Txhua tus kab mob inflammatory tuaj yeem ua rau mob ntev thiab yuav cuam tshuam rau tus neeg mus ntev. Mob bronchitis yog tsis muaj kev zam, qhov exacerbation ntawm uas ua rau kev sib cais ntawm hnoos qeev thaum hnoos. Muaj catarrhal o ntawm lub bronchial mucosa. Nrog rau nws, cov qauv ntawm cov ntaub so ntswg hauv lub ntsws hloov. Exacerbation tshwm sim 2-3 zaug hauv ib xyoos. Vim li cas tus kab mob rov qab los, yuav kho li cas thiab yuav ua li cas?
Vim li cas bronchitis thiaj li mob ntev?
Nyob rau hauv bronchitis ntev, lub bronchi ua o. Pathology ua rau hnoos fits thiab copious sputum ntau lawm, kev qaug zog yog pom. Kev rov tshwm sim tuaj yeem tshwm sim tau ob lossis ntau xyoo.
Zoo li txhua yam kab mob ntev, bronchitis muaj ob theem: exacerbation thiab remission. Pathology tuaj yeem ncav cuag ntau xyoo. Nyob rau tib lub sij hawm, txhua exacerbation qhia irreversibleKev hloov pauv hauv cov qauv thiab cov khoom ntawm bronchial mucosa thiab cov leeg.
Kev cuam tshuam tuaj yeem tshwm sim - nqaim ntawm bronchial kab noj hniav, qhov no yog qhov zoo rau cov mob ntsws ntev. Ib qho exacerbation (cov keeb kwm kho mob ua pov thawj rau qhov no) ua rau ua tsis taus pa luv, oxygen tshaib plab thiab intoxication ntawm lub cev.
Vim li cas bronchitis thiaj li mob ntev? Thaum pib, tus neeg mob raug kev txom nyem los ntawm bronchitis. Raws li kev kis kab mob (kab mob, fungal, viral), kab mob ua pa dhau los, hypothermia, cov kab mob no nyuaj.
hnoos tuaj yeem tshwm sim los ntawm kev tsis haum tshuaj. Piv txwv li, rau ib yam tshuaj.
Negative factor
Kev mob ntsws ntev ntev tshwm sim hauv cov xwm txheej zoo li no:
- kab mob tsis zoo los yog nqa ntawm ob txhais ceg;
- yam tsis zoo sab nraud: haus luam yeeb, ua haujlwm hauv chav plua plav lossis txias, hauv kev tsim khoom phom sij;
- kev tiv thaiv tsis zoo;
- kev hloov pauv rau cov kab mob ua pa;
- bronchial hypersensitivity;
- SARS nquag;
- kab mob foci ntawm qhov mob hauv lub cev.
Relapse feem ntau tshwm sim hauv cov neeg mob uas nyob hauv thaj chaw uas muaj huab cua ntub thiab txias.
Cov xwm txheej predisposing rau exacerbation
Ua rau mob ntev hauv lub bronchi yog qhov nyuaj heev. Nws yog ib qho ua tsis tau rau ib qho kev qhia tshwj xeeb.
Yog li, cov xwm txheej uas cuam tshuamexacerbation ntawm bronchitis:
- kab mob ntawm lub ntsws sab sauv;
- foci ntawm tus kab mob hauv lub cev (piv txwv li, mob pyelonephritis);
- ua pa tsis zoo (vim lub qhov ntswg tawg, qhov ntswg polyps);
- congestion in the ntsws (vim: plawv tsis ua hauj lwm);
- yuav haus cawv;
mob raum tsis ua haujlwm
Cov kab mob ntsws ntev feem ntau tshwm sim hauv cov neeg haus luam yeeb ntev.
Kev tshwm sim ntawm exacerbation: cov tsos mob
Cov tsos mob tseem ceeb ntawm kev mob ntsws ntev yog hnoos. Nrog nws txoj kev txhawb zog, peb tuaj yeem tham txog kev rov qab los ntawm tus kab mob. Qee lub sij hawm hnoos hnoos heev thiab ua rau mob taub hau.
