支气管炎:修订间差异

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{{Infobox disease

| Name = 支氣管炎

| DiseasesDB = 29135
== 病理生理 ==
| Image = Bronchitis.jpg
急性支气管炎常常发生在[[感冒]]或感染以后。最早的临床特点是气管及支气管下粘液腺分泌的粘液增加。气道的损害可以造成肺部炎症,肺组织的[[中性粒细胞]]浸润。中性粒细胞释放许多化学物质,再促进粘液分泌。
| Caption = Figure A shows the location of the lungs and bronchial tubes. Figure B is an enlarged view of a normal bronchial tube. Figure C is an enlarged view of a bronchial tube with bronchitis.
| ICD10 = {{ICD10|J|20||j|20}}-{{ICD10|J|21||j|20}}, {{ICD10|J|42||j|40}}
| ICD9 = {{ICD9|466}}, {{ICD9|491}}, {{ICD9|490}}
| ICDO =
| OMIM =
| MedlinePlus = 001087
| eMedicineSubj = article
| eMedicineTopic = 807035
| eMedicine_mult = {{eMedicine2|article|297108}}
| MeshID = D001991
| MeshNumber = I
}}{{medical}}
'''支氣管炎'''是肺部支氣管(中至大的大小之呼吸道)的發炎。<ref name=NIH2011Def>{{cite web|title=What Is Bronchitis?|url=http://www.nhlbi.nih.gov/health/health-topics/topics/brnchi|accessdate=1 April 2015|date=August 4, 2011}}</ref>症狀包括咳痰、喘鳴、呼吸急促及胸口不適。<ref name=NIH2011Def>{{cite web|title=What Is Bronchitis?|url=http://www.nhlbi.nih.gov/health/health-topics/topics/brnchi|accessdate=1 April 2015|date=August 4, 2011}}</ref>支氣管炎有急性和慢性兩種。<ref name=NIH2011Def>{{cite web|title=What Is Bronchitis?|url=http://www.nhlbi.nih.gov/health/health-topics/topics/brnchi|accessdate=1 April 2015|date=August 4, 2011}}</ref>
<!-- Acute bronchitis -->
急性支氣管炎的咳嗽症狀一般持續三週,<ref name=AFP2010>{{cite journal|last1=Albert|first1=RH|title=Diagnosis and treatment of acute bronchitis.|journal=American family physician|date=1 December 2010|volume=82|issue=11|pages=1345-50|pmid=21121518}}</ref>逾九成是病毒感染引起的。<ref name=AFP2010/>病毒經人們咳嗽的飛沫或直接接觸傳播。<!-- <ref name=NIH2011Def/> --> 風險因素包括吸煙、塵埃和空氣污染。<ref name=NIH2011Def/>一小部份病症是高量空氣污染物或細菌直接引起,細菌包括肺炎黴漿菌和百日咳桿菌。<ref name=AFP2010/><ref>{{cite web|title=What Causes Bronchitis?|url=http://www.nhlbi.nih.gov/health/health-topics/topics/brnchi/causes|accessdate=1 April 2015|date=August 4, 2011}}</ref>急性支氣管炎的治療是休息、止痛藥(乙醯酚胺) 和非類固醇抗發炎藥物幫助退燒。<ref name=Tac2012>{{cite journal|last1=Tackett|first1=KL|last2=Atkins|first2=A|title=Evidence-based acute bronchitis therapy.|journal=Journal of pharmacy practice|date=December 2012|volume=25|issue=6|pages=586-90|pmid=23076965}}</ref><ref>{{cite web|title=How Is Bronchitis Treated?|url=http://www.nhlbi.nih.gov/health/health-topics/topics/brnchi/treatment|accessdate=1 April 2015|date=August 4, 2011}}</ref>
<!-- Chronic bronchitis -->
慢性支氣管炎的定義是持續兩年或以上,<ref name=GOLD2013Chp2>{{cite book |last=Vestbo |first=Jørgen |title=Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease |year=2013 |publisher=Global Initiative for Chronic Obstructive Lung Disease |pages=9–17 |chapter=Diagnosis and Assessment |chapterurl=http://www.goldcopd.org/uploads/users/files/GOLD_Report_2013_Feb20.pdf#26}}</ref>每年裡超過三個月的有痰咳嗽。大部分慢性支氣管炎患者有慢性阻塞性肺病。<ref name=Harr2012>{{cite book |first1=John J. |last1=Reilly |first2=Edwin K. |last2=Silverman |first3=Steven D. |last3=Shapiro |chapter=Chronic Obstructive Pulmonary Disease |pages=2151–9 |editor1-first=Dan |editor1-last=Longo |editor2-first=Anthony |editor2-last=Fauci |editor3-first=Dennis |editor3-last=Kasper |editor4-first=Stephen |editor4-last=Hauser |editor5-first=J. |editor5-last=Jameson |editor6-first=Joseph |editor6-last=Loscalzo |year=2011 |title=Harrison's Principles of Internal Medicine |edition=18th |publisher=McGraw Hill |isbn=978-0-07-174889-6}}</ref>吸煙是最常見的致病原因,其他原因包括空氣污染和基因(後者重要性較低)。<ref name=Lancet2012>{{cite journal |author=Decramer M, Janssens W, Miravitlles M |title=Chronic obstructive pulmonary disease |journal=Lancet |volume=379 |issue=9823 |pages=1341–51 |date=April 2012 |pmid=22314182 |doi=10.1016/S0140-6736(11)60968-9}}</ref>慢性支氣管炎的治療是戒煙、疫苗預防、復康治療、吸入性支氣管擴張劑和類固醇。<ref name=GOLD2007/>一些患者需要長期吸氧治療或肺臟移植。<ref name=GOLD2007>{{cite journal | author = Rabe KF, Hurd S, Anzueto A, Barnes PJ, Buist SA, Calverley P, Fukuchi Y, Jenkins C, Rodriguez-Roisin R, van Weel C, Zielinski J | title = Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary | journal = Am. J. Respir. Crit. Care Med. | volume = 176 | issue = 6 | pages = 532–55 |date=September 2007 | pmid = 17507545 | doi = 10.1164/rccm.200703-456SO | url = http://ajrccm.atsjournals.org/content/176/6/532.long }}</ref>
<!-- Epidemiology -->
急性支氣管炎是最常見的病症之一。<ref name=Tac2012/><ref name=Chest2006>{{cite journal|last1=Braman|first1=SS|title=Chronic cough due to acute bronchitis: ACCP evidence-based clinical practice guidelines.|journal=Chest|date=January 2006|volume=129|issue=1 Suppl|pages=95S-103S|pmid=16428698}}</ref>分別約5%成人和約6%兒童每年最少一次出現症狀。<ref name=Wen2006>{{cite journal|last1=Wenzel|first1=RP|last2=Fowler AA|first2=3rd|title=Clinical practice. Acute bronchitis.|journal=The New England journal of medicine|date=16 November 2006|volume=355|issue=20|pages=2125-30|pmid=17108344}}</ref><ref name=Flem2007>{{cite journal|last1=Fleming|first1=DM|last2=Elliot|first2=AJ|title=The management of acute bronchitis in children.|journal=Expert opinion on pharmacotherapy|date=March 2007|volume=8|issue=4|pages=415-26|pmid=17309336}}</ref>在2010年,慢性阻塞性肺病3億2900萬人,即約5%人口。<ref name=YLD2012>{{cite journal | author = Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, Shibuya K, Salomon JA, Abdalla S, Aboyans V | title = Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010 | journal = Lancet | volume = 380 | issue = 9859 | pages = 2163–96 |date=December 2012 | pmid = 23245607 | doi = 10.1016/S0140-6736(12)61729-2 |display-authors=etal}}</ref>在2013年,它引起的死亡數字為2900萬,比1990年的2400 萬有所上升。<ref name=GDB2013>{{cite journal|last1=GBD 2013 Mortality and Causes of Death|first1=Collaborators|title=Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.|journal=Lancet|date=17 December 2014|pmid=25530442|doi=10.1016/S0140-6736(14)61682-2}}</ref>


