According to the phases of the process, exacerbations and remissions alternate during chronic bronchitis.

The main factors contributing to the development of acute bronchitis are:

  • physical factors (raw, cold air, sharp difference in temperature, exposure to radiation, dust, smoke);
  • chemical factors (the presence of pollutants in atmospheric air - carbon oxide, hydrogen sulfide, ammonia, chlorine vapor, acids and alkalis, tobacco smoke, etc.);
  • harmful habits (smoking, alcohol abuse);
  • congestion processes in a small circulation circle (cardiovascular pathologies, violation of the mechanism of mukiciliary clearance);
  • the presence of foci of chronic infection in the oral cavity and nose - sinusitis, tonsillites, adenoiditis;
  • hereditary factor (allergic predisposition, congenital disorders of the bronchology system).

It has been established that smoking is the main provocation in the development of various bronchopulmonary pathologies, including chronic bronchitis. Smokers are sick of chronic bronchitis 2-5 times more often than non-smoking. The harmful effect of tobacco smoke is also observed with active, and under passive smoking.

Provisited to the occurrence of chronic bronchitis, a long-term impact on the person of harmful production conditions: dust - cement, coal, flour, wood; Persons of acids, alkalis, gases; Uncomfortable temperature and humidity mode. Air pollution by emissions of industrial enterprises and transport, fuel combustion products has an aggressive impact primarily on the human respiratory system, causing damage and irritation of the bronchi. High concentration of harmful impurities in the air of large cities, especially in windless weather, leads to severe exacerbations of chronic bronchitis.

Repeated ARVI, sharp bronchitis and pneumonia, chronic nasopharynacles, kidneys may further cause the development of chronic bronchitis. As a rule, the infection is enjoyed by the already existing damage to the respiratory dying by other damaging factors. The crude and cold climate contributes to the development and exacerbation of chronic diseases, including bronchitis. An important role belongs to heredity, which under certain conditions increases the risk of chronic bronchitis.

Symptoms of bronchitis

Acute bronchitis

The main clinical symptom of acute bronchitis is a low chest cough - usually appears against the background of already existing manifestations of acute respiratory infection or simultaneously with them. The patient has an increase in temperature (up to moderately high), weakness, malaise, nasal congestion, a runny nose. At the beginning of the disease, cough dry, with a scarce, difficult to discontinued with a sputter, amplifying at night. Frequent kola attacks cause painful sensations in the muscles of the abdominal press and chest. After 2-3 days, the sputum (mucosa, mucous-purulent), and the cough becomes wet and soft. In the lungs, dry and wet raids are listened. In uncomplicated cases of acute bronchitis, shortness of breath is not observed, and its appearance indicates the defeat of small bronchi and the development of obstructive syndrome. The patient's condition is normalized for several days, the cough may still continue for several weeks. Long high temperature indicates the accession of bacterial infection and the development of complications.

Chronical bronchitis

Chronic bronchitis occurs, as a rule, in adults, after repeatedly transferred sharp bronchitis, or with long-term irritation of the bronchi (cigarette smoke, dust, exhaust gases, chemicals pairs). Symptoms of chronic bronchitis are determined by the activity of the disease (exacerbation, remission), character (obstructive, unstructive), the presence of complications.

The main manifestation of chronic bronchitis is a long cough for several months more than 2 years in a row. The cough is usually wet, appears in the morning hours, accompanied by the release of a minor amount of sputum. Cough strengthening is observed in cold, raw weather, and sinking - in a dry warm season. General health There are almost no patients at the same time, the cough for smokers becomes the usual phenomenon. Chronic bronchitis over time progresses, the cough is enhanced, acquires the nature of the attacks, becomes an adsady, unproductive. Complaints on purulent sputum, malaise, weakness, fatigue, sweating at night. Join the shortness of breath with loads, even minor. In patients with predisposition to allergies, the phenomena of bronchospasm arise, indicating the development of obstructive syndrome, asthmatic manifestations.

Complications

Bronchopneumonia is a frequent complication in acute bronchitis, develops as a result of a decrease in local immunity and layering of a bacterial infection. Repeated sharp bronchitis (3 or more times a year), lead to the transition of the inflammatory process into a chronic form. The disappearance of provoking factors (the refusal of smoking, climate change, the change of work) can completely deliver the patient from chronic bronchitis. When progressing chronic bronchitis, repeated sharp pneumonia arise, and with a long flow, the disease can go into chronic obstructive pulmonary disease. Obstructive changes of bronchial trees are considered as a distant state (asthmatic bronchitis) and increase the risk of bronchial asthma. Complications appear in the form of lung emphysema, pulmonary hypertension, bronchiectatic disease, cardiopulmonary failure.

