Bronchitis refers to chronic non-specific inflammation of the trachea, bronchial mucosa and surrounding tissues. The main cause of bronchitis is chronic non-specific inflammation of the bronchus caused by repeated infections of viruses and bacteria. When the temperature drops, the respiratory tract small blood vessel spasm ischemia, and the defense function declines, it is conducive to disease; smoke, dust, air pollution and other chronic irritation can also occur; smoking can cause bronchospasm, mucosal variation, reduced cilia movement, and increased mucus secretion, which is beneficial to infection; allergies Factors also have a certain relationship.
1. Acute bronchitis
In the early stage of acute bronchitis, symptoms of upper respiratory tract infection are often manifested. Patients usually have clinical manifestations such as nasal congestion, runny nose, sore throat, and hoarseness. The systemic symptoms are relatively mild, but there may be low-grade fever, chills, general fatigue, consciously itchy throat, irritating cough and pain behind the breastbone. The amount of sputum is not much in the early stage, but the sputum is not easy to cough up. After 2 to 3 days, the sputum may turn from mucous to mucopurulent. The patient’s exposure to cold, inhalation of cold air or irritating gas can aggravate or induce coughing. Patients often cough more prominently when they wake up in the morning or at night. Cough can also be paroxysmal and sometimes persistent. Severe coughing is often accompanied by nausea, vomiting and chest and abdominal muscle pain. If accompanied by bronchospasm, there may be wheezing and shortness of breath. Generally speaking, the course of acute bronchitis is self-limiting, and systemic symptoms can subside within 4 to 5 days, but the cough can sometimes be prolonged for several weeks.
Physical examination can sometimes find dry rales, which disappear after coughing; occasionally, wet rales can be heard at the bottom of the lungs, and wheezing can be heard when accompanied by bronchospasm. Usually the white blood cell count is normal, and there are no abnormal findings on chest X-rays.
2. Chronic bronchitis
Chronic bronchitis refers to patients who have chronic cough and sputum for more than three months every year after excluding various other causes of chronic cough, and continue for two years. It is not necessarily accompanied by persistent airflow restriction.
(1) Repeated cough and gradually worsening cough is a prominent manifestation of this disease. Mild cases only get onset in winter and spring, especially before and after getting up in the morning, and cough less during the day. In summer and autumn, the cough lessens or disappears. Severe patients have a cough all the year round, worse in winter and spring, and cough day and night, especially in the morning and evening.
(2) expectoration of sputum Generally, sputum is white mucus and foamy, and it is more frequent in the morning, and it is often difficult to spit out because of its stickiness. Symptoms worsen rapidly after infection or cold, the amount of sputum increases, the viscosity increases, or it appears yellow purulent sputum or accompanied by wheezing. Occasionally there is blood in the sputum due to severe cough.
(3) Asthma When combined with respiratory tract infection, the symptoms of asthma (wheezing) can occur due to congestion and edema of the bronchiolar mucosa, obstruction of sputum, and narrowing of the bronchial lumen. The patient had a wheezing sound when breathing in the throat, and a wheezing sound on auscultation of the lungs.
(4) Repeated infections Repeated respiratory infections are prone to occur during cold seasons or sudden temperature changes. At this time, the patient’s asthma worsened, the amount of sputum was significantly increased and purulent, accompanied by general fatigue, chills, fever, etc. Wet sounds appear in the lungs, and the blood white blood cell count increases. Recurrent respiratory infections are especially likely to worsen the condition of elderly patients and must be given full attention.
There are no special signs in the early stage of the disease, and a little wet or dry rales can be heard at the bottom of the lungs of most patients. Sometimes it disappears temporarily after coughing or expectorating sputum. Signs of emphysema can be found in long-term cases.
The relationship between chronic bronchitis and chronic obstructive pulmonary disease (COPD), emphysema, and bronchial asthma: chronic bronchitis is closely related to chronic obstructive pulmonary disease and emphysema. Clinically, patients have symptoms such as cough and sputum. At that time, COPD cannot be diagnosed immediately. If the patient has only the clinical manifestations of “chronic bronchitis” and/or “emphysema” without persistent airflow limitation, the diagnosis of COPD cannot be made, and the patient can only be diagnosed as “chronic bronchitis” and/or “Emphysema”. However, if the patient’s lung function suggests persistent airflow limitation, the diagnosis is COPD. Some patients may also suffer from chronic bronchitis and emphysema while suffering from bronchial asthma. For example, patients with bronchial asthma are often exposed to irritating substances, such as smoking, cough and sputum will also occur, and cough and sputum are an important feature of chronic bronchitis. Such patients can be diagnosed as “wheezing bronchitis.”
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