2021 JRS指南:咳嗽和咳痰的管理

2021-02-25 日本呼吸学会 Respir Investig ;S2212-5345(21)00032-0.

咳嗽和痰液是门诊常见的主诉。在本文摘中,我们对这两种症状进行了概述,并讨论了急性(最长三周)和长期/慢性咳嗽(超过三周)的处理方法。我们提供了流程图,以及对其诊断和处理的逐步解释。大多数急性咳嗽的病例

中文标题:

2021 JRS指南:咳嗽和咳痰的管理

英文标题:

The Japanese respiratory society guidelines for the management of cough and sputum (digest edition)

发布机构:

日本呼吸学会

发布日期:

2021-02-25

简要介绍:

咳嗽和痰液是门诊常见的主诉。在本文摘中,我们对这两种症状进行了概述,并讨论了急性(最长三周)和长期/慢性咳嗽(超过三周)的处理方法。我们提供了流程图,以及对其诊断和处理的逐步解释。大多数急性咳嗽的病例是由于感染引起的。在慢性呼吸道疾病中,咳嗽可能是呼吸道感染的症状,如肺结核、恶性肿瘤如肺部肿瘤、哮喘、慢性阻塞性肺疾病、慢性支气管炎、支气管炎。药物引起的肺损伤、心力衰竭、鼻窦疾病、鼻支气管综合征、嗜酸窦炎、咳嗽变异性哮喘(CVA)、特应性咳嗽、慢性喉部过敏、胃食管反流(GER)和感染后咳嗽。过峰咳嗽不应开具抗生素,但对非典型感染可考虑使用。对于持续性/慢性咳嗽,建议探索单一/主要原因。当出现痰液时,应进行痰涂片/培养(一般细菌、霉菌)、细胞学、细胞分化、胸部计算机断层扫描(CT)、鼻窦X线或CT检查。鼻窦炎有两种类型。传统鼻窦炎和嗜酸细胞性鼻窦炎分别以中性炎症和嗜酸细胞性炎症为主要表现。最常见的干咳原因包括CVA、过敏性咳嗽/喉过敏(慢性)、GER和感染后咳嗽。在最后一章,我们讨论了未来的挑战和展望。希望通过对咳嗽高敏综合征病理的明确,进一步开发 "病理特异性非特异性治疗药物",为慢性难治性咳嗽患者带来福音。

