bronchiectasis(英文).ppt

Bronchiectasis Department of Respiratory Medicine, the Second Affiliated Hospital, Nanjing Medical University Shen Hong Definition Bronchiectasis（支气管扩张） is a chronic condition with irreversible dilatation and destruction of bronchi commonly diagnosed by high resolution CT scan of the chest. Aetiology The initial bronchial damage which leads to bronchiectasis is often caused by childhood infections such as whooping cough（百日咳） or measles（麻疹）. Severe lung infections in adults, such as Staphylococcus aureus (金黄色葡萄球菌）pneumonia, aspiration pneumonia, or TB may also result in bronchiectasis. Other conditions associated： Inflammatory, e.g. Wegener’s granulomatosis. Rheumatoid arthritis（类风湿关节炎）. Inflammatory bowel disease. Immunodeficiency, e.g. HIV infection. Mucociliary defects such as cystic fibrosis, Kartagener’s syndrome, primary ciliary dyskinesia, and Young’s syndrome. Allergic bronchopulmonary aspergillosis（变应性支气管肺曲菌病）. α1-antitrypsin（抗胰蛋白酶） deficiency Clinical symtoms Patients usually present with recurrent chest infections. The presentation is variable depending on the severity of the bronchiectasis. Mild bronchiectasis (tubular bronchiectasis) : no sputum production or small volumes (5 ml) of mucoid or light mucopurulent phlegm Sputum sample from a patient with mild tubular bronchiectasis predominantly expectorating mucoid sputum (clear/grey) when clinically stable. More advanced bronchiectasis (varicose and cystic bronchiectasis, cystic bronchiectasis being the most severe), between exacerbations patients usually expectorate mucopurulent or frankly purulent sputum on a daily basis even when apparently clinically stable Sputum sample from a patient with advanced cystic bronchiectasis expectorating purulent sputum (dark yellow or green) even when clinically stable. Examination Bronchogram used historically to diagnose bronchiectasis. There is bronchial dilatation in the left lower lobe in keeping with left lower lobe bronchiectasis. tubular bronchiectasis Chest