耳鼻咽喉科・頭頸部外科87巻10号

2015年09月発行

特集 長引く咳を診る

成人の咳嗽の鑑別

著者： 檜澤伸之¹

所属機関： ¹筑波大学医学医療系呼吸器内科

ページ範囲：P.770 - P.775

文献概要

POINT

●慢性咳嗽は，原因が曖昧な状態で漫然と鎮咳薬，抗炎症薬や抗菌薬が投与され，生活の質が著しく低下したまま放置されてしまう危険がある。

●肺炎，肺結核，肺がん，間質性肺炎，喘息，慢性閉塞性肺疾患の有無を病歴聴取，身体所見や胸部画像検査，呼吸機能検査で鑑別する。

●咳喘息，アトピー咳嗽，副鼻腔気管支症候群，さらには胃食道逆流などを念頭に治療的鑑別を進める。

●原因によらず内因性の咳感受性亢進が慢性咳嗽に一定の役割を果たしている可能性がある。

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