Diagnostics

Treatment of bronchitov

In the case of bronchitis with a severe concomitant form of ARVI, treatment is shown in the pulmonology department, with an uncomplicated bronchitis treatment - outpatient. Therapy of bronchitis should be comprehensive: the fight against infection, restoration of bronchial passability, elimination of harmful provoking factors. It is important to pass a full course of treating acute bronchitis to eliminate its transition to a chronic form. In the first days of the disease, bedding is shown, abundant drinking (1.5 - 2 times more norm), a dairy-vegetable diet. At the time of treatment, the abandonment of smoking is required. It is necessary to increase the air humidity in the room, where it is a sick bronchitis, since the cough in the dry air is enhanced.

Therapy of acute bronchitis may include antiviral drugs: interferon (intranasal), with influenza - rematadine, ribavirin, with adenovirus infection - RNA-AZU. In most cases, antibiotics are not used, with the exception of cases of attachment of a bacterial infection, with a protracted course of acute bronchitis, with a pronounced inflammatory response according to the results of laboratory tests. Mulitatic and expectorant (bromgexin, ambroxol, expectorant herbal collection, inhalation with soda and salt solutions are prescribed to improve the sputum removal of sputum. In the treatment of bronchitis, a vibratory massage, medical gymnastics, physiotherapy is used. With a dry unproductive painful cough, the doctor may assign the reception of drugs that overwhelm the cough reflex - oxladin, the pronoxdiazine, etc.

Chronic bronchitis requires long-term treatment, both during the exacerbation period and during the remission. With the exacerbation of bronchitis, antibiotics are prescribed with purulent wet (after determining the sensitivity to them selected microflora), diluted with sputum and expectorant drugs. In the case of the allergic nature of chronic bronchitis, antihistamine drugs are required. Mode - Seuming, necessarily warm abundant drink (alkaline mineral water, tea with raspberries, honey). Sometimes healing bronchoscopy is carried out, with washing the bronchi with various drug solutions (bronchial lavage). Respiratory gymnastics and physilation (inhalation, UHF, electrophoresis) is shown. At home, you can use mustard pieces, medical jars, warming compresses. Vitamins and immunostimulators are taken to enhance the resistance of the body. Outside the exacerbation of bronchitis, preferably spa treatment. Very useful walking in the fresh air, normalizing respiratory function, sleep and general condition. If for 2 years there is no exacerbation of chronic bronchitis, the patient is removed from the dispensary observation from the pulmonic grotto.

Forecast

Acute bronchitis in uncomplicated form lasts about two weeks and ends with complete recovery. In the case of accompanying chronic diseases of the cardiovascular system, a prolonged course of the disease is observed (month or more). The chronic form of bronchitis has a long flow, shift periods of exacerbations and remission.

Prevention

Preventive measures to prevent many bronchopulmonary diseases, including acute and chronic bronchitis, include: liquidation or weakening the impact on the respiration organs of harmful factors (dustiness, air pollution, smoking), timely treatment of chronic infections, prevention of allergic manifestations, improving immunity, healthy lifestyle.

Etiology.Bronchitis is inflammation of the mucous membranes.

Causes of bronchitis: supercooling, ORVI, inflammation of the apparent cavities of the nose or runny nose.

Bronchitis is rarely found in children as an independent isolated disease (primary bronchitis). In total, it develops at the same time or as a complication of acute rinopharygitis, tracheite, laryngitis. The repeated and tightened flow of bronchitis is more often observed in young children. Bronchites can wear asthmatic character and be one of the manifestations of bronchial asthma.

The disease arises as a result of the lesion of the bronchi viral (flu, paragripp, adenoviral infection, respiratory-syntial viruses, measles viruses, cough) or bacterial infection (streptococci, staphylococcal, pneumococci, etc.), impact of physical and chemical factors (dry, hot, cold Air, sulfur gas, nitrogen oxides, etc.).

In addition, there may be passive and active smoking, alcohol, etc. For bronchitis, the bronchitis is characterized by violations of the bronchial patency of the edema-inflammatory nature, the blood flow and swelling of the mucous membrane, in the lumen of the bronchi, the degenerative changes in the creation of the epithelium are noted. In severe cases, the process captures, except for the mucous membrane, deep layers of the walls of the bronchi. With bronchitis, the self-purification of the bronchi is disturbed and the sputum of sputum is accumulated in the respiratory tract. The accumulation of the secret causes a cough, which contributes to the purification of the bronchi. Thus, the main symptoms are cough and the appearance of sputum

Clinic.

Clinical picture acute bronchitis depends on etiology. Very often, the disease develops against the background of an acute respiratory viral infection.

