van Haren E H, Mannes G P
Atrium Medisch Centrum, afd. Longziekten, Henri Dunantstraat 5, 6419 PC Heerlen.
Ned Tijdschr Geneeskd. 2004 Jan 17;148(3):120-5.
Patients with bronchiectasis usually have chronic pulmonary infection with secondary obstructive airway disease. This disease has to be distinguished from chronic obstructive pulmonary disease (COPD). The diagnosis is established with the help of high resolution CT scan of the thorax. Further diagnostic evaluation is necessary to identify aetiologic factors. The treatment is complicated and involves many aspects: treatment of underlying conditions, recognition of exacerbations, boosting of tracheobronchial clearance, treatment of haemoptysis, surgical resection of affected lung segments and antibiotic therapy. Antibiotic therapy can focus on treatment of exacerbations but chronic suppressive antibiotic therapy is also used. Favourable results have been reported for maintenance treatment with macrolids as well as anti-inflammatory therapy.
支气管扩张症患者通常患有慢性肺部感染并伴有继发性阻塞性气道疾病。这种疾病必须与慢性阻塞性肺疾病(COPD)相区分。通过胸部高分辨率CT扫描来确诊。需要进一步的诊断评估以确定病因。治疗复杂且涉及多个方面:治疗基础疾病、识别病情加重、增强气管支气管清除能力、治疗咯血、对受影响的肺段进行手术切除以及抗生素治疗。抗生素治疗可侧重于治疗病情加重,但也会使用慢性抑制性抗生素治疗。据报道,大环内酯类药物维持治疗以及抗炎治疗取得了良好效果。