What Are the Common Signs of Bronchitis In Children?

Pediatric bronchitis refers to the inflammation of the bronchi. The lesions of children with bronchiolitis mainly occur in the bronchioles of the lungs, that is, the bronchioles. Therefore, the disease name is "bronchiolitis", which is usually caused by viruses such as the common cold and influenza. Complications caused by infection may also be caused by bacterial infection, which is a common acute upper respiratory infection in children.

Pediatric bronchitis

Chinese name: Pediatric bronchitis
Human body parts: Respiratory tract

complication: Adenovirus
Medical Terminology: Bronchiolitis

Children with bronchitis

Bronchitis in children, the disease name is "Bronchiolitis". The cause of bronchiolitis is mainly respiratory syncytial virus, which can account for 80% or more; others are adenovirus, parainfluenza virus, rhinovirus, influenza virus, etc .; a few cases can be caused by mycoplasma pneumoniae. Capillary bronchial congestion, edema, increased mucus secretion, and necrotic mucosal epithelial cells fall off and block the lumen, resulting in significant emphysema and atelectasis. Yan usually involves alveoli, alveolar walls and interstitial lungs, so it can be considered a special type of pneumonia.

Capillary bronchitis is different from general bronchitis or bronchitis. The clinical symptoms are like pneumonia, but mainly wheezing. This disease mostly occurs in children under 2.5 years old, 80% are under 1 year old, and most of them are under 6 months old. Children. Typical bronchiolitis usually occurs 2 to 3 days after an upper respiratory tract infection, with persistent dry cough and fever. The body temperature is characterized by moderate and low fever, and asthma is characteristic. The condition is 2 days after the occurrence of asthma. It was more severe on the 3rd day, and the breathing increased significantly during the onset of wheezing, reaching 60 to 80 times per minute, accompanied by prolonged exhalation and Hohhot air laryngeal wheezing; severely ill children showed nasal diarrhea and "three concave signs" "(That is, the supraclavicular fossa, upper sternum fossa, and upper abdomen are indented during inhalation), the face is pale, the mouth is blue, or cyanosis appears, and the child is often irritable and moaning. Children with more severe illness may be combined with heart failure or Respiratory failure, which can be relieved in most cases after treatment, rarely causes death.

Children should be sent to the hospital for treatment after the onset of illness. Because bronchitis is mostly caused by a viral infection, antibiotic treatment is generally not required in the early stages of onset. If you are suspected of secondary bacterial infection in the late stage of the disease, you can use antibiotics. The symptomatic treatment is the main treatment, which can be summarized as "sedative cough." In addition, good care is also important. Pay special attention not to disturb the children and let them rest quietly. Indoors To maintain a certain humidity, severe children can cooperate with nebulization and inhalation, and timely sputum suction to keep the airway open, can also be treated with traditional Chinese medicine.

Pediatric bronchitis Most of the healing of bronchiolitis is good, and the course of disease usually ranges from 5 days to 9 days. However, it should be noted that children with capillary bronchitis are prone to asthma in the future. According to the national epidemiological survey of pediatric asthma and the follow-up of children with bronchiolitis in infants, it is found that 20% to 40% of them have Children develop asthma in children later, so we must actively prevent bronchiolitis to reduce the incidence of asthma.

Capillary bronchitis can sometimes cause epidemics. In the 1970s, the epidemic occurred three times in rural areas in southern China. In the 1980s, it was in the Yuncheng area of Shanxi. In the 1990s, it was epidemic in Beijing and Tianjin. There was still no understanding. At that time, the disease names were different and the pathogens were unknown. Later, the Ministry of Health organized a national collaboration to monitor and study the epidemic, and it was named "epidemic asthmatic pneumonia." Finally, in 1997, the pathogen of asthmatic pneumonia-respiratory syncytial virus was successfully isolated, and the epidemic pathogen was identified as respiratory syncytial virus A subtype. This will be useful for the future production of effective vaccines to prevent capillary bronchial Popularity has provided important evidence.

Pediatric bronchitis disease symptoms

(1) It is more common in children under 1 year old, especially in infants under 6 months.

(B) the disease can occur all year round, but more common in winter and spring.

(3) The onset is relatively rapid, and there are early symptoms of colds, such as cough and sneezing. The cough worsens after 1 to 2 days, and there is paroxysmal dyspnea, wheezing, pale, cyanosis of the lips, and three concave signs. Early wheezing of lung signs The sound is dominant, followed by wet sounds. Severe symptoms can be associated with congestive heart failure, respiratory failure, hypoxic encephalopathy, and water and electrolyte disorders. Generally, the body temperature does not exceed 38.5 ° C, and the course of disease is 1 to 2 weeks.

