支氣管擴張的研究進展課件

支氣管擴張(bronchiectasis)呼吸科呂寒靜何謂支氣管擴張？支氣管由于管壁的肌肉、軟骨和彈性組織結構破壞引起官腔的擴張和變形。BronchiectasisDefinitionBronchiectasisisachronicinflammatoryordegenerativeconditionofoneormorebronchiolesofthelungsmarkedbydilatation.為什么會支氣管擴張？支氣管被牽拉：結核后支氣管阻塞：感染、異物、腫瘤（內長、外壓）為什么會支氣管擴張？支氣管先天發(fā)育障礙和遺傳因素：1.巨大氣管－支氣管癥（tracheobronchomegaly)2.Kartagener綜合征(不動纖毛綜合征,immotileciliasyndrome)3.副鼻竇－支氣管綜合征（sinobronchialsyndrome）Thesinobronchialsyndromeconsistsofchronicsinusitisandchronicnonspecificinflammationofthelowerairways,typicallychronicbronchitis,bronchiectasisanddiffusepanbronchiolitis.Thisairwaydiseaseofunknownetiologyisnotrelatedtosmoking.ItiscommoninJapanandispoorlydescribedinwesterncountries.Wereportacaseinanon-Asianpatient.Theknownefficacyoflong-termlow-doseerythromycintherapyjustifiescarefuldiagnosisofsinobronchialsyndromeinpatientsofnon-Asianethnicorigin.4.先天性軟骨缺失癥（congenitalcartilagedeficiency）5.支氣管肺隔離癥(bronchopulmanarysequestration)

支氣管擴張有哪些病理特點？支氣管壁的肌肉、軟骨和彈性組織結構破壞引起管腔擴大。（柱狀、囊狀）鱗狀上皮取代纖毛柱狀上皮。杯狀細胞、粘液細胞增生。毛細血管擴張。

支氣管擴張有哪些病生特點？與病變范圍有關阻塞性通氣功能障礙阻塞為主的混合性通氣功能障礙V/Q比例失調肺源性心臟病、右心衰竭

BronchiectasissymptomsThemosttypicalsymptomisachroniccoughthatproducesthick,whiteorgreensputumandmaybethefirstsymptomofbronchiectasis.Symptomsbeginusuallyafterarespiratoryinfection.應做哪些輔助檢查？影像學：胸片、CT。確診依據(jù)。纖維支氣管鏡肺功能血常規(guī)痰菌其他支氣管擴張如何治療？控制急性感染保持呼吸道引流通暢：祛