相关资料下载:
[AttachmentFileName(sort=1, fileName=2021 JRS指南:咳嗽和咳痰的管理.pdf)] GetToolGuiderByIdResponse(projectId=1, id=140461c0020e16d4, title=2021 JRS指南:咳嗽和咳痰的管理, enTitle=The Japanese respiratory society guidelines for the management of cough and sputum (digest edition), guiderFrom=Respir Investig ;S2212-5345(21)00032-0., authorId=0, author=, summary=咳嗽和痰液是门诊常见的主诉。在本文摘中,我们对这两种症状进行了概述,并讨论了急性(最长三周)和长期/慢性咳嗽(超过三周)的处理方法。我们提供了流程图,以及对其诊断和处理的逐步解释。大多数急性咳嗽的病例, cover=https://img.medsci.cn/2021315/1615739351464_2020535.jpg, journalId=0, articlesId=null, associationId=197, associationName=日本呼吸学会, associationIntro=null, copyright=0, guiderPublishedTime=Thu Feb 25 00:00:00 CST 2021, originalUrl=, linkOutUrl=, content=<p>咳嗽和痰液是门诊常见的主诉。在本文摘中,我们对这两种症状进行了概述,并讨论了急性(最长三周)和长期/慢性咳嗽(超过三周)的处理方法。我们提供了流程图,以及对其诊断和处理的逐步解释。大多数急性咳嗽的病例是由于感染引起的。在慢性呼吸道疾病中,咳嗽可能是呼吸道感染的症状,如肺结核、恶性肿瘤如肺部肿瘤、哮喘、慢性阻塞性肺疾病、慢性支气管炎、支气管炎。药物引起的肺损伤、心力衰竭、鼻窦疾病、鼻支气管综合征、嗜酸窦炎、咳嗽变异性哮喘(CVA)、特应性咳嗽、慢性喉部过敏、胃食管反流(GER)和感染后咳嗽。过峰咳嗽不应开具抗生素,但对非典型感染可考虑使用。对于持续性/慢性咳嗽,建议探索单一/主要原因。当出现痰液时,应进行痰涂片/培养(一般细菌、霉菌)、细胞学、细胞分化、胸部计算机断层扫描(CT)、鼻窦X线或CT检查。鼻窦炎有两种类型。传统鼻窦炎和嗜酸细胞性鼻窦炎分别以中性炎症和嗜酸细胞性炎症为主要表现。最常见的干咳原因包括CVA、过敏性咳嗽/喉过敏(慢性)、GER和感染后咳嗽。在最后一章,我们讨论了未来的挑战和展望。希望通过对咳嗽高敏综合征病理的明确,进一步开发 "病理特异性非特异性治疗药物",为慢性难治性咳嗽患者带来福音。</p>, tagList=[TagDto(tagId=319, tagName=咳嗽)], categoryList=[CategoryDto(categoryId=12, categoryName=呼吸, tenant=100), CategoryDto(categoryId=85, categoryName=指南&解读, tenant=100), CategoryDto(categoryId=21100, categoryName=达仁堂循证e学界, tenant=100)], articleKeywordId=0, articleKeyword=, articleKeywordNum=6, guiderKeywordId=319, guiderKeyword=咳嗽, guiderKeywordNum=6, haveAttachments=1, attachmentList=null, guiderType=0, guiderArea=指南, guiderLanguage=1, guiderRegion=4, opened=0, paymentType=, paymentAmount=10, recommend=0, recommendEndTime=null, sticky=0, stickyEndTime=null, allHits=6919, appHits=679, showAppHits=0, pcHits=1298, showPcHits=6237, likes=8, shares=36, comments=39, approvalStatus=1, publishedTime=Mon Mar 15 00:36:48 CST 2021, publishedTimeString=2021-02-25, pcVisible=1, appVisible=1, editorId=2020535, editor=qiushida2, waterMark=0, formatted=0, memberCards=[], isPrivilege=0, deleted=0, version=2, createdBy=null, createdName=qiushida2, createdTime=Mon Mar 15 00:29:16 CST 2021, updatedBy=2020535, updatedName=qiushida2, updatedTime=Sat Jan 06 21:49:06 CST 2024, courseDetails=[], otherVersionGuiders=[], isGuiderMember=false, ipAttribution=, attachmentFileNameList=[AttachmentFileName(sort=1, fileName=2021 JRS指南:咳嗽和咳痰的管理.pdf)])
2021 JRS指南:咳嗽和咳痰的管理.pdf
下载请点击:
评论区 (28)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=2190437, encodeId=6f57219043ea0, content=可以分享下吗?谢谢, beContent=null, objectType=guider, channel=null, level=null, likeNumber=6, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e73b8499481, createdName=ms6000001866461031, createdTime=Fri Mar 01 16:10:45 CST 2024, time=2024-03-01, status=1, ipAttribution=广东省), GetPortalCommentsPageByObjectIdResponse(id=2123951, encodeId=de00212395169, content=想看翻译版, beContent=null, objectType=guider, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKoHy8lhEjIX8ibua5aMrcUJrZpqibv4vbdYCjdC7v5pwSXxtUQ3iaY2QjuicI2BkeIr1QkeMuT7vZPdw/132, createdBy=3f2a5264274, createdName=小娟紫, createdTime=Wed Apr 05 21:35:03 CST 2023, time=2023-04-05, status=1, ipAttribution=浙江省), GetPortalCommentsPageByObjectIdResponse(id=1191398, encodeId=9031119139821, content=😋, beContent=null, objectType=guider, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0bd16489264, createdName=ms5000002061899932, createdTime=Wed Feb 09 12:31:43 CST 2022, time=2022-02-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1077124, encodeId=41bc10e71246d, content=值得学习, beContent=null, objectType=guider, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f3ff5641305, createdName=ms7000001516202991, createdTime=Sun Dec 05 18:07:37 CST 2021, time=2021-12-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1064130, encodeId=25c3106413063, content=全英文啊,好难啊😨, beContent=null, objectType=guider, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=14df5648874, createdName=李文武, createdTime=Tue Oct 26 16:32:33 CST 2021, time=2021-10-26, status=1, ipAttribution=)]
    2024-03-01 ms6000001866461031 来自广东省