(4) The white blood cells are usually normal or slightly increased. Blood gas analysis showed that hypoxemia and arterial blood carbon dioxide partial pressure decreased or increased. Chest x-rays showed thickened lung texture, enhanced bilateral lung transparency, or small shadows and atelectasis. Conditions can be used for rapid diagnosis of respiratory secretion virus to determine the virus type.

Pediatric bronchitis disease characteristics

The onset of acute bronchitis in children can be urgent and slow. Most of them have symptoms of upper respiratory tract infection first, but also suddenly

Pediatric bronchitis Frequent and deep dry cough appears, and bronchial secretions gradually develop. Infants and young children do not expectorate and swallow more through the pharynx. Patients with mild symptoms had no apparent illness, and those with severe fever had a temperature of 38 to 39 ° C, occasionally reaching 40 ° C, and retreated within 2 to 3 days. Feeling tired, affecting sleep appetite, and even vomiting, diarrhea, abdominal pain and other gastrointestinal symptoms. Older children complained of headaches and chest pain. Cough usually lasts for 7 to 10 days, sometimes for 2 to 3 weeks, or recurrent. If not treated properly, it can cause pneumonia, white blood cells are normal or slightly lower, and those who are elevated may have secondary bacterial infections.

Children with healthy bodies rarely have complications, but in children with malnutrition, low immune function, congenital respiratory malformations, chronic nasopharyngitis, and rickets, they are not only prone to bronchitis, but also complicated by pneumonia, otitis media, laryngitis, and parasinusitis. .

Causes of bronchitis in children

Mostly infected by viruses and bacteria. According to epidemiological investigations, rhinovirus, syncytial virus, influenza virus, and rubella virus are the main causes. The more common bacteria are pneumococcus, hemolytic streptococcus, staphylococcus, influenzae, salmonella, and diphtheria. In addition, sudden changes in temperature, air pollution, anatomical and physiological characteristics of respiratory tract in children, allergic factors and low immune function are all causes of this disease. ^[1]

Pediatric bronchitis home care

Bronchitis is a common respiratory disease in children with a high prevalence, which can occur throughout the year, and peaks in winter and spring. When suffering from bronchitis, children often have varying degrees of fever, cough, loss of appetite or vomiting, diarrhea, etc. Smaller children may also have wheezing, wheezing and other symptoms of bronchiolitis. Although a small number of children may develop bronchial pneumonia, most of the children are relatively mild. They are mainly treated and treated at home with medicines. Parents should follow the doctor's advice to give the children medicine and time home care:

I. Keep warm: temperature changes, especially cold stimuli, can reduce local resistance of the bronchial mucosa and aggravate bronchitis. Therefore, parents should add or remove clothing to children in time with temperature changes, especially to cover children during sleep. Good quilt to keep your body temperature above 36.5 .

Second, feed more water: children with bronchitis have varying degrees of fever, water evaporation is large, you should pay attention to feed more water to children. It can be replenished with sugar water or sugar salt water, or with rice soup or egg soup. The diet is mainly semi-liquid to increase the body's moisture and meet the needs of the body.

Third, adequate nutrition: children with bronchitis have a large consumption of nutrients, coupled with fever and bacterial toxins affecting gastrointestinal function, digestion and malabsorption, so the nutritional deficiency of children should not be ignored. In this regard, parents should take a small number of multiple meals method for children, giving a light, adequate nutrition, balanced and easy to digest and absorb semi-liquid or liquid diet, such as porridge, cooked noodles, egg custard, fresh vegetables, fruit juice and so on.

Fourth, turn over and pat back: When the child coughs and sputum, it shows that the bronchial secretions increase. To promote the smooth discharge of secretions, aerosolized inhalants can be used to help expectorants, 2 to 3 times a day, 5 to 20 minutes each. If it is an infant, in addition to patting the back, it should also help to turn over every 1 to 2 hours to keep the child in a semi-recumbent position to facilitate the discharge of sputum.

V. Antipyretic; children with bronchitis usually have moderate to low fever. If the body temperature is below 38.5 ° C, antipyretics are generally not needed, mainly for the treatment of the cause, and the problem is fundamentally solved. If the body temperature is high, older children can be physically cooled, that is, wet the head with a cold towel or wipe with warm water, but children should not use this method, if necessary, use drugs to cool down.

6. Maintain a good family environment: The child's room should be warm, well ventilated and well-lit, and there must be some humidity in the air to prevent excessive drying. If there is a smoker in the home, it is best to quit smoking or go outdoors to prevent the harmful effects of smoking on the child.