Thaum lub sijhawm tshem tawm cov kab mob bronchitis, hnoos qhuav, hnoos qeev cais me ntsis. Qhov hnoos tuaj yeem nrog hawb pob. Yog tias mob bronchitis nyob rau theem mob, ces qhov ntim ntawm cov hnoos qeev nce ntau heev.
Tus mob ntsws ntev yog ib qho pathology thaum lub sij hawm kev loj hlob ntawm cov bronchial mucosa hloov pauv:
- puas tsuaj bronchial mucus secretion mechanism;
- deformed mechanism rau tshem tawm cov hnoos qeev hauv lub bronchi;
- bronchial tiv thaiv tsis muaj zog;
- phab ntsa bronchial ua rau mob, tuab.
Cov kab mob ntsws ntev heev tshwm sim sai heev, vim tias cov kab mob bronchial feem ntau cuam tshuam los ntawm cov kab mob uas nyob hauv huab cua.
Cov tsos mob tseem ceeb ntawm exacerbation ntawm tus mob bronchitis:
- ua tsis taus pa txawm nrogtaug kev;
- nausea;
- sweating;
- qaug zog ntawm lub cev;
- hawb pob thaum ua pa;
- xiav qhov ntswg thiab pob ntseg, ntiv tes thiab ntiv taw;
- puag yog ntxhov;
- txo qis hauv qib kev ua haujlwm;
- dizzy;
- lub plawv dhia nrawm txawm tias so;
- mob taub hau.
hnoos hauv cov mob ntsws ntev tuaj yeem qhuav lossis ntub dej. Qhov ntim ntawm cov hnoos qeev zais hauv ib hnub yog tsawg dua 150 grams. Sputum muaj cov cim txawv: dej, pob tshab, mucous, nrog cov ntshav los yog purulent impurities.
Thaum exacerbated, cov kua paug ntawm cov xim ntsuab yog tsim nyob rau hauv cov mucosa. Thaum cov hnoos qeev tshwm sim, cov kab mob microbial tau qhib. Hauv qhov no, koj yuav tsum tau mus nrhiav tus kws kho mob tam sim ntawd kom nws tuaj yeem kho qhov kev kho mob.
Hais yuav luag ib txwm tshwm sim thaum lub sijhawm exacerbation, vim tias qhov khoob hauv lub bronchi tau txhaws nrog hnoos qeev.
Thaum lub sijhawm exacerbation, tus neeg mob feem ntau raug tus kab mob los yog kab mob. Nws yog nws tus tuav. Tus kws kho mob ntsuas qhov mob hnyav los ntawm cov tsos mob thiab cov cim qhia ntawm kev ua pa sab nraud.
Kev faib tawm
Qhov ua rau mob ntsws ntsws ntev "hais" lawv cov kev faib tawm. Yog li, mob bronchitis tau muab faib ua "ua rau" hom:
- hom kev ywj pheej ntawm bronchitis - tshwm yam tsis muaj kev cuam tshuam ntawm cov txheej txheem inflammatory hauv lub cev;
- hom thib ob - ib qho teeb meem los ntawm lwm yam kab mob. Feem ntau: pneumonia, tuberculosis. Qhov no pathology manifests nws tus kheej raws li ib tug teeb meemnyob rau hauv daim ntawv ntawm bronchitis.
Muaj lwm qhov kev faib tawm - raws li qib kev koom tes ntawm cov ntaub so ntswg bronchopulmonary hauv cov txheej txheem pathological:
- obstructive bronchitis - lub lumen ntawm lub bronchi nqaim;
- tsis-obstructive bronchitis - bronchial dav tseem zoo ib yam.
