Professor of Pediatrics, University of Washington School of Medicine, Chief, Pulmonary and Sleep Medicine Division, Seattle Children's Hospital, Seattle, Washington, USA.
Paediatr Respir Rev. 2011 Jun;12(2):119-23. doi: 10.1016/j.prrv.2010.10.012. Epub 2010 Nov 26.
There are multiple aetiologies for childhood bronchiectasis unrelated to cystic fibrosis. Some of these aetiologies, such as those predisposing to recurrent lung infections, e.g. immunodeficiencies, require treatment of the underlying condition and disease-specific pulmonary pathogens within the airway. Regardless of aetiology, the treatments for bronchiectasis include antibiotics, airway clearance regimens, immunizations to prevent infections, and in some cases asthma therapies. The grade of evidence for specific treatments is low with few randomized controlled trials in children. Extrapolations of care provided to adults with bronchiectasis and patients with cystic fibrosis may not always be justified. Comprehensive care programs for children with bronchiectasis have demonstrated clinically relevant improvements over 2-7 year periods. Multi-center research is needed to rigorously evaluate current treatment practices for children with this disorder.
儿童支气管扩张症有多种病因，与囊性纤维化无关。其中一些病因，如易发生反复肺部感染的病因，如免疫缺陷，需要治疗潜在疾病和气道内特定的肺部病原体。无论病因如何，支气管扩张症的治疗包括抗生素、气道清除方案、预防感染的免疫接种，以及在某些情况下的哮喘治疗。具体治疗方法的证据级别较低，儿童中很少有随机对照试验。将成人支气管扩张症患者和囊性纤维化患者的治疗方法外推并不总是合理的。对支气管扩张症儿童进行全面护理计划已证明在 2-7 年内具有临床相关的改善。需要多中心研究来严格评估这种疾病儿童的当前治疗实践。