Clinical diagnosis of bronchitis in children

(A) clinical manifestations

1. Fever, chills, headache, dry throat, etc.

2. The main symptoms are cough and sputum.

(B) the main types

1. The initial stage of acute bronchitis is dry cough, and the amount of sputum gradually increases, becoming mucopurulent

Pediatric bronchitis sputum.

2. Chronic bronchitis is dominated by a persistent cough, which does not heal for many months, and worsens sooner or later, especially at night. The amount of sputum is more or less, and coughing is faster. Symptoms are milder in summer and prone to acute attacks in winter, making the condition worse. Anti-relapse author, more thin and weak. May be complicated by atelectasis, emphysema, and bronchiectasis.

(Three) physical and chemical testing

1. Early breath sounds can become thick, and blisters can be heard on both sides.

2. X-ray examination: no special findings were found in acute cases. Chronic patients may have corresponding chronic inflammation changes.

Differential diagnosis of bronchitis in children

(1) Those with less severe condition must be distinguished from upper respiratory tract infection.

(2) Bronchial foreign body: When there is airway obstruction and infection, its respiratory symptoms are similar to acute bronchitis. Pay attention to ask if there is a history of inhalation of foreign body in the airway. After treatment, the effect is not good. Chest X-ray examination showed obstruction such as atelectasis and emphysema.

(3) Hilar bronchial lymph node tuberculosis: According to the history of tuberculosis exposure, tuberculin test and chest X-ray examination.

(D) bronchiolitis: more common in infants under 6 months, with obvious acute attacks

Pediatric bronchitis Sexual asthma and dyspnea. The body temperature is not high, and the rales in the lungs are not obvious at the onset of wheezing, and fine wet rales can be heard after remission.

(5) Bronchial pneumonia: When acute bronchitis is severe, it should be distinguished from bronchial pneumonia.

Pediatric bronchitis treatment

Pediatric bronchitis to control infection

If acute bronchitis is a bacterial infection, the following antibacterial drugs can be used: Compound Xinnuomin 0.05 / kg / day for two oral administration, penicillin 3-50000 U / mg / day for two intramuscular injections, medicamycin, red 30-50 mg / kg / day of oral administration of 3-4 times.

If there is no clear bacterial infection or mixed infection, or use ribavirin 10-15 mg / kg / day twice intramuscularly, or 5 mg / kg / day twice as nebulized inhalation, try a-interference. 200,000 U / day intramuscular injection.

Pediatric bronchitis symptomatic treatment

1. Antitussive and expectorant: if the sputum is sticky and difficult to suck out, you can use aerosolized inhalation and select 10% ammonium chloride mixture. ). . Frequent dry cough affects sleep and rest, can take a small amount of antitussive drugs, such as promethazine and chlorpromazine 0.5-1mg / kg / times, 2-3 times a day, care should be taken to avoid excessive medication and prolonged time, affecting the Physiological vitality makes secretions difficult to discharge.

2. Antispasmodic

Aminophylline: 2-4 mg / kg / time orally 3-4 times / day.

Shuchuanling: 1-2 mg / day under 6 years old, orally 3-4 times or 0.1 mg / kg / time, Shuchuanling aerosol (0.5% 1 = 0.1 mg) 1-2 / time daily 2-3 times.

For severe wheezing, prednisone 1 mg / kg / day can be added in 3 oral doses, with a course of 4-7 days. Beclomethasone propionate aerosol can also be used. Topical medication can reduce the side effects of systemic medication. It is difficult for infants and young children to cooperate and should not be used. Children 1-2 (50g-100g) each time, 2-4 times a day.

Pediatric bronchitis Chinese medicine treatment

1. Antitussive and asthma: During the remission period, some traditional Chinese medicine preparations for antitussive and asthma can be used, which can also relieve symptoms to a certain extent.

2. External sticking medicine: After many infants and young children get sick, long-term medication can bring the poisonous effects of some drugs. The safety and convenience of external sticking Chinese medicine is also a good way. At present, there are a lot of herbs such as expectorant, phlegm-removing Baicaoqi paste and Sanjiu paste for winter.

Pediatric bronchitis massage

Through traditional Chinese medical massage, acupoint massage and massage are performed on children with symptoms of bronchitis to unblock the breath to achieve a therapeutic effect. Currently well-known pediatric massage clinics include Shanghai Kangyao Pediatric Massage, Qingdao Pediatric Massage, and Beijing Yuming Pediatric Massage.