Raws li cov hnoos qeev, bronchitis tau muab faib ua:
- catarrhal bronchitis yog mucous, tab sis tsis muaj cov kua paug hauv cov kua paug tawm;
- catarrhal-purulent thiab purulent bronchitis - opaque purulent inclusions nyob rau hauv cov hnoos qeev.
Kev mob hnyav ntawm cov kab mob bronchitis feem ntau yog tshwm sim los ntawm kev kis kab mob ua pa, arrhythmia, spontaneous pneumothorax thiab kev tawm dag zog lub cev.
theem ntawm exacerbation
theem ntawm exacerbation tuaj yeem tsim kom meej meej los ntawm cov hnoos qeev expectorant. Yog li, xws li cov cim qhia ua lub luag haujlwm tseem ceeb: xim, ntim, sib xws. Cov cim no "dictate" keeb kwm ntawm tus kab mob. Cov kab mob bronchitis nyob rau theem mob tshwm sim los ntawm kev ua pa tsis ua haujlwm.
Cia peb txheeb xyuas cov theem ntawm exacerbation:
- pib ntawm kev rov qab los. Thaum lub sij hawm no, cov hnoos qeev secreted yog viscous, tuab thiab nyuaj rau cais. Cov xim ntawm qhov sib xws yog ntsuab. Feem ntau, expectoration tshwm sim thaum sawv ntxov. Thiab thaum nruab hnub, cov mucus liquefies, tso tawm me me.
- Lub sijhawm kawg. Sputum purulent xim av. Sib cais ntau ntau.
Kev sib cais ntawm kev rov qab los yog qhov txawv raws li daim duab kho mob ntawm pathology:
- 1 hom: rov ua kom ntim ntau ntxivexpectorant hnoos qeev. Tej zaum nws yuav purulent. Ua pa luv zuj zus.
- 2nd hom: nyob rau hauv hom thib ob ntawm kev rov ua dua, mob ntsws ntev yog yam ntxwv los ntawm purulent hnoos qeev ntau lawm.
- 3rd hom: rau tag nrho cov cim ntawm thawj ob hom, cov tsos mob hauv qab no yuav tsum tau ntxiv:
- febrile xeev ntawm tus neeg mob;
- nce thiab hnoos ntau zaus;
- ORZ (lub lim tiam);
- ntxhi thaum ua pa;
- ua pa nce 25% (thaum piv nrog ua pa hauv lub xeev noj qab haus huv);
- nce lub plawv dhia thiab lub plawv dhia (piv rau lub xeev noj qab haus huv).
Tus kab mob rov qab tuaj yeem ua rau hypoxia thiab exacerbation ntawm lwm cov kab mob ntev hauv tus neeg mob.
ICD code rau exacerbation ntawm mob ntsws bronchitis
Nws yuav tsum raug sau tseg tias ICD yog kev faib tawm thoob ntiaj teb ntawm cov kab mob. Nov yog ib daim ntawv tswj xyuas tshwj xeeb uas ua kom muaj kev sib koom ua ke ntawm txoj hauv kev.
Raws li ICD, nrog rau kev ua kom mob ntsws ntev ntev, nyob ntawm daim ntawv ntawm kev loj hlob ntawm tus kab mob, subcodes txawv, uas yog:
- J40 - code rau catarrhal bronchitis (cov ntaub ntawv: mob thiab mob ntev);
- J42 - Mob ntsws mob ntsws, tsis qhia meej.
Purulent-obstructive form (mixed) bronchitis muaj cov lej hauv qab no: J41 lossis J44. Cov cai tshwj xeeb yog nyob ntawm qhov muaj cov kab mob purulent lossis spasm hauv bronchi.
Tus kab mob no kuj tau muab faib ua lwm cov lej, nyob ntawm theem ntawm kev loj hlob ntawm exacerbation. Yog li, code J41 raws li ICD-10 - exacerbation ntawm mob bronchitis, tracheitis, tracheobronchitis nrogpurulent hnoos qeev.