With acute bronchitis, there is a sharp start. The disease begins acutely with temperature increase. The child makes complaints of headache, general malaise, decline in appetite, obsessive dry cough. The main symptom is the stubborn cough, first dry, then the 3-4th day becomes wet, possibly flipping. In the lungs, rigid breathing, wet wars are medium-recorded. Their quantity is reduced by refuse. By the 6-8th day, the cough decreases, wheezing in the lungs disappear.

Early children can not dig a sputum and swallow it, and the abundance of sputum causes vomiting. The shortness of breath is missing or little expressed, when the chest feeling and listening to young children, gross wheezes are determined.

Bronchitis in young children most often lasts long. Very often in breast and newborn children, bronchitis can complicate pneumonia.

Sometimes bronchitis occurs not immediately together with sharp respiratory diseases, but in a later date. This process appears when attaching a bacterial microflora, manifested by a deterioration of the state, there may be a re-increasing body temperature, a cough strengthening, dry wheels appear in the lungs.

Acute bronchitis - The inflammatory disease of the bronchi, mainly infectious nature, manifested by cough (dry or with sputum release) and continued no more than 3 weeks.

  • Etiology

  • The disease causes viruses (influenza viruses, paragripping, adenoviruses, respiratory and sycitial, korilla, cough, etc.), bacteria (staphylococci, streptococci, pneumococci, etc.); Physical and chemical factors (dry, cold, hot air, nitrogen oxides, sulfur gas, etc.). Prehastages to the disease Cooling, tobacco smoking, alcohol consumption, chronic focal infection in the uniceringeal region, disruption of nasal respiration, thoracic deformation.

  • Pathogenesis

  • The damaging agent penetrates the trachea and bronchi with inhaled air, hematogenic or lymphogenic path (uremic bronchitis). The acute inflammation of the bronchial tree may be accompanied by a violation of the bronchial patency of the edema-inflammatory or bronchospast mechanism. Characterized hyperemia and swelling of the mucous membrane; On the walls of the bronchi in their lumen, the mucous, mucous-purulent or purulent secret; Degenerative changes in the family epithelium. With severe forms inflammatory process It captures not only the mucous membrane, but also deep tissues of the bronchi wall.

  • Classification

  • Posted by several forms: sharpness; acute prestructiveburhite; Bronchiolitis.

    Types depending on the nature of inflammation: Catarial, purulent and purulent necrotic.

    From the causes of acute bronchitis Eliminate: infectious bronchitis, which develops under the action of infectious agents (most often viruses, less often - bacteria), as well as non-infectious bronchitis (chemical and physical).

    The localization of the process is distinguished:acute bronchitis of distal and proximal localization.

  • Clinic

  • Cough, isolation of sputum, rhinora, pain in the throat, weakness, headache, shortness of breath.

    The cough is painful, he is accompanied by sore pain, can disturb in the night hours and lead to a breakdown of sleep. At the same time, the condition deteriorates even more due to constant lack of sleep. 2-3 days after the start of the disease, the cough becomes wet, with the release of sputum, which can be mucous (transparent) or purulent (greenish color). The last sign indicates the attachment of a bacterial infection. In cases where the cough is quite pronounced and is very long, traces of blood can appear in sputum.

  • Treatment .

  • Bedding, abundant warm drinking with honey, raspberry, lime color; Preheating alkaline mineral water; acetylsalicylic acid is 0.5 g 3 times a day, ascorbic acid up to 1 g per day, vitamin A 3 mg 3 times a day; mustard pieces, jars on the chest. With severe dry cough, codeine (0.015 g) is prescribed with sodium bicarbonate (0.3 g) 2-3 times a day. The drug selection can be Liebeksin 2 tablets 3-4 times a day. From expectorant means effective infusion of thermopsis (0.8 g per 200 ml 1 tablespoon 6-8 times a day); 3% solution of potassium iodide (1 tablespoon 6 times a day), bromgexin of 8 mg 3-4 times a day for 7 days, etc. The inhalation of expectorant means, mucolithics, heated mineral alkaline water, 2% sodium bicarbonate solution, eucalyptus, anise oil with a steam or pocket inhaler. Inhalations spend 5 minutes 3-4 times a day for 3-5 days. Bronchospasm is stopped by the appointment of Euphilline (0.15 g 3 times a day). Antihistamines are shown. With the ineffectiveness of symptomatic therapy for 2-3 days, and antibiotics and sulfonamides in the same doses are prescribed by the medium and severe course of the disease in the same doses as in pneumonia.