==症状 ==
==症状 ==
第17行: 第36行:
* 在大多数情况下,急性支气管炎是由病毒引起的,几天后将自行痊愈,无需抗生素;如怀疑合并有细菌感染或防止细菌感染,抗生素也可以考虑;
* 在大多数情况下,急性支气管炎是由病毒引起的,几天后将自行痊愈,无需抗生素;如怀疑合并有细菌感染或防止细菌感染,抗生素也可以考虑;
* 避免吸烟。
* 避免吸烟。

== 预后 ==
急性支气管炎一般约为10天或11天。极少会变成慢性。


== 参考文献 ==
== 参考文献 ==
<reference/>
{{Reflist}}


== 外部链接 ==
== 外部链接 ==

2017年6月2日 (五) 08:01的版本

支氣管炎
Figure A shows the location of the lungs and bronchial tubes. Figure B is an enlarged view of a normal bronchial tube. Figure C is an enlarged view of a bronchial tube with bronchitis.
类型支氣管痙攣慢性阻塞性肺病respiratory signs and symptoms[*]疾病
分类和外部资源
醫學專科胸腔醫學
ICD-11CA20
ICD-10J20-J21, J42
ICD-9-CM466, 491, 490
DiseasesDB29135
MedlinePlus001087
eMedicinearticle/807035 article/297108
MeSHD001991
[编辑此条目的维基数据]

