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題名 | 咳嗽--臨床鑑別診斷=Cough--Clinical Differential Diagnosis |
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作 者 | 鍾國謀; 黃旭加; | 書刊名 | 秀傳醫學雜誌 |
卷期 | 2:1 2000.01[民89.01] |
頁次 | 頁25-30 |
分類號 | 415.4 |
關鍵詞 | 咳嗽; Cough; |
語文 | 中文(Chinese) |
中文摘要 | 咳嗽為常見的臨床主訴,呼吸系統及非呼吸系統的疾病均可引發咳嗽,其鑑別診 斷需靠詳實的病史詢問、理學檢查及診斷工具。急性咳嗽通常是由呼吸系統的發炎性病變引 致。慢性咳嗽而胸部X光片正常者,需考慮鼻涕倒流症候群、支氣管性哮喘及胃食道逆流; Angiotensin converting enzyme inhibitor (ACEI) 引發的咳嗽在高血壓族群亦非罕見) 。慢性咳嗽而X光片不正常者,常見的是慢性炎症,例如結核( tuberculosis )、支氣管 擴張( bronchiectasis )、慢性阻塞性肺病( chronic obstructive pulmonary disease )及腫瘤( neoplasm )。 其他一些少見的疾病則有慢性心衰竭( congestive heart failure )、縱膈腔疾病( mediastinal disease )、肋膜疾病( pleural disease )及 肺間質性病變( interstitial lung disease )。 |
英文摘要 | Cough, stimulated mostly by vagal reflex, is a defense mechanism of the lung. It can be generated by different causes including a variely of non-airway related diseaces. Detail history and characteristics of cough (such as onset, duration, productive or non-productive, timing and associated symptoms) are useful in diagnosis. Acute cough is usually a result of acute infectious diseases of airway. Chronic cough in those who have normal chest X-ray films are usually caused by cough variant asthma, postnasal drip syndrome (PNDS) and gastroesophageal reflux disease (GERD). While cough induced by angiotensin converting enzyme inhibitors (ACEI) should always be considered in patients receiving these drugs. Meanwhile, chronic cough with abnormal X-ray films may include lung tumors and chronic inflammattions such as tuberculosis, bronchiectasis, and chronic obstructive plumonary disease (COPD), etc. |
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