    Amoxicillin 500 mg 3p / d

    Doxycycline 100 mg 2 r / day

    Trimethopris 160 mg 2p / day

  • 33. Chronic bronchitis. Etiology, pathogenesis, classification, clinic, treatment and prevention.Chronic progressive diseasebased on which the degenerative inflammatory lesion of the mucous membrane of the tracheobronchial with the restructuring of the secretory apparatus and sclerosis of the bronchial wall, developing as a result of long-term inflammation, harmful agents and manifested by coughing, isolation of sputum and shortness of breath. The diagnosis is legitimate if there is a long cough at least 3 months per year at least 2 years.

    Etiology. Caused Factors: Smoking, Infection (Viral or Bacterial), Toxic Impact, Professional Harmfulness, Insufficiency B-1-Antitrypsin, Home Air Pollution.

    Pathogenesis: Mechanical and chemical irritation of the mucous membrane causes an increase in the formation of the bronchial secret and leads to a change in its viscosity properties. The toxic effect on cells and discrimination leads to a violation of the function of the fiscal epithelium, increasing the insufficiency of the mucociliary eccasetor. Prolonged impact toxic in-in Leads to dystrophy and destruction of the semicircle cells and the formation of sections of the mucous membranes free from the flicker epithelium. The same changes causes the action of respiratory viruses. The violation of the mukiciliary clearance leads to a drawing of its functions: secretory, cleansing, protective because of which plots of mucous loss lose the ability to prevent adhesion microorganism.

    Inflammation in the mucosa of bronchi leads to the formation of oxidative stress, which leads to damage to the pulmonary tissue with the development of emphysema and peribrous fibrosis, causing irreversible bronchial obstruction and the transition of chronic bronchitis in COPD.

  • Classification:

    By etiology: Viral, bacterial, from the effects of chemical and physical factors, dust.

    According to morphological changes: catarrhal and purulent.

    With the flow: Stage of remission and exacerbation.

    According to functional changes: Unstructive and obstructive.

    By complications: Respiratory failure, heart failure, chronic pulmonary heart and lung emphysema.

    Classification HB: Simple (catarrhal), mucous - purulent, other chronic obstructive pulmonary diseases: chronic asthmatic bronchitis, emphysematous hb, obstructive hb, hb with difficulty breathing.

    Emphysematous type (type A): the expiratory stenosis of small respiratory tract and the mechanism of the air trap develops by a sharp decrease in the portability of the physical activity, the shortness of cyanosis, puffing breathing. Auscultative: Dry wheezes may not be, the productive cough is not very characteristic. Bologna is called pink puffers.

    Bronchic Type (type b): Productive cough, reduction of streaming indicators, early respiratory failure. Call blue wandes.

    Clinic. With a simple chronic bronchitis, there is a cough, malaise, weakness, increased fatigue, auscultative: rigid breathing, sometimes weakened. With mucified-purulent chronic bronchitis, there may be a wet sonorous fine-pushed wheezing.

    In chronic obstructive bronchitis, there is an increase in cough, sputum, shortness of breath, diffuse cyanosis (lips, uches, acricyanosis), rare deep breathing, barrel-shaped chest. Percussian Displacement of lung boundaries down, their low-speed, box sound. Auscultative - Uniform weakened breathing with elongated exhalation, scattered dry buzzes disappearing after shaking.

    Treatment.

    Beta - 2 agonists - relax the smooth muscles of the bronchi and increase the frequency of the cilia of the epithelium.

    Anticholinergiki is the first line of therapy HB, blockade of polyaroreceptors 1 and 3 of the type of large bronchi aspects an increased afferent stimulation and leads to a decrease in bronchokonstriction, phenomena of tracheobronheal dyskinesia, hypercreene and discrimination.

    Theophylline: - contributes to the improvement of mukiciliary clearance, stimulates the respiratory center, reduces the likelihood of hypoventilation and carbon dioxide accumulation. The range of the therapeutic concentration is 5-15 μg / ml.

    Moorgulators and Mulcolics: Ambroxol - causes the depolymerization of acidic mucopolysaccharides of bronchial mucus, improves the rheological sv-va of sputum, increases the synthesis of surfactant. Average therapeutic dose \u003d 30 mg 3 times a day.

    Acetylcisteine: destroys the disulfide bonds of sputum mucopolysaccharides and stimulates glass-shaped cells, due to an increase in glutathione synthesis, has antioxidant St. B and promotes detoxification process. It is assigned to 600 -1200 mg / day in the form of tablets or with a nebulizer at a dose of 300-400 mg 2 times / day.

    GKS is used in the ineffectiveness of basic therapy in maximum dosages.

    Antibiotics Zhmpirically. Use amoxicillin, macrolides (azithromycin), cephalosporins 2 generations.

