Bronchitis acute

Bronchitis acute - diffuse acute inflammation of the tracheobronchial tree. Refers to frequent diseases.

Etiology, pathogenesis. The disease is caused by viruses (influenza viruses, parainfluenza, adenoviruses, respiratory syncytial, measles, pertussis, etc.), bacteria (staphylococci, streptococci, pneumococci, etc.); Physical and chemical factors (dry, cold, hot air, nitrogen oxides, sulfur dioxide, etc.). Predispose to the disease cooling, smoking tobacco, drinking alcohol, chronic focal infection in the nasopharyngeal region, violation of nasal breathing, deformation of the chest. The injuring agent penetrates the trachea and bronchi with inhaled air, hematogenous or lymphogenous pathway (uremic bronchitis). Acute inflammation of the bronchial tree can be accompanied by a violation of the bronchial patency of the inflammatory or bronchospastic mechanism. Characterized by hyperemia and swelling of the mucosa; On the walls of the bronchi in their lumen, slimy, mucopurulent or purulent secret; Degenerative changes of the ciliary epithelium. In severe forms, the inflammatory process captures not only the mucous membrane, but also the deep tissues of the bronchial wall.

Symptoms, course. Bronchitis of infectious etiology often begins with a background of acute rhinitis, laryngitis. With a mild course of the disease, there is a sadness behind the sternum, dry, less often a wet cough, a feeling of weakness, weakness. There are no physical signs or severe breathing, dry wheezes are defined above the lungs. Body temperature is subfebrile or normal. The composition of peripheral blood does not change. Such a course is observed more often with trachea and large bronchi. In the middle-moderate course, general malaise, weakness, severe dry cough with difficulty breathing and shortness of breath, pain in the lower parts of the chest and abdominal wall, associated with muscle overexertion during coughing, are markedly expressed. Cough gradually becomes wet, sputum gets mucopurulent or purulent. Above the lungs surface, hard breathing is heard, dry and wet finely bubbling rales. The body temperature remains subfebrile for several days. There are no marked changes in the composition of peripheral blood. The severe course of the disease is observed, as a rule, with the predominant involvement of bronchioles (see Bronchiolitis). Acute symptoms of the illness subsided by the 4th day and with a favorable outcome completely disappear by the 7th day. Acute bronchitis with violation of bronchial patency has a tendency to protracted flow and transition to chronic bronchitis.

Severe acute bronchitis of toxic-chemical etiology. The disease begins with a painful cough with the discharge of mucous or bloody sputum, the bronchospasm quickly joins (against the background of prolonged exhalation dry wheezing sounds are heard) and progressing dyspnea (up to suffocation), increasing respiratory insufficiency and hypoxemia. Radiographically, the symptoms of acute emphysema can be determined. Symptomatic erythrocytosis breaks down, the hematocrit values ​​increase. Heavy current can also take acute dusty bronchitis. In addition to coughing (at first dry and then wet), marked shortness of breath, cyanosis of the mucous membranes. A boxed shade of percussion sound, hard breathing, dry wheezes are determined. A small erythrocytosis is possible. X-ray reveals increased transparency of pulmonary fields and a moderate expansion of the roots of the lungs.

Treatment. Bed rest, plentiful warm drink with honey, raspberry, lime color; Heated alkaline mineral water; Acetylsalicylic acid 0.5 g 3 times a day, ascorbic acid up to 1 g per day, vitamin A 3 mg 3 times per day; Mustard, cans on the chest. When expressed by dry cough appoint codeine (0.015 g) with sodium hydrogen carbonate (0.3 g) 2-3 times a day. The drug of choice can be libexin 2 tablets 3-4 times a day. Of the expectorants are effective infusion of thermopsis (0.8 g per 200 ml of 1 tablespoon 6-8 times a day); 3% solution of potassium iodide (1 tablespoon 6 times a day), bromhexine 8 mg 3-4 times a day for 7 days, etc. Inhalations of expectorants, mucolytics, heated mineral alkaline water, 2% sodium hydrogen carbonate solution , Eucalyptus, anise oil using a steam or pocket inhaler. Inhalation is carried out 5 minutes 3-4 times a day for 3-5 days. Bronchospasm is stopped by the appointment of euphyllin (0.15 g 3 times a day). Antihistamines are indicated. If the symptomatic therapy is ineffective for 2-3 days, as well as for the moderate and severe disease, antibiotics and sulfonamides are prescribed in the same doses as for pneumonia.

Prevention. Elimination of the possible etiologic factor of acute bronchitis (dustiness and gas contamination of work premises, hypothermia, smoking, alcohol abuse, chronic and focal infection in the respiratory tract, etc.), as well as measures aimed at increasing the body's resistance to infection (hardening, vitaminization of food).