支氣管炎是肺部支氣管(中至大的大小之呼吸道)的發炎。[1]症狀包括咳痰、喘鳴、呼吸急促及胸口不適。[1]支氣管炎有急性和慢性兩種。[1] 急性支氣管炎的咳嗽症狀一般持續三週,[2]逾九成是病毒感染引起的。[2]病毒經人們咳嗽的飛沫或直接接觸傳播。 風險因素包括吸煙、塵埃和空氣污染。[1]一小部份病症是高量空氣污染物或細菌直接引起,細菌包括肺炎黴漿菌和百日咳桿菌。[2][3]急性支氣管炎的治療是休息、止痛藥(乙醯酚胺) 和非類固醇抗發炎藥物幫助退燒。[4][5] 慢性支氣管炎的定義是持續兩年或以上,[6]每年裡超過三個月的有痰咳嗽。大部分慢性支氣管炎患者有慢性阻塞性肺病。[7]吸煙是最常見的致病原因,其他原因包括空氣污染和基因(後者重要性較低)。[8]慢性支氣管炎的治療是戒煙、疫苗預防、復康治療、吸入性支氣管擴張劑和類固醇。[9]一些患者需要長期吸氧治療或肺臟移植。[9] 急性支氣管炎是最常見的病症之一。[4][10]分別約5%成人和約6%兒童每年最少一次出現症狀。[11][12]在2010年,慢性阻塞性肺病3億2900萬人,即約5%人口。[13]在2013年,它引起的死亡數字為2900萬,比1990年的2400 萬有所上升。[14]

症状

支气管炎患者常有咳嗽,咳痰,呼吸困难、喘鸣(呼吸短促)、鼻塞、畏寒、发烧、胸部疼痛啾,有时疲劳乏力。

诊断

体检时常会发现呼吸气声强度降低、喘息和呼气时间延长。多数医生靠持续的干咳或湿咳作为支气管炎诊断的证据。

  • 胸部X光;
  • 痰样本显示了中性粒细胞及病原微生物培养证明有细菌感染;
  • 验血显示炎症反应(如白血球增加,C-反应蛋白增高)。

治疗

  • 对细菌性急性支气管炎患者,可以使用相应的抗生素;
  • 在大多数情况下,急性支气管炎是由病毒引起的,几天后将自行痊愈,无需抗生素;如怀疑合并有细菌感染或防止细菌感染,抗生素也可以考虑;
  • 避免吸烟。

参考文献

<reference/>

外部链接

参见

  1. ^ 1.0 1.1 1.2 1.3 What Is Bronchitis?. August 4, 2011 [1 April 2015]. 
  2. ^ 2.0 2.1 2.2 Albert, RH. Diagnosis and treatment of acute bronchitis.. American family physician. 1 December 2010, 82 (11): 1345–50. PMID 21121518. 
  3. ^ What Causes Bronchitis?. August 4, 2011 [1 April 2015]. 
  4. ^ 4.0 4.1 Tackett, KL; Atkins, A. Evidence-based acute bronchitis therapy.. Journal of pharmacy practice. December 2012, 25 (6): 586–90. PMID 23076965. 
  5. ^ How Is Bronchitis Treated?. August 4, 2011 [1 April 2015]. 
  6. ^ Vestbo, Jørgen. Diagnosis and Assessment (PDF). Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease. Global Initiative for Chronic Obstructive Lung Disease. 2013: 9–17. 
  7. ^ Reilly, John J.; Silverman, Edwin K.; Shapiro, Steven D. Chronic Obstructive Pulmonary Disease. Longo, Dan; Fauci, Anthony; Kasper, Dennis; Hauser, Stephen; Jameson, J.; Loscalzo, Joseph (编). Harrison's Principles of Internal Medicine 18th. McGraw Hill. 2011: 2151–9. ISBN 978-0-07-174889-6. 
  8. ^ Decramer M, Janssens W, Miravitlles M. Chronic obstructive pulmonary disease. Lancet. April 2012, 379 (9823): 1341–51. PMID 22314182. doi:10.1016/S0140-6736(11)60968-9. 
  9. ^ 9.0 9.1 Rabe KF, Hurd S, Anzueto A, Barnes PJ, Buist SA, Calverley P, Fukuchi Y, Jenkins C, Rodriguez-Roisin R, van Weel C, Zielinski J. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am. J. Respir. Crit. Care Med. September 2007, 176 (6): 532–55. PMID 17507545. doi:10.1164/rccm.200703-456SO. 
  10. ^ Braman, SS. Chronic cough due to acute bronchitis: ACCP evidence-based clinical practice guidelines.. Chest. January 2006, 129 (1 Suppl): 95S–103S. PMID 16428698. 
  11. ^ Wenzel, RP; Fowler AA, 3rd. Clinical practice. Acute bronchitis.. The New England journal of medicine. 16 November 2006, 355 (20): 2125–30. PMID 17108344. 
  12. ^ Fleming, DM; Elliot, AJ. The management of acute bronchitis in children.. Expert opinion on pharmacotherapy. March 2007, 8 (4): 415–26. PMID 17309336. 
  13. ^ Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, Shibuya K, Salomon JA, Abdalla S, Aboyans V; et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. December 2012, 380 (9859): 2163–96. PMID 23245607. doi:10.1016/S0140-6736(12)61729-2. 
  14. ^ GBD 2013 Mortality and Causes of Death, Collaborators. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.. Lancet. 17 December 2014. PMID 25530442. doi:10.1016/S0140-6736(14)61682-2.