    PreventionWeight treatment of sharp bronchitis and respiratory diseases, early detection and treatment of initial stages of chronic bronchitis, hardening the body.

  • 34. Bronchial asthma. Etiology, pathogenesis, classification, clinic, diagnosis, treatment.

  • Ba - chronic inflammatory The disease of the respiratory tract in which many cells and cellular elements take part - the development of bronchial hyperreactivity (increased sensitivity to various nonspecific stimuli compared to the norm); The leading role in inflammation belongs eosinophilas, fat cells and lymphocyte,) which leads to the repeated episodes of whistling wheezing, shortness of breath, feelings in breast and cough, especially at night or early in the morning (the obstruction of the respiratory tract is often reversible or spontaneously or under the action of treatment).

    Etiology: Development factors: heredity, allergens, infections, professional sensitizers, tobacco smoking, air pollution, food, exercise stress, emotional factors.

    Pathogenesis: Early asthmatic reaction is mediated histamine, leukotriene and manifests itself with a reduction in the smooth muscle of respiratory tract, hypersecretion of mucus, elemental mucous membrane.

    Late asthmatic reaction develops in each second adult patient with bronchial asthma. Lymphokins And other humoral factors cause migration of lymphocytes, neutrophils and eosinophils and lead to the development of a late asthmatic reaction. Mediators produced by these cells are able to damage the epithelium of the respiratory tract, maintain or activate the process of inflammation, stimulate afferent nerve endings.

    Clinical forms Ba:

      Exogenous (atopic, allergic) - provoked by environmental allergens

      Endogenous (neatopic, nonallergic) - provoking factor unknown

      Aspirin - arises against the background of intolerance to the NSAID

      Special forms - professional, asthma of physical effort, night asthma, Cashchal Asthma.

    Bronchitis - This is a disease in which an inflammatory process occurs in the mucous membrane of the bronchi. In this case, the walls of the walls and the increased separation of the mucous membrane occurs, so bronchitis causes difficulty breathing and cough.

    Depending on how bronchitis proceeds, allocate is a sharp form and chronic. In acute bronchitis, the disease progresses a rapid pace, damaging the upper layers of the bronchi. Arises coughing With the release of sputum, the temperature does not increase much. Acute bronchitis is divided depending on the peculiarities of the lesion of the bronchial patency on obstructive bronchitis and the unstructive.

    At bronchitis there is a damage to small bronchi, an increase in the tone of their muscles, swelling of the mucous membrane and an increased amount of sputum. This type of bronchitis in adults causes a whistle with breathing, strong cough and attacks. The obstructive form of bronchitis in children is most dangerous in that there are spasms in bronchi and provoke a suffocation. With a protracted process, chronic bronchitis occurs.

    For the chronic shape of the bronchitis, the structural damage to the walls of the bronchi is characterized, and sometimes the tissues of the lung. He causes a long cough arising against the background of the brightness of the bronchi. The aggravation of chronic bronchitis occurs during the change of seasons, in the cold and damp season, in the summer periods the cough becomes rare. The smokers more often observed chronic bronchitis due to the defeat of the lungs and the larynx. In case of insufficient treatment of chronic bronchitis, complications may occur in the lungs.

    Causes of bronchitis

    Are bronchitis? Increased, as the cause of acute bronchitis can be various viruses and infections:, cortex, pneumococci, staphylococci, and others. Bronchitis can arise from physical and chemical factors: cold, low and high air temperatures, dust particles, gases, chemical and toxic substances.

    How is bronchitis transmitted? The disease is transmitted by air-droplet when communicating, coughing and sneezing. In most cases, the acute form of bronchitis is a consequence of viral infection. First, the bacteria fall into the nasal cavity, then distributed to the throat area, bronchi and cause bronchitis.

    To the risk factors causing the development of the chronic form of bronchitis, can be attributed:

    • smoking;
    • asthma;
    • chronic diseases of the nasal cavity;
    • abuse of alcohol drinks;
    • climatic and environmental conditions (dust, cold temperatures, environmental pollution);
    • violations of the breast shape.

    The cause of bronchitis in children can be any infection, as the children's respiratory system is not fully developed and is more susceptible to diseases than in an adult. Weak immunity can be another factor in the development of bronchitis. Bronchitis in children is dangerous in that it gives complications to other organs, spasms arise and accumulates a large amount of sputum. Bronchitis in children may arise against the background of smoking parents, accommodation in unfavorable environmental and climatic conditions.