Diagnosis
Kev kuaj mob bronchitis yog txhawm rau txheeb xyuas cov tsos mob thiab xam phaj tus neeg mob. Raws li qhov tshwm sim ntawm qhov kev soj ntsuam, tus kws kho mob pom cov lus qhia tsis zoo uas ua rau muaj kab mob.
Kev kuaj mob nyuaj. Tus neeg mob yuav tsum xeem dhau qhov kev xeem hauv qab no:
- kuaj ntshav (kev dav dav thiab biochemical) txhawm rau kuaj pom muaj cov txheej txheem inflammatory;
- urinalysis;
- laboratory kawm txog expectorant hnoos qeev;
- lub hauv siab x-ray kom pom qhov txhab;
- spirography los txiav txim siab ua haujlwm ntawm kev ua pa sab nraud;
- FBS (fibronchoscopy) yog cov ntaub ntawv qhia kev kuaj mob tshaj plaws. Ua tsaug rau nws, koj tuaj yeem pom cov duab kho mob ntawm tus kab mob thiab txheeb xyuas cov kab mob oncological lossis tuberculosis hauv lub sijhawm.
X-ray thiab CT scan.
Kev kho mob
Nyob rau hauv cov ntaub ntawv ntawm exacerbation ntawm mob ntsws bronchitis, kev kho mob yuav tsum ua kom tiav. Cov hom phiaj kho tau zoo:
- kom txo qis exacerbation;
- kom txhim kho lub neej zoo;
- kom txhim kho kev ua siab ntev;
- mus ncua kev zam txim.
Yog tias pib muaj qhov exacerbation, lub luag haujlwm tseem ceeb ntawm kev kho yog tshem tawm cov txheej txheem inflammatory hauv bronchi thiab txhim kho bronchial patency.
Yog tias qhov ua rau muaj kab mob etiology, ces kev kho mob yuav tsum yog nrog tshuaj tua kab mobtshuaj.
- Expectorants: ACC, Lazolvan, Flavamed, Bromhexine.
- Nws raug pom zoo kom noj mucolytics: Ambroxol, Bromhexine, Carbocysteine.
- Y Bronchodilators: Eufillin, Theophylline, Salbutamol.
Kev kho mob nyuaj suav nrog kev siv tshuaj tua kab mob, tshuaj tua kab mob, tshuaj tua kab mob, tshuaj tiv thaiv kab mob, tshuaj tiv thaiv kab mob. Recommended inhalation, physiotherapy.
Tshuaj tua kab mob
Nws yog ib qho tsim nyog yuav tsum siv cov tshuaj tua kab mob hauv cov neeg mob uas muaj cov kab mob purulent exacerbation ntawm tus mob bronchitis. Kev kho mob, uas cov tshuaj tau sau ib nrab-synthetic muaj pes tsawg leeg, yuav tsum complex.
Yog li, yog tias mob ntsws qhuav tshwm sim (raws li qhov teeb meem) tawm tsam keeb kwm ntawm mob ntsws ntev, tus kws kho mob tau sau cov tshuaj hauv qab no:
- penicillins ("Amoxicillin", "Augmentin"),
- Ycephalosporins ("Ceftriaxone"),
- macrolides ("Sumamed", "Azithromycin"),
- Yfluoroquinolones ("Ciprofloxacin").
Tshuaj tua kab mob tua cov kab mob plab hnyuv microflora. Txhawm rau kho nws, nws raug pom zoo kom noj cov tshuaj probiotics ("Lineks", "Laktovit", "Bifiform").
Kev nyuaj siab
Kev mob ntsws ntev ntev tuaj yeem ua rau muaj ntau yam teeb meem. Cov kws kho mob faib lawv ua ob pawg:
- pab pawg kis kab mob (pneumonia, bronchiectasis, asthmatic thiab bronchospastic Cheebtsam);
- pab pawg thib ob: kev loj hlob ntawm tus kab mob hauv qab.
