支气管扩张_2010年.pptVIP

BRONCHIECTASIS Zhiwen Zhu The 1st affiliated hospital of Sun Yat-sen university, pulmonary department BRONCHIECTASIS Definition Etiology Pathology Clinical presentation Diagnosis differential diagnosis Treatment Definition Bronchiectasis is a condition anatomically defined by chronic, irreversible dilation and distortion of the bronchi caused by inflammatory destruction of the muscular and elastic components of the bronchial walls. Etiology Conditions associated with the development of bronchiectasis 1. Postinfection Bacterial pneumonia Tuberculosis Pertussis Measles Influenza Etiology 2. Proximal airway obstruction Foreign body aspiration Benign airway tumors Middle lobe syndrome Extrinsic compression by enlarged lymph nodes of the right middle lobe of the lung that obstructed bronchi and lead to right middle lobe atelectasis and recurrent infection. Etiology 2. Proximal airway obstruction Foreign body aspiration Benign airway tumors Middle lobe syndrome Extrinsic compression by enlarged lymph nodes of the right middle lobe of the lung that obstructed bronchi and lead to right middle lobe atelectasis and recurrent infection. Etiology 3.Abnormal host defense Ciliary dyskinesia ( Kartagener’s syndrome) Humoral immunodeficiency 4.Genetic disorders Cystic fibrosis α1- Antitrypsin deficiency 5.Others Pathology Dilation and distortion of the bronchi Damage of airway epithelium Dilation and hyperplasia of blood capillary Clinical presentation The production of large quantities of purulent and often foul-smelling sputum. The volume of sputum can be used for estimating the severity of the disease Mild 10 mL Moderate 10~150 mL Severe 150 mL ※ Dry bronchiectasis usually involve the upper lobes Clinical presentation 2. Chronic cough 3. Hemoptysis: Frequent More commonly in dry variety Usually mild (blood streaking of purulent sputum) Massive hemoptysis is usually from dilated bronchial arteries or bronchial-pulmonary anastomoses under systemic