Pediatric bronchitis acupoint injection therapy

1 Licorice injection

Licorice from Xinjiang, after decoction, deproteinized with alcohol, is made into 50% licorice injection, bottled, sealed and autoclaved for later use.

Methods: The common acupuncture points are Feishu, Zhongfu, Kongzui, Fenglong, Dingchuan. Once every other day, use 3-4 acupuncture points on one or both sides. Inject 0.5ml into each hole, and the dosage is about 3ml each time. 10 times as a course of treatment. Ear acupuncture (selection points: lung, Dingchuan, adrenal gland) can be used at the same time.

Source: PLA General Force 218.

Note: 1. Effective for antitussive and expectorant.

2. After the injection, the local swelling and pain are obvious and disappear on its own within a few hours. Hypertension and pregnant women with caution.

Pediatric bronchitis diet therapy

Bronchitis in children is mostly secondary to respiratory infections or a clinical symptom of some acute respiratory infections. The cause is a variety of bacteria or viruses, or a combined infection. Symptoms can be slow or urgent, most of them have symptoms first, cough is the main manifestation, starting with dry cough, and later there is sputum, such as bacterial infection, spit yellow sputum. Infants with severe systemic symptoms may have fever, and even gastrointestinal symptoms such as vomiting, diarrhea, and abdominal pain.

Diet therapy for bronchitis in children:

1. Lily porridge: 20 grams of fresh lily, 50 grams of glutinous rice, boiled porridge, served with rock sugar. Spleen and lung, cough and asthma.

2. Mustard porridge: Chopped mustard head, 50 grams of rice, boiled for porridge. Warm phlegm drink.

3 Almond porridge: 20 peeled tips of almonds, 50 grams of japonica rice, a total of porridge served.

4 Pear porridge: 3 cored slices of Yali pear for juice. 50 grams of rice is boiled and mixed into the pear juice when cooked. Qingxin moisturizes the lungs, relieves coughs and annoys.

5. Yam soup: 200 grams of yam cooked to knead the mud, 250 grams of corn fried fried ground powder, 500 grams of almond peeled sharp fried ground powder. Bring 10 grams of corn and almond flour with boiling water every morning, mix with yam paste, and mix with sesame oil. Benefits Qi tonic, warms the lungs, and is used in children for a long time without cough or repeated attacks.

Diet therapy for wind-cold bundle pulmonary bronchitis in children

1. Perilla porridge: 30 grams of atractylodes and 100 grams of japonica rice, cook porridge as usual, add 10-15 grams of perilla leaves while hot, and serve hot.

2. Vinegar Tofu Recipe: 50 ml of vinegar, 300 g of tofu, 30 g of vegetable oil, and a little green onion. Pour the oil into the green onion, add a little salt, and then add the tofu. Press the tofu into a mud and stir fry. Add vinegar and a little water to continue the stir fry.

3 Egg ginger recipe: 1 egg, 12 grams of ginger. Break the eggs, chop the ginger, then stir the two flavors together, cook and eat, 2 times a day.

You can choose 10 grams of white fungus and 10 grams of black fungus, soak your hair in warm water, wash it into a bowl with 30 grams of rock sugar, add an appropriate amount of water, and steam in a steamer for 3 hours. 2-3 tablespoons each time, 3 times a day, can nourish yin and kidney, nourish lungs and cough.

You can also open 2 eggs into a pot, fry with hemp, cook with vinegar, take 1 each morning and evening, and eat it often.

After peeling and slicing 5 000 grams of cucumber, cut into 1 cm cubes, add 1500 grams of sugar and mix well, put it in the jar and seal it, and take it out when sizing. Take every morning and evening on an empty stomach. Each half a small bowl is about 100 grams, especially for those who suffer from cough and asthma in winter and summer.

25 grams of peeled chestnuts, 500 grams of lean pork, cut into pieces, add salt, ginger, and tempeh a little bit, cook and simmer, and eat them separately.

90 grams of jellyfish skin and 30-50 grams of white radish. Wash the jellyfish to remove salt, cut the white radish into filaments, mix the two, add 300-600 ml of water, and cook to 150-200 ml. Take 20 ml each time, taking 2 times a day. The remaining jellyfish and shredded radish are mixed with rock sugar to enhance the effect. This can prevent chronic bronchitis.

One old hen is depilated, the internal organs are washed, and then go to the pharmacy to buy back 20 grams of Chuanbei and 50 grams of Codonopsis, put in a casserole with an appropriate amount of rock sugar and chicken, add water and cook until the chicken is cooked, once each morning and evening. Eat chicken for soup, remember to drink hot soup, eat it within 1 week, and even eat for half a month. It should be taken from the winter solstice to prevent the recurrence of chronic bronchitis.