    可以分享下吗?谢谢

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=2190437, encodeId=6f57219043ea0, content=可以分享下吗?谢谢, beContent=null, objectType=guider, channel=null, level=null, likeNumber=6, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e73b8499481, createdName=ms6000001866461031, createdTime=Fri Mar 01 16:10:45 CST 2024, time=2024-03-01, status=1, ipAttribution=广东省), GetPortalCommentsPageByObjectIdResponse(id=2123951, encodeId=de00212395169, content=想看翻译版, beContent=null, objectType=guider, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKoHy8lhEjIX8ibua5aMrcUJrZpqibv4vbdYCjdC7v5pwSXxtUQ3iaY2QjuicI2BkeIr1QkeMuT7vZPdw/132, createdBy=3f2a5264274, createdName=小娟紫, createdTime=Wed Apr 05 21:35:03 CST 2023, time=2023-04-05, status=1, ipAttribution=浙江省), GetPortalCommentsPageByObjectIdResponse(id=1191398, encodeId=9031119139821, content=😋, beContent=null, objectType=guider, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0bd16489264, createdName=ms5000002061899932, createdTime=Wed Feb 09 12:31:43 CST 2022, time=2022-02-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1077124, encodeId=41bc10e71246d, content=值得学习, beContent=null, objectType=guider, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f3ff5641305, createdName=ms7000001516202991, createdTime=Sun Dec 05 18:07:37 CST 2021, time=2021-12-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1064130, encodeId=25c3106413063, content=全英文啊,好难啊😨, beContent=null, objectType=guider, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=14df5648874, createdName=李文武, createdTime=Tue Oct 26 16:32:33 CST 2021, time=2021-10-26, status=1, ipAttribution=)]
    2023-04-05 小娟紫 来自浙江省

    想看翻译版

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=2190437, encodeId=6f57219043ea0, content=可以分享下吗?谢谢, beContent=null, objectType=guider, channel=null, level=null, likeNumber=6, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e73b8499481, createdName=ms6000001866461031, createdTime=Fri Mar 01 16:10:45 CST 2024, time=2024-03-01, status=1, ipAttribution=广东省), GetPortalCommentsPageByObjectIdResponse(id=2123951, encodeId=de00212395169, content=想看翻译版, beContent=null, objectType=guider, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKoHy8lhEjIX8ibua5aMrcUJrZpqibv4vbdYCjdC7v5pwSXxtUQ3iaY2QjuicI2BkeIr1QkeMuT7vZPdw/132, createdBy=3f2a5264274, createdName=小娟紫, createdTime=Wed Apr 05 21:35:03 CST 2023, time=2023-04-05, status=1, ipAttribution=浙江省), GetPortalCommentsPageByObjectIdResponse(id=1191398, encodeId=9031119139821, content=😋, beContent=null, objectType=guider, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0bd16489264, createdName=ms5000002061899932, createdTime=Wed Feb 09 12:31:43 CST 2022, time=2022-02-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1077124, encodeId=41bc10e71246d, content=值得学习, beContent=null, objectType=guider, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f3ff5641305, createdName=ms7000001516202991, createdTime=Sun Dec 05 18:07:37 CST 2021, time=2021-12-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1064130, encodeId=25c3106413063, content=全英文啊,好难啊😨, beContent=null, objectType=guider, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=14df5648874, createdName=李文武, createdTime=Tue Oct 26 16:32:33 CST 2021, time=2021-10-26, status=1, ipAttribution=)]
    2022-02-09 ms5000002061899932