Tej zaumCov tsos mob ntawm cov teeb meem xws li emphysema, pulmonary hypertension, cor pulmonale, cardiopulmonary tsis ua hauj lwm, mob ntsws, bronchial hawb pob.
tshuaj ntsuab
Kev kho mob ntawm cov mob ntsws ntev tuaj yeem ua tiav nrog kev pab ntawm pej xeem cov tshuaj. Xav txog cov zaub mov txawv tshaj plaws:
- Decoction ntawm apricot kernels. Los ntawm 20 g ntawm cov noob, nws yog ib qhov tsim nyog los tshem tawm cov nucleoli. Ncuav 1 khob dej npau rau lawv. Nqa mus rau ib lub boil thiab simmer rau 5 feeb tshaj tsawg tshav kub. Tshem tawm ntawm qhov cub thiab lim tom qab 2 teev. Haus ib decoction ntawm ¼ khob 3-4 zaug ib hnub twg. Kernels noj tau.
- Gush ntawm horseradish thiab txiv qaub. Nws yuav siv 150 g ntawm horseradish thiab 3 pieces ntawm txiv qaub. Scroll los ntawm cov khoom xyaw hauv cov nqaij grinder thiab sib tov kom huv si. Cov txiaj ntsig slurry yuav tsum tau noj ntawm lub plab khoob thaum sawv ntxov thiab thaum mus pw. Cov tshuaj no muaj cov tshuaj tiv thaiv kab mob thiab txhawb kev expectoration zoo.
- tshuaj ntsuab. Nws yog ib qho tsim nyog yuav tau ua cov tshuaj sau los ntawm cov tshuaj ntsuab: coltsfoot, plantain, licorice, thyme. 1 st. Ncuav ib spoonful ntawm sib tov nrog 0.5 liv ntawm boiling dej. Cia nws brew rau 3 teev. Haus 1/3 khob rau 10 hnub.
- mis nyuj kub nrog zib ntab thiab dej qab zib. Nws yog ib qho tsim nyog kom sov cov mis nyuj, ncuav rau hauv ib khob. Ntxiv 1 tsp rau nws. zib mu, ib tug pinch ntawm ntsev thiab ib tug me me piece ntawm butter (hais ntawm lub ntsis ntawm ib tug riam). Sib tov kom huv si thiab haus hauv me me sips. Koj yuav tsum haus tag nrho lub khob, thiab tom qab ntawd npog koj tus kheej nrog ib daim pam sov. Nws yog ib qho zoo anti-inflammatory, ua kom sov thiabexpectorant.
Cabbage thiab zib ntab compress. Koj yuav xav tau ib tug loj cabbage nplooj. Zib ntab yuav tsum tau thov rau nws nrog ib txheej nyias. Siv lub compress rau thaj tsam bronchial thiab kho. Nco ntsoov insulate sab saum toj. Khaws lub compress txhua hmo
Yuav ua li cas rau qhov exacerbation?
Yog tias mob ntsws ntev tau ua rau nws tus kheej hnov, qhov exacerbation ntawm kev kho nrog tshuaj, nws raug nquahu kom ntxiv rau kev kho tshuaj:
- kho lub cev - pab txhawb kom rov zoo sai;
- physiotherapy ce (tso cai thaum kho cov exacerbation ntawm tsis-obstructive bronchitis);
- noj cov vitamins A, B, C thiab biostimulants (aloe kua txiv, propolis).
Koj tuaj yeem ua qhov zaws. Nws txhawb kev expectoration thiab muaj cov nyhuv bronchodilatory.
Tus mob ntsws ntev yog ib yam kab mob uas tuaj yeem ua rau muaj qhov tshwm sim loj. Tsis tas yuav ncua kev kho mob. Koj tsis tuaj yeem kho tus kheej. Muab koj txoj kev noj qab haus huv rau ib tus kws kho mob uas muaj peev xwm paub txog. Tsuas yog nws thiaj li sau tau ib txoj kev kho mob zoo. Noj qab nyob zoo!