    Bronchitis during pregnancy

    During pregnancy, after establishing a diagnosis, the most often specialists prescribe the treatment of bronchitis using such medicineslike antibiotics. Although such medicines are harmful to the health of pregnant women, especially in the 1st trimester, but they are almost the only way to avoid more serious complications. After all, when the bronchitis is protracted, it can easily entail the occurrence of pneumonia, and, as a result, intrauterine infection of the fetus.

    If it is possible to do without antibacterial drugs in the treatment of bronchitis in a pregnant woman, then a qualified specialist attributes her medicines that are aimed at removing intoxication, and also help restore damaged bronchial functions.
    Inxication occurs when bronchitis, because the body of the patient is poisoning the work and decay products that produce microbes. This is what causes the majority of symptoms that accompany such a disease as bronchitis. This includes weakness, and malaise, and poor well-being, and light fatigue. In order to effectively recover from intoxication, which is subject to the patient's body, the compliance with the beddown is required for a long time, as long as the temperature does not fall to the norm.

    In addition, in this case, the use of abundant heat drinking, such as hot tea, is desirable with honey, heated Borjomi or warm milk with soda, herbs champs and lime tea.

    It is worth noting that the cough, which arises in connection with such a disease, can be different in its type. Only a qualified specialist washes accurately set exactly what type of cough in a pregnant patient and appoint a corresponding course of treatment. That is why in no case it should not be treated from cough and bronchitis at all on their own, on their own, assigning medicines, especially those who fight the cough. After all, incorrectly chosen medicine will not only improve the general condition, but also worsen it.

    Bronchitis in children

    The causes of infectious bronchitis in children are viruses or harmful bacteria that have fallen into the human body. Allergic bronchitis arises due to the impact on the child's respiratory system of stimuli and allergens that provide negative impact on lung fabric. Accordingly, the effective measure of the treatment of such a type of bronchitis will not so much drugs, how much removing the causes of the disease.

    Types of bronchitis

    There are such types of bronchitis in children like:

    • infectious;
    • allergic.

    This classification is based on the causes of its occurrence.

    There are types of bronchitis in children who are based on its duration:

      • acute;
      • recurrent;
      • chronic.

    Acute bronchitis is diagnosed when it lasts about 1-3 weeks, recurring - when the disease manifests itself at least three times a year, and chronic - when the child is sick for three months and more, and this happens at least 2 years in a row. At the same time, experts also identify such a type of disease as bronchiolitis, which are subject to children who have not reached 1 year from the date of birth.

    How to recognize bronchitis in a child

    Typically, bronchitis is accompanied by such symptoms as the high temperature and the presence of severe greed when the child breathes. A child still worsens the well-being and general condition of the body. In this case, you should immediately show the child to the doctor, and not search the Internet answer to the question "How to cure bronchitis in a child", and after finding the necessary information to independently develop a course of treatment without attracting the relevant specialist. Answer the question "How to cure bronchitis in a child" will be able to just as possible only in the Children's Doctor's office after inspecting your child and establish the correct diagnosis of the disease.

    Symptoms of bronchitis

    Bronchitis has different shapes and types, therefore symptoms depend on the nature and development of the disease. Of the main symptoms of bronchitis, you can allocate:

    • dry cough without sputum, weakness, slight increase in body temperature;
    • chest pain;
    • sensation of spasm in the throat;
    • wars when coughing and inhale.

    With acute bronchitis, pain and throat, fatigue and lethargy arises. Then the dry and strong cough is manifested, after a few days it becomes wet, with a slight sputum, yellow or greenish color. With a heavy stage, high temperatures rises. Acute bronchitis occurs within 10 days, then the symptoms gradually fade.

    The chronic form of bronchitis begins with a wet cough, which can be observed for several months or years. A characteristic symptom of this form of bronchitis is the increased highlighting of sputum, especially in the morning clock and deep cough. Over time, chronic bronchitis develops, the patient has weakness, fast fatigue, shortness of breath, cough manifests itself by attacks, muscle pain. Sometimes he can lead to the development of bronchospasm, signs of asthma. Symptoms of chronic bronchitis can be observed in a patient for a long time.

    The symptoms of bronchitis in children are a frequent cough with attacks, replacing with an expectoration with a sputum, shortness of breath and breathing with a whistle, wet wheezing, high temperature. There is strong weakness, fatigue and apathy. Bronchitis in children continues for 2-3 weeks, as a small child cannot quickly cope with the mocrysto, and the manifestation of the disease is more pronounced than in adults.

    Treatment of bronchitis

    How to treat bronchitis? This disease requires special attention already in the early stages of development. The treatment of bronchitis in children and in adults may differ by some moments, but for all certain procedures are the same. The patient must observe a strict bed mode, since the sharp form of bronchitis can give complications on the lungs. In the treatment, it is necessary to drink more warm liquid in the form of tea and herbal beams. If the air indoors is dry, it is necessary to moisten it to alleviate wetting the sputum and speed up the process of recovery. At high temperatures during bronchitis, taking antipyretic drugs.

