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> <span>經(jīng)?？忍凳窃趺椿厥?/span> </div> <div id="8hh5rq1ip" class="ar_con_nr"> <div id="8hh5rq1ip" class="con_l fl"> <article class="ar_con bg louti"> <div id="8hh5rq1ip" class="ar_title"> <h1>經(jīng)?？忍凳窃趺椿厥?/h1> <div id="8hh5rq1ip" class="ar_title_b"> <div id="8hh5rq1ip" class="sub_title clear"> <span id="8hh5rq1ip" class="sp2 c6 fl">時間：<time class="fxtime">2016-08-19 16:46:36</time></span> <span id="8hh5rq1ip" class="sp1 c6 fl"><em id="zuozhe" class="noshow">鞏詩2</em><em class="user_id noshow">756</em>由 <em class="nickname"></em> 分享</span> <span id="8hh5rq1ip" class="fl arc_btn"></span> </div> </div> </div> <div id="8hh5rq1ip" class="y_ju"></div> <div id="8hh5rq1ip" class="con_article con_main" id="contentText"> <p>經(jīng)?？忍凳窃趺椿厥?/p><p> 　　咳痰是呼吸系統(tǒng)疾病的重要癥狀。痰的主要來源是氣管、支氣管腺體和杯狀細胞的分泌物。在正常情況下，呼吸道的腺體不斷有小量分泌物排出，形成一層薄的粘液層，保持呼吸道的濕潤，并能吸附吸入的塵埃、細菌等微生物，借助于柱狀上皮纖毛的擺動，將其排向喉頭，隨咳嗽咳出，或被咽下。所以一般不感覺有痰。下面是學(xué)習(xí)啦小編為大家整理的一些相關(guān)知識，希望對大家能幫助!</p><p> 　　<strong>咳痰的病因</strong></p><p> 　　(一)病因及病因分類</p><p> 　　1.呼吸道疾病從鼻咽部到小支氣管整個呼吸道黏膜受到刺激時.均可引起咳嗽。刺激效應(yīng)以喉部杓狀間腔和氣管分叉部黏膜最敏感。肺泡受刺激所致咳嗽，一般認為是由于肺泡內(nèi)稀薄分泌物、滲出物、浸出物進入小支氣管引起的，也與分布于肺的C纖維末梢受到刺激，尤其是化學(xué)性刺激有關(guān)。</p><p> 　　當(dāng)呼吸道各部位、如咽、喉、氣管、支氣管和肺受到刺激性氣體(如冷熱空氣和香煙煙霧、氯氣、溴、酸、氨等)、各種粉塵、異物、各種病原微生物所致的炎癥、出血以及腫瘤浸潤等的不良刺激時，均可引起有咳嗽與咳痰癥狀的呼吸道疾病。例如：</p><p> 　　(1)上呼吸道疾病：因細菌、病毒、冷空氣或刺激性氣體等刺激所致的炎癥性瘴病，如鼻炎、鼻竇炎、扁桃體炎、急性或慢性咽炎、喉炎、過敏性鼻炎等。</p><p> 　　(2)氣管、支氣管疾?。喝绺鞣N疾病微生物侵襲所致的急性、慢性支氣管炎癥、支氣管結(jié)核，支氣管擴張以及支氣管腫瘤或過敏因素所致的支氣管哮喘等。</p><p> 　　(3)肺部疾?。阂愿鞣N病原體侵襲所致的肺炎、肺結(jié)核，肺膿瘍等最為常見。此外還有白血病、尿毒癥和結(jié)締組織病所致的肺浸潤和特發(fā)或繼發(fā)的肺間質(zhì)纖維化疾病等。</p><p> 　　(4)呼吸道的原發(fā)性或轉(zhuǎn)移性惡性、良性腫瘤繼發(fā)感染性炎癥。</p><p> 　　(5)原發(fā)或繼發(fā)的胸膜腔疾病(氣胸、血胸、胸腔積液)伴發(fā)支氣管或肺部的感染。</p><p> 　　(6)其他：如縱隔腫瘤、各種病因引起的淋巴結(jié)腫大或胸骨后甲狀腺腫大等壓迫氣管或支氣管所致的繼發(fā)性呼吸道感染。</p><p> 　　2.胸膜疾病胸膜疾病所致的咳痰多為繼發(fā)性，如常見的肺膿腫、肺結(jié)核并發(fā)膿氣胸、外傷性氣胸、血氣胸等。</p><p> 　　3.心血管疾病如二尖瓣狹窄或其他原因所致左心衰竭引起肺淤血、急性肺水腫;因右心及體循環(huán)的靜脈栓于脫落引起肺栓塞;羊水、氣栓、瘤栓引起肺栓塞;肺泡與支氣管內(nèi)漏出液或滲出液，刺激肺泡壁及支氣管黏膜等均可引起咳嗽與咳痰。