《慢性咳嗽病因诊断和治疗》-公开课件.pptVIP

Common causes Postnasal drip Asthma Gastroesophageal reflux Transient airway hyperresponsiveness Medication-related Chronic bronchitis Smoking and other environmental irritants Rare Causes of Chronic Cough Tracheobronchial collapse Lung cancer Tuberculosis Other lung infection Occupational environment-induced cough Bronchiectasis Sarcoidosis Rare Causes of Chronic Cough Left ventricular failure Interstitial lung disease Metastatic breast carcinomatosis Hyperthyroidism Carcinoid tumor Retained suture Hodgkins disease Zenkers diverticulum Etiology: Adults　 同时患AR和AS AR先于AS出现占43-64% AR与AS同时出现占21-25% 总结 慢性咳嗽是呼吸科门诊最常见就诊的症状 引起慢性咳嗽的病因有多种，但最常见的疾病有三种，分别是后鼻滴溜综合征、哮喘、胃食道返流综合征。 经验治疗是鉴别和治疗慢性咳嗽的主要手段 谢谢！ * * * * * Etiology: 0 to 18 months Chronic cough may occur in children and adults. Holinger (1991) reviewed 72 infants and children less than 16 years old with chronic cough greater than 4 weeks and a normal CXR. He noted that the causes for cough in children to vary by age group. Infants (age 0 to 18 months) are most likely to have gastroesophageal reflux (GERD), aortic arch anomalies (vascular ring or aberrant innominate artery), or cough variant asthma. Chronic Cough: 0 to 18 Months Etiology: 18 months to 6 years Children 18 months to 6 years old most commonly have sinusitis or cough variant asthma. Chronic Cough: 1.5 to 6 Years Etiology: Adolescents Adolescent children most commonly have cough variant asthma, psychogenic or habitual cough, or sinusitis. Chronic Cough: 6 to 16 Years Etiology: Adults adults have very different underlying etiologies for chronic cough. Irwin (1990) studied 102 consecutive adults patients with chronic cough and identified postnasal drip (both allergic and infectious causes) (41%), cough variant asthma (24%) and gastroesophageal reflux (21%) to be the most common etiologies of chronic cough in adults. * * * * 慢性咳嗽误诊 慢性支气管炎 急性支气管炎 慢性咽喉炎 支气管内膜结核 声带结节 心理异常 慢性咳嗽 美国（1991年）有2400万咳嗽患者去内科门诊就医； 不吸烟者慢性咳嗽发病率14－23％； 平