    If bronchitis occurs in severe, accompanied by colds and chronic diseasesPatient must be placed in the hospital. Light bronchitis can be cured at home, following all the recommendations of the doctor. The treatment of any form of bronchitis includes the fight against infection, restoration of bronchial passability, elimination of disease risk factors. With incorrect treatment, sharp bronchitis quickly flows into a chronic form and a lot of time is required for recovery.

    What to treat bronchitis? The sharp form of bronchitis is treated with antiviral drugs. Antibiotics with bronchitis are shown in the case when the disease proceeds with bacterial infection and need to be destroyed. In the treatment of bronchitis, anticipation preparations are used - mercolics, thanks to which the sputum dies, easily moves and is quickly excreted when the bronchi cough. Widely used in bronchitis therapy various herbal fees, syrups, inhalation based on herbs and drugs, diluted means.

    When using an integrated approach, bronchitis can be cured faster. If there is a strong and dummy cough, with a small amount of mucus, antitussive agents are applied. In the case of a protracted treatment of bronchitis and the difficulties of removal of sputum, the position drainage is used. For the same purpose, a vibratory massage is used to make the mucus actively stand out. The faster the bronchi is released from sputum, the sooner the patient will recover.

    The treatment of bronchitis in children is carried out taking into account the structure of the respiratory and severity of the disease. With the obstructive form of bronchitis, it is necessary to use the means that shoot the attacks of spasm. Simple bronchitis forms are treated with the help of sputum removal methods: inhalation, positional massage, charging, respiratory exercises. If bronchitis is manifested with complications and there is a risk of lung damage, the patient is assigned to the reception of antibiotics. Often, the treatment of bronchitis in children can be held in hospital conditions.

    Bronchita prevention

    The prevention of bronchitis includes the exclusion of all risk factors provoking the development of the disease: supercooling, inhalation of toxic and chemically active substances, smoking and alcohol. In cold climatic conditions, bronchitis is developing faster and more difficult is treated. Changing climatic conditions and refusal to work in harmful production will help to exclude the occurrence of bronchitis.

    If chronic bronchitis arose due to harmful conditions in production, it is necessary to strictly observe protective measures - apply special masks and respirators. But it is best to change the work. Patients who have recently transferred bronchitis or a cold illness, as well as with low immunity, should avoid communicating with patients with persons, places with increased accumulation of people during the outbreak of the flu epidemic or cold.

    Of great importance in the prevention of bronchitis is given to the abandonment of smoking, as it is one of the provoking factors in the development of respiratory diseases. Tabak I. tobacco smoke Provokes the disease, destroys the surface of the bronchi and the lungs. People with chronic bronchitis are strictly forbidden to smoke, as a complication on the lungs can occur. Alcoholic beverages should also be limited, and in chronic forms are equally excluded from use, since ethanol negatively affects the mucous membrane.

    Regular vaccination against diseases caused by pneumococci, influenza viruses is also included in the prevention measures of the chronic form of bronchitis. This type of prevention is needed both adults and children in front of the autumn and winter period.

    When the first signs of bronchitis, it is necessary to immediately receive advice and treatment from the doctor. The disease is easier to treat at the first stages of development, not allowing complications. After passing the treatment of bronchitis with adults, and especially children, it will be useful to relax and restore the forces in the spa complex. Fresh air, challenge procedures, regular gymnastics and full nutrition - all this will help strengthen health and prevent bronchitis recurrence.

    Folk remedies in the treatment of bronchitis

    To date, such a technique has become even more popular than 10-20 years ago. The thing is that the folk remedies from the bronchitis ensure effective treatment through the use of natural organic components. But the main thing is in the almost complete absence of side effects in the treatment of folk recipes. You can also be able to avoid complications that are quite common in the use of medicines, drug therapy, the use of antibiotics.

    Do not forget also that medical method Treatment is accompanied by a number of restrictions, contraindications due to age or physiological features of a particular patient. Even the sharp and chronic forms of bronchitis are amenable to very effective treatment, if carefully and competently examine the properties of therapeutic herbs, plants, animal products and make optimal recipes.

    Herbs in the treatment of bronchitis

    The most popular folk remedies from the bronchitis are recipes based on medicinal plants. Thus, the chronic and acute form of bronchitis gives back to treatment with such herbs as an alta, licorice root, St. John's wort, a chamber, plantain, yarrow, oregano, linden, mother-and-stepmother.