Pediatric bronchitis medication

Children with bronchitis should pay attention to rest, maintain air circulation in the bedroom, and maintain proper temperature and humidity. Give digestible food and drink plenty of water. Provide complex vitamin B and vitamin C, 1 tablet each time, 3 times a day. For children with chronic and multiple onset, vitamin AD should be supplied, 1 tablet each time, 2-3 times a day. Juvenile and frail children can take sulfa drugs or penicillin drugs in mild cases, and be matched with certain phlegm and cough medicines to play a synergistic treatment. Sulfonamides can be used as a combination of sulfamethoxazole, 20 mg per kilogram of body weight per day, and taken orally twice a day. Due to the slow excretion of sulfa drugs, it is easy to cause crystal precipitation in the kidney, so sufficient water should be supplied during the medication to facilitate excretion. Some children are allergic to sulfa drugs. After use, rash, exfoliative dermatitis, etc., can not be used if you have a history of allergies. Penicillin drugs can be used amoxicillin, 40-80 mg per kilogram of body weight daily, orally after 3 to 4 meals. Oral penicillin drugs should also pay attention to whether there is a history of penicillin allergies, children with allergies to penicillin should be used with caution, specific children, and children who are prone to allergies should even be disabled. Such children can be changed to cephalosporins cefradine, 25-50 mg per kg of body weight daily, divided into 3 to 4 doses. Huatan antitussive medicine can be used Huatan tablets, 1/2 one l each time, 3 times a day.

For allergic cough caused by various reasons, an increase in eosinophil count can be found through a blood test. Such coughs often have a longer duration and can increase the antiallergic drug cyproheptadine, which is 0.25 mg per kilogram of body weight per day. Take 3 times orally. For children who have repeatedly suffered from bronchitis, he should be allowed to actively participate in physical exercise, strengthen their physique, pay attention to changes in the climate, and avoid too much or too little clothing. If the bronchitis does not heal repeatedly, you should go to the hospital to check carefully for congenital malformations, bronchiectasis, hypoproteinemia, tuberculosis, and chronic sinusitis and tonsillitis.

Pediatric bronchitis prevention and care

First of all, pay attention to the child's hot and cold, do not wear too hot, and let him have appropriate cold tolerance exercise. The temperature is high, don't just think that the child is cold, but more importantly, pay attention not to keep the child warm at all times, so that the sweaty clothes are more likely to catch a cold.

If your child has a cold, take some medication as soon as possible without delaying the illness. Chinese Medicine

Pediatric bronchitis drugs Pediatrics believes that pediatric disease is easy and changes rapidly. After a child has a cold, taking an hour earlier and taking an hour later, the results are completely different. Parents who have been in contact with children for a long time should learn to observe whether the child has abnormalities in the cold, and should deal with them when they are found to be abnormal.

If your child is sick, heal them all at once, and don't stop halfway. When a child has a fever exceeding 39 ° C, the body temperature should be lowered to below 38 ° C within 2 hours. If the body temperature continues above 39 ° C for more than 2 hours, it will cause damage to brain cells and affect children's intelligence. Some children have tonsil swelling or cough (bronchitis) after a cold. Because there is no one-time cure, the subsequent colds will first appear as tonsil swelling or cough, and it is difficult to completely cure. It will become chronic after a long time. Tonsillitis and chronic bronchitis.

The last thing is training.

Pediatric bronchitis complications

1. Bronchopneumonia: Children may develop complications such as high fever, hypoxia, dyspnea, acute respiratory failure, and even atelectasis, emphysema, empyema, pneumothorax, lung abscess, pericarditis, and sepsis, which can be life-threatening.

2. Bronchiectasis: When children with bronchitis are not treated properly, it can be transformed into chronic bronchial purulent inflammation, destroying the bronchial wall and deforming and expanding the bronchial wall, and destroying the tube wall tissue, causing the bronchus to lose its original natural defense ability and reducing coughing efficiency And sputum function, providing conditions for further infection. Over time, the vicious circle has further expanded, and the condition has worsened, making it difficult to cure. Children may have prolonged intermittent fever, with a large amount of purulent sputum or hemoptysis. Further development can lead to pulmonary heart disease.

3 Chronic bronchitis, emphysema, and pulmonary heart disease: If the bronchitis in children cannot be completely cured and recurrent, it will turn into chronic bronchitis and further develop into emphysema and pulmonary heart disease. Children can have recurrent illness, long-term cough, expectoration, wheezing, labor shortness of breath, palpitation, cyanosis, edema, and long-term cure. ^[2]