    😋

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=2190437, encodeId=6f57219043ea0, content=可以分享下吗?谢谢, beContent=null, objectType=guider, channel=null, level=null, likeNumber=6, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e73b8499481, createdName=ms6000001866461031, createdTime=Fri Mar 01 16:10:45 CST 2024, time=2024-03-01, status=1, ipAttribution=广东省), GetPortalCommentsPageByObjectIdResponse(id=2123951, encodeId=de00212395169, content=想看翻译版, beContent=null, objectType=guider, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKoHy8lhEjIX8ibua5aMrcUJrZpqibv4vbdYCjdC7v5pwSXxtUQ3iaY2QjuicI2BkeIr1QkeMuT7vZPdw/132, createdBy=3f2a5264274, createdName=小娟紫, createdTime=Wed Apr 05 21:35:03 CST 2023, time=2023-04-05, status=1, ipAttribution=浙江省), GetPortalCommentsPageByObjectIdResponse(id=1191398, encodeId=9031119139821, content=😋, beContent=null, objectType=guider, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0bd16489264, createdName=ms5000002061899932, createdTime=Wed Feb 09 12:31:43 CST 2022, time=2022-02-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1077124, encodeId=41bc10e71246d, content=值得学习, beContent=null, objectType=guider, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f3ff5641305, createdName=ms7000001516202991, createdTime=Sun Dec 05 18:07:37 CST 2021, time=2021-12-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1064130, encodeId=25c3106413063, content=全英文啊,好难啊😨, beContent=null, objectType=guider, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=14df5648874, createdName=李文武, createdTime=Tue Oct 26 16:32:33 CST 2021, time=2021-10-26, status=1, ipAttribution=)]
    2021-12-05 ms7000001516202991

    值得学习

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=2190437, encodeId=6f57219043ea0, content=可以分享下吗?谢谢, beContent=null, objectType=guider, channel=null, level=null, likeNumber=6, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e73b8499481, createdName=ms6000001866461031, createdTime=Fri Mar 01 16:10:45 CST 2024, time=2024-03-01, status=1, ipAttribution=广东省), GetPortalCommentsPageByObjectIdResponse(id=2123951, encodeId=de00212395169, content=想看翻译版, beContent=null, objectType=guider, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKoHy8lhEjIX8ibua5aMrcUJrZpqibv4vbdYCjdC7v5pwSXxtUQ3iaY2QjuicI2BkeIr1QkeMuT7vZPdw/132, createdBy=3f2a5264274, createdName=小娟紫, createdTime=Wed Apr 05 21:35:03 CST 2023, time=2023-04-05, status=1, ipAttribution=浙江省), GetPortalCommentsPageByObjectIdResponse(id=1191398, encodeId=9031119139821, content=😋, beContent=null, objectType=guider, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0bd16489264, createdName=ms5000002061899932, createdTime=Wed Feb 09 12:31:43 CST 2022, time=2022-02-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1077124, encodeId=41bc10e71246d, content=值得学习, beContent=null, objectType=guider, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f3ff5641305, createdName=ms7000001516202991, createdTime=Sun Dec 05 18:07:37 CST 2021, time=2021-12-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1064130, encodeId=25c3106413063, content=全英文啊,好难啊😨, beContent=null, objectType=guider, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=14df5648874, createdName=李文武, createdTime=Tue Oct 26 16:32:33 CST 2021, time=2021-10-26, status=1, ipAttribution=)]
    2021-10-26 李文武

    全英文啊,好难啊😨

    0

拓展阅读

咳嗽中医诊疗专家共识意见(2011版)

中华中医药学会内科分会肺系病专业委员会 · 2011-05-15

2011 CPS儿童和青少年看护者指南:感冒和咳嗽的治疗

加拿大儿科学会(CPS,Canadian Paediatric Society) · 2011-11-30

中国儿童慢性咳嗽诊断与治疗指南(2013年修订)

中华医学会儿科学分会呼吸学组 · 2014-03-01

2015 咳嗽的诊断与治疗指南

中华医学会呼吸病学分会哮喘学组 · 2016-05-02

2016 咳嗽物联网医学分级诊疗中国专家共识

中国呼吸科专家组(统称) · 2016-05-10

2016年咳嗽的诊断与治疗指南解读

暂未更新 · 2017-04-26