    Make a decoction of these herbs and drink two or three times a day in warmth during the day. By the way, even in pharmacies sell special herbal fees that are brewed and drink. Such a collection to buy reasonably, because there the number and quality of herbs was selected by experts in order to ensure the maximum effect. Of course, it is impossible to know how to treat bronchitis by folk remedies, not knowing the properties of those herbs that you are going to apply. That is why it is desirable to select plants to specialists in this area.

    Inhalation and aromatherapy

    This is another excellent means when bronchitis. Now we will tell you how to cure bronchitis by folk remedies using inhalation, as well as gaining momentum of popularity aromatherapy. In principle, you can use the inhaler sold in the pharmacy. If you do not want to spend money, take an old, known to many since childhood. We are talking about how you breathe above the pan or the mission, covered with a towel head. As an inhalation, use steam from hot boiled potatoes. If you add some ginger or garlic there, efficiency will increase. It is also helpful to add a pair of droplets of essential oil from thyme, eucalyptus or tea tree.

    As for aromatherapy, it is not only helpful to treat bronchitis at home in this way, but also nice. To do this, you will need a special aroma lamp. Use also suitable aromatic oils having the greatest medical properties. These may be fruit oils, trees. Such essential oils like pine kidney, fir, orange are considered the most suitable in the treatment of bronchitis.

    Milk and bronchitis

    Do not everyone know that milk, namely, goat, has excellent properties. In particular, when it comes to folk medicine. So we treat bronchitis at home and use goat milk. The fact is that this milk does not cause allergic reactions, which means it comes to everyone. It is also faster and easier to digest than any other milk.

    If you do not have allergies to honey, we offer you an excellent home recipe. Take a glass of warm milk and add a tablespoon of good honey there. Stir carefully and start drinking. Just drinking needed in small sips and with breaks, so that milk could warm your throat. Drink such milk mixtures twice a day. Milk can be taken even a little hot, but not cold. The first glass drove in the morning before meal, that is, on an empty stomach. The second drank before you sleep. So if you suits such a recipe, I am pleased to treat bronchitis at home and get rid of the disease with a delicious way.

    There is another recipe with milk. By the way, remember one very important thing about goat milk. In no case boil it to achieve the desired temperature. Warm up to the desired condition, but do not bring to the boil. Otherwise, there will be no sense from such a popular recipe. The peculiarity of goat milk is that with boiling out of it all useful properties.

    As for the recipe, then you will need a goat milk, as well as famous Mineral Water Borjomi. Make a kind of cocktail in proportions one to one. The drink should also be warm, but not very hot. Drink as well as milk with honey, gradually and twice a day. You can alternate drinks day every other day.

    For many years it turned out that with such a disease like bronchitis folk Methods Treatments cope with their tasks more than effectively. Unfortunately, many vintage recipes No other herbs are no longer working due to the fact that certain herbs disappeared, the components lost their properties as a result of attempts to improve the product through genetic modifications.

    A few more recipes for the treatment of bronchitis

    We want to offer you a popular treatment of bronchitis in adults with other recipes and products that have still retained their relevance and can be perfectly helping you.

    1. Butter. Melt 200 grams of honey, add 200 grams butter, as well as two grams of propolis. Mix the components, let it cool and place it in the refrigerator. When the mass freezes, eat one tablespoon an hour before meals.
    2. Aloe juice. If you are lucky to make such a juice, you are very lucky. This will help not only from the bronchitis, but also will well strengthen the body. So, mix the juice, only freshly squeezed, with honey in proportions one to one. Drink little by little two or three times during the day before each meal.
    3. Ginger. Popular recipes from ginger-based bronchitis have perfectly showed themselves. It can be used in different types - decoction, tea, simple marinated ginger added to salads or other dishes. In combination with other natural and useful components, value and efficiency increases.
    4. Cabbage. The recipe is strange, but still effective. To do this, you need a cabbage sheet, pre-lubricated with honey. Put it on your chest and use as a compress. Cover only a warm blanket and do not get out of it for four hours.
    5. Mustard pieces. Until now, enjoy greatly popular in the treatment of bronchitis and diseases similar to it. The composition of the mustard pieces allows an irritating effect contributing to the improvement of blood flow by the body. It also increases the efficiency of the body's protective function, they begin to better depart sputum from the respiratory organs. If there is no high temperature, and there are no contraindications of doctors, pair the feet in hot water by adding mustard there. After that, wear warm woolen socks, lie down under the blanket and drink one of the drinks prepared by the recipes, which we told you today.

    As you can see, traditional medicine is relevant and effective. It is only important to use its capabilities and potential correctly. Of course, any treatment requires advice to doctors. So do not ignore the advice and consult specialists.


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