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 Posted: Sun 1:42, 20 Mar 2011 Post subject: ghd outlet 32 patients with cough variant asthma m |
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32 patients with cough variant asthma misdiagnosis
Inflammation in 25 cases, 2 cases of pulmonary tuberculosis, bronchiectasis in 3 cases, 2 cases of chronic pharyngitis. 1.5 before treatment all patients diagnosed with a variety of antibiotics, antitussives and other objects, and 2 cases of anti-TB drug trials have been treated for six months. Once the diagnosis of CVA after giving aminophylline, to help prepare, such as oral prednisone, 1 week after the switch to Pulmicort and asthma Kang-speed aerosol inhalation. 2 CVA is discussed as the main clinical signs of coughing and asthma. Traditional view is that asthma is bronchial smooth muscle spasm, airway stenosis caused by, in recent years, people gradually realized the nature of asthma is due to eosinophils, mast cells and T lymphocytes and other inflammatory cells in chronic airway inflammation. Inflammatory cells produce and secrete inflammatory mediators, the increased airway responsiveness (BHR), which displayed a variety of non-specific stimulation of the extraordinary response. According to the 2002 Institute of Respiratory Diseases, Chinese Medical Association revised asthma prevention and treatment guidelines for asthma, typical asthma diagnosis, but a considerable part of the asthma, the clinical symptoms not typical, only showed recurrent dry cough, wheeze and no physical examination beep, but only for long-term performance (> February) stubborn cough. Often misdiagnosed as upper respiratory tract infection or acute and chronic bronchitis, but the anti-infective treatment fails,[link widoczny dla zalogowanych], and is sensitive to the bronchodilator. Study the causes of misdiagnosis, I believe that may: (1) is a grassroots non-specialist hospitals lack of understanding of the CVA, so such patients diagnosed as normal according to conventional thinking, upper respiratory tract infections, bronchitis. Misdiagnosis of 32 cases,[link widoczny dla zalogowanych], both long-term, repeated use of antibiotics, antitussives and other objects, 3 patients with pulmonary tuberculosis based only on past history, chest radiograph suggestive of not only ineffective, but increased the economic burden of patients, resulting in pharmaceutical waste and toxic side effects to patients. There is an urgent need to improve the general understanding of medical workers of CVA, no significant wheezing, chest wheeze is not known and does not negate the existence of asthma. (2) For the clinical chronic cough, the inspection can not find a clear cause,[link widoczny dla zalogowanych], the antibiotic treatment fails in patients with cough and can not reasonably use special checks to help diagnose, but also one of the causes of misdiagnosis. . Pulmonary function and application of current clinicians Determination of airway responsiveness as a basis for diagnosis of asthma were little; In fact, both of which are commonly used in diagnosis of bronchial asthma physiological methods. Bronchial dilation test which is relatively safe, practical way. Therefore, clinicians should improve understanding of the highly suspect the CVA should be routinely checked for early diagnosis. Conditions are not yet available on the medical unit for this test, the proposed pilot line treatment of bronchial spasm agent, if the lesions improved rapidly after treatment or recovery is also a means of diagnosis of CVA. (3) medical history is not detailed. As with many other diseases, history is very important for the diagnosis of CVA, chronic dry cough, asthma patients should be asked in detail about the family history,[link widoczny dla zalogowanych], personal history of allergies, seizures incentives, environmental, seasonal factors, this group of l9 (53.1%) had allergy, 25 patients (78.1%) and home decoration, the environment,[link widoczny dla zalogowanych], seasonal factors, if seriously asked about the history, combined with the necessary auxiliary examination, many patients may avoid misdiagnosis. Diagnosis of CVA is the most important to improve the clinician's understanding of this disease. Chronic intractable cough, the disease after the exclusion of other organic disease should focus on consideration of the disease. Height Skeptics in time for the selection of methods related to the diagnosis or treatment of early experimental bronchodilators, so only to avoid or reduce misdiagnosis and mistreatment.
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