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Diagnosis and treatment of chronic bronchitis
A small leukocytosis with a stab shift in the leukocyte formula is possible. With exacerbation of purulent bronchitis, a slight change in the biochemical parameters of inflammation occurs (C-reactive protein, sialic acids, fibronogen, seromucoid, etc. increase). Sputum examination: macroscopic, cytological, biochemical. With a pronounced exacerbation of sputum, it becomes purulent in nature: predominantly neutrophilic leukocytes appear in it, the level of acid mucopolysaccharides and DNA fibers increase, which increase the viscosity of sputum, the amount of lysozyme decreases, etc. Using bronchoscopy, the endobronchial manifestations of the inflammatory process and stages of the inflammatory process are assessed: catarrhal, purulent, atrophic, hypertrophic, hemorrhagic and severity, but mainly to the level of subsegmental bronchi. In the phase of exacerbation of chronic bronchitis, therapy is directed to eliminating the inflammatory process, improving bronchial patency, and also restoring impaired general and local immunological reactivity. Antibacterial therapy is prescribed, which is selected taking into account the sensitivity of sputum microflora, is prescribed orally or parenterally, sometimes combined with intratracheal administration. Showing inhalation. They use expectorant, mucolytic drugs, a plentiful drink to restore and improve bronchial patency. Herbal medicine with the use of marshmallow root, leaves of coltsfoot, plantain.
Prescribe proteolytic enzymes (trypsin, chymotrypsin) that reduce the viscosity of sputum. Acetylcysteine has the ability to break the disulfide bonds of mucus proteins and contributes to a strong and rapid liquefaction of sputum. Bronchial drainage improves with the use of mucoregulators that affect the secretion and the production of glycoproteins in bronchial epithelium (bromhexine). In case of insufficiency of bronchial drainage and the existing symptoms of bronchial obstruction, bronchospasmolytic drugs are added to the treatment: aminophylline, anticholinergics (atropine in aerosols), adrenostimulants (ephedrine, salbutamol, berotek). In a hospital, intratracheal lavage with purulent bronchitis must be combined with sanitation bronchoscopy (3-4 sanitation bronchoscopy with a break of 3-7 days). When restoring the drainage function of the bronchi, physiotherapy exercises, chest massage, and physiotherapy are also used. With the development of allergic syndromes, calcium chloride and antihistamines are used; in the absence of effect, a short course of glucocorticoids can be prescribed to relieve the allergic syndrome, but the daily dose should not be more than 30 mg. The danger of activation of infectious agents does not allow the use of glucocorticoids for a long time. Patients with chronic bronchitis complicated by respiratory failure and chronic pulmonary heart are shown to use Veroshpiron (up to 150-200 mg / day).
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Diagnosis and treatment of chronic bronchitis
- Chronic bronchitis treatment
If the patient smokes all his life, and irreversible changes have already come, then banning smoking is useless - it will not help. But if you smoke less than 20 years in a row, that is, there are no irreversible changes yet - quit smoking, definitely. If the profession is harmful - change. Hardening. Start with wiping, back massage with a bath towel between the shoulder blades. Bronchospasmolytic drugs. If non-obstructive - during
- Prevention and treatment of chronic obstructive bronchitis
The goal of treatment and prevention is to reduce the rate of progression of diffuse damage to the bronchi, leading to increasing respiratory failure, reduce the frequency of exacerbations, prolong remission, increase exercise tolerance, and improve the quality of life. Patient education. The active participation of patients in the treatment process is one of the main conditions
- Exacerbation of chronic bronchitis
Chronic bronchitis is a disease associated with prolonged exposure to non-specific irritants (tobacco smoke, etc.) on the respiratory tract, accompanied by mucus hypersecretion and inflammatory and degenerative changes in the bronchi and lung tissue. A key symptom of the disease is a chronic productive cough, observed for at least 3 months for 2 consecutive years with
- The clinical picture of chronic bronchitis
The main symptoms of the disease that cause the patient to see a doctor are increasing shortness of breath, sometimes accompanied by coughing sputum production and wheezing. Shortness of breath - can vary within a very wide range: from a feeling of lack of air during standard physical exertion to severe respiratory failure. Dyspnea usually develops
- LECTURE No. 19. Respiratory diseases. Acute bronchitis. Clinic, diagnosis, treatment, prevention. Chronical bronchitis. Clinic, diagnosis, treatment, prevention
LECTURE No. 19. Respiratory diseases. Acute bronchitis. Clinic, diagnosis, treatment, prevention. Chronical bronchitis. Clinic, diagnosis, treatment,
- Diagnosis and treatment of chronic pancreatitis
Laboratory data: 1) general blood test (neutrophilic leukocytosis with a shift to the left, there may be lymphocytosis, eosinophilia, thrombocytopenia); 2) urinalysis (increased amylase, peptidase); 3) a biochemical blood test (an increase in amylase, lipase, trypsin and its inhibitor, elastase; 4) an amylase and glycemic curve with a double glucose load according to the Staub – Traugott test; with pancreatitis
- LECTURE No. 5. Chronic heart failure in children. Clinic, diagnosis, treatment
Heart failure is a condition in which the heart, despite a sufficient flow of blood, does not provide the body with a need for blood supply. Causes of chronic circulatory failure: direct effect on the myocardium (toxic, infectious, traumatic), cardiovascular disease. Classification. Classification of chronic heart failure (according to
- 74. CHRONIC GLOMERULONEPHRITIS. ETHIOLOGY, PATHOGENESIS, CLINIC, DIAGNOSTIC, TREATMENT PRINCIPLES.
kidney glomerular disease. Etiology is the outcome of OGN (? - hemolytic streptococcus), or occurs with systemic lupus erythematosus, hepatitis, and a snakebite. Pathogenesis is an autoimmune mechanism: autoAt to own kidney tissue. Clinic - Hematuric form - severe hematuria, swelling on the face, hypertension, signs of general intoxication, changes in the heart,
- LECTURE No. 10. Chronic diseases of the colon in children. Clinic, diagnosis, treatment
Chronic non-specific diseases of the colon. 1. Functional disorders: 1) chronic constipation; 2) irritable bowel syndrome; 3) diverticular disease. 2. Organic disorders: 1) chronic colitis; 2) ulcerative colitis; 3) Crohn's disease; 4) intestinal amyloidosis. Classification of functional bowel disorders. 1. Intestinal upset: 1) irritable syndrome
- 52. LUNG HEART. ETHIOLOGY, PATHOGENESIS OF ACUTE AND SUBCUTANEOUS, CHRONIC PULMONARY HEART, CLINIC, DIAGNOSTIC, TREATMENT PRINCIPLES.
Pulmonary sero-pathological condition, characterized by hypertrophy of the right ventricle caused by hypertension of the pulmonary circulation, which develops with damage to the bronchopulmonary apparatus, pulmonary vessels, chest deformity, or other diseases that impair lung function. Acute heart lay-wedge symptom complex arising from pulmonary artery thromboembolism, and with
- LECTURE No. 17. Bronchial obstructive syndrome. Clinic, diagnosis, treatment. Respiratory failure. Clinic, diagnosis, treatment
Bronchial obstructive syndrome is a clinical symptom complex observed in patients with generalized obstruction of bronchial patency, its leading manifestation is expiratory dyspnea, asthma attacks. Diseases accompanied by airway obstruction. The main causes of airway obstruction in children. 1. Obstruction of the upper respiratory tract: 1) acquired: a)