何謂支氣管炎？
支氣管炎這詞指的是肺部內的支氣管發炎。支氣管是把氣管連接到肺部組織的氣道，氣管與兩個主要支氣管相連，支氣管再分支多次成為更多網狀細支(支氣管和細支氣管)。這些細支的終點是在稱之為肺泡的顯微泡囊處，氧氣再由肺泡進入血液。支氣管炎就是支氣管有發炎，或者是支氣管在支氣管內層分泌過多黏液。
發炎通常是由像是感冒、流行性感冒、間接細菌感染(傳染性支氣管炎)的病毒感染造成的，支氣管炎也有可能是吸入讓肺部發炎的物質造成的，例如，化學污染物、灰塵、氨(用於一些清潔產品)、煙。患有其他肺部疾病的人，例如，氣喘，也像慢性鼻竇炎的人一樣，支氣管炎可能會經常發作。
人們患的支氣管炎通常輕微，一般不會造成任何長久的傷害，可是對老年人、吸煙者或其他患有慢性心臟或肺部疾病的人，可能讓支氣管炎更嚴重。
傳染性(急性)支氣管炎的症狀是什麼？
傳染性支氣管炎一般在冬天發作。初期通常和一般感冒的症狀類似—疲倦、喉嚨痛，之後才咳嗽。通常咳嗽初期會乾咳，之後會咳出白色、黃色或綠色的痰。嚴重的話可能會發燒。若症狀持續或益加嚴重，肺炎是支氣管炎的嚴重併發症，，醫生可能會讓您做胸部X光掃瞄，以確保支氣管炎沒併發肺炎。
慢性支氣管炎是什麼？
慢性支氣管炎與急性支氣管炎相反，醫生用慢性支氣管炎的術語來形容支氣管炎長期持續數月。年年都會咳嗽、支氣管內層也會分泌黏液，持續時間一次比一次久。慢性支氣管炎的成因通常是長期吸入刺激物，例如煙味。
肺部主要的變化是支氣管內層分泌更多黏液，導致咳嗽，而傳染性支氣管炎主要是呼吸道發炎，兩者不同。吸煙是導致慢性支氣管炎最常見的成因。
持續吸入刺激物通常會導致情況更加嚴重，呼吸道末稍發炎、損傷讓呼吸更困難。刺激物進一步破壞肺泡氣囊，可能會造成肺氣腫，這讓肺部無法支持身體其他部位運行，病人呼吸困難。支氣管炎和肺氣腫可能個別發生，但通常會一起發生。(譯文)
What is bronchitis?
Bronchitis is a term that means inflammation of the bronchi in the lungs. The bronchi are air passages that connect the windpipe (trachea) to the lung tissue. The trachea connects to 2 main bronchi which branch many times to form a network of increasingly fine passages (bronchi and bronchioles). These fine passages end at microscopic sacs called alveoli, where oxygen is taken up by the blood. In bronchitis the bronchi become inflamed or secrete excess mucus onto the lining of the bronchi.
The inflammation is usually caused by a viral infection such as cold or flu or a secondary bacterial infection (infectious bronchitis). However, bronchitis can also result from inhaling substances that irritate the lungs, such as chemical pollutants, dust, ammonia (used in some cleaning products) and smoke. People who have other lung problems, such as asthma, may get frequent attacks of bronchitis, as may people with chronic sinusitis.
Bronchitis is usually mild and normally doesn’t cause any long-term damage, but it can become serious in elderly people, people who smoke, or those who are chronically ill with heart or lung disease.
What are the symptoms of infectious (acute) bronchitis?
Infectious bronchitis commonly occurs in winter. It often starts with similar symptoms to that of a common cold — tiredness and a sore throat — then a cough develops. This cough is often dry at first but later on becomes productive, with white, yellow or green sputum being coughed up. If the attack is severe, fever may result.
If the symptoms persist or get worse, your doctor may send you for a chest X-ray to ensure you haven’t developed pneumonia, which can be a serious complication of bronchitis.
What is chronic bronchitis?
Chronic bronchitis, as opposed to acute bronchitis, is the term doctors use to describe bronchitis that goes on long-term, often for months. The coughing and mucus production can return each year and can last longer each time. Chronic bronchitis is usually caused by long-term inhalation of irritants, such as cigarette smoke.
The predominant change in the lungs is that more mucus is produced by the lining of the bronchi which leads to a cough, as opposed to infectious bronchitis which is predominantly inflammation of the airways. Smoking is the most common cause of chronic bronchitis.
Often, continued exposure to the irritant can lead to progressive worsening of the condition, and inflammation and scarring of the small airways make breathing more difficult.
Emphysema may develop — this is when the irritants also promote destruction of the alveolar air sacs. This makes it hard for the lungs to support any kind of exertion without the person becoming breathless. Bronchitis and emphysema may occur separately but often occur together.
How is bronchitis treated?
Acute bronchitis
If you have acute bronchitis, your doctor may advise you to:
- rest;
- drink plenty of fluids, and;
- take medications such as paracetamol to reduce pain and fever.
Most cases of acute bronchitis do not require antibiotics. However, if you are coughing up lots of yellow or green sputum, you have a very high fever that won’t go away, or you are particularly unwell, your bronchitis may have a bacterial cause. In this case, your doctor will prescribe antibiotics, which should quickly clear up the infection.
If you smoke, stop — at least until you feel better, if you can’t give up at this stage. However, you should be aware that if you continue to smoke you greatly increase your risk of developing recurring chronic bronchitis and other serious diseases.
Chronic bronchitis
There are several options your doctor may recommend if you have chronic bronchitis.
- Giving up smoking will slow the rate that the disease progresses and should improve your breathlessness. This is by far the most important thing you can do to help if you are a smoker.
- Bronchodilators may be prescribed. These medications expand the airways to make it easier to breathe. They are often taken in the form of an inhaler.
- Corticosteroids and antibiotics may be given during periods when you have a chest infection. Corticosteroids may be used regularly in people with severe disease or frequent exacerbations.
- An annual flu vaccination may prevent you from catching influenza in the winter, and is recommended for people with chronic bronchitis.
- Vaccination against pneumococcal disease is also recommended for people with chronic bronchitis.
轉載自http://www.mydr.com.au/respiratory-health/bronchitis
翻譯：Aaron Liao in Australia
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