</p><p> 　　4.中樞神經(jīng)因素從大腦皮質(zhì)發(fā)出沖動傳至延髓咳嗽中樞，可隨意引起咳嗽或抑制咳嗽反射，如腦炎、腦膜炎時可招致干咳，若合并氣道感染時還有咳痰。</p><p> 　　(二)發(fā)病機制</p><p> 　　咳嗽是由延髓咳嗽中樞受刺激引起。刺激主要來自呼吸系統(tǒng)疾病，亦可來自呼吸系統(tǒng)以外的囂官(如腦、耳、內(nèi)臟)，但大部分系來自呼吸道黏膜、肺泡與胸膜，經(jīng)迷走神經(jīng)和三叉神經(jīng)與皮膚的感覺神經(jīng)纖維傳入，激動經(jīng)喉下神經(jīng)、膈神經(jīng)與脊神經(jīng)分別傳到咽肌、聲門、膈肌與其他呼吸機，引起咳嗽動作。首先足快速、短促吸氣，膈肌下降，聲門迅速關(guān)閉，隨后呼氣肌、膈肌與腹肌快速收縮，肺內(nèi)壓迅速升高，然后聲門突然開放，肺內(nèi)高壓氣流噴射而出，沖擊聲門裂隙而發(fā)生咳嗽動作和特別的音響(即咳嗽)，呼吸道內(nèi)的分泌或異物，亦隨之被排出，即咳痰。</p><p> 　　<strong>咳痰的治療</strong></p><p> 　　對癥治療：黏液溶解劑，例如愈創(chuàng)甘油醚600mg，每日2次，口服;痰液濕化劑;支氣管擴張劑，如β受體激動劑和抗膽堿能藥物;碘制劑(碘化鉀飽和溶液);乙酰半胱氨酸吸入劑;α鏈道酶吸入劑(僅用于囊性纖維化患者)。機械手段促進痰液清除的方法有：震顫閥的治療、胸壁振蕩的物理治療。</p><p> 　　注意事項</p><p> 　　采取措拖避免抑制咳痰，因為痰液潴留可能會干擾或損害肺泡通氣，導(dǎo)致肺抗感染能力下降。通過使痰液稀釋和祛痰劑以減輕支氣管痙攣和使氣道開放，抗生素可從根本上治療感染。</p><p> 　　濕潤患者周圍的空氣，這將減輕黏膜炎癥并可稀釋分泌物。對肺部進行物理療法，如體位引流并同時叩擊背部，以使分泌物疏松，霧化療法是必需的。</p><p> 　　為患者提供安靜的休息環(huán)境。保持患者的呼吸道不受刺激物刺激。如果患者絕對臥床，囑其經(jīng)常改換體證，以促進分泌物排出。</p><p> 　　特殊人群</p><p> 　　(一)兒科指南</p><p> 　　因為兒室的氣道狹窄，所以分泌物增多會迅速阻塞氣道和出現(xiàn)呼吸窘迫。兒童咳嗽的原因包括哮喘、支氣管擴張、支氣管炎、急性支氣管炎、囊性纖維化和百日咳。</p><p> 　　當(dāng)照顧一個有咳嗽、咳痰的菝子時，給予服用祛痰藥，為的不是止咳，而是為了緩解黏膜炎癥并防止分泌物干燥，提供濕空氣或氧氣，值得注意的是，對于嬰兒空氣過于潮濕可誘發(fā)支氣管過度痙攣或使體內(nèi)產(chǎn)生水分過多。</p><p> 　　(二)老年指南</p><p> 　　因為咳嗽、咳痰常是嚴重的急慢性痰病的一個癥狀，故要經(jīng)常詢問老年患者有無咳嗽、咳痰的情況。</p><p> 　　患者咨詢</p><p> 　　勸患者不要吸煙。因為吸煙會使其病情加劇。調(diào)查研究說明，戒煙幾十年是有益的。教他們進行深呼吸。當(dāng)患者咳嗽時用夾板固定傷口。告訴患者咳嗽時采取坐位或直立位，如果可能的話，盡量擴張胸廓。教患者和其家屬正確拍擊背部以使分泌物變松易排出。</p><p> 　　告訴人們當(dāng)其咳嗽和處理污染的組織時要捂住嘴和鼻子，以保障自己和他人不受咳嗽飛沫和分泌物的感染，務(wù)必準備一個盛組織和痰液的容器。</p><p> 　　<strong>咳痰的預(yù)防</strong></p><p> 　　1、養(yǎng)成良好的生活習(xí)慣，不抽煙。</p><p> 　　2、必須在重油煙處工作的人，盡量保護好自己，比如戴上口罩，定時出去呼吸一些新鮮空氣，每年起碼做一次檢查等。</p><p> 　　3、積極預(yù)防原發(fā)疾病，注意穿衣保暖，避免因為感冒、肺炎等引起的咳嗽咯痰。</p><p> 　　4、空氣污染較嚴重是，出門注意采取防護措施，尤其是老年人、兒童和體質(zhì)虛弱者。</p><p> 　　宜：</p><p> 　　1、宜吃滋陰潤肺的食物;</p><p> 　　2、宜吃生津養(yǎng)肺的食物;</p><p> 　　3、宜吃高熱量、高維生素、高蛋白的易消化或半流質(zhì)食物;</p><p> 　　4、宜吃清淡、流質(zhì)、松軟的食物;</p><p> 　　5、宜吃富含鈣、鐵的食物。</p><p> 　　忌：</p><p> 　　1.忌食辛辣刺激食物;</p><p> 　　2.忌食過于咸、膩的食物。</p> </div> <div 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