Scottish Centre for Respiratory Research, University of Dundee, Dundee, UK.
University at Buffalo, State University of New York, Buffalo, NY, USA.
NPJ Prim Care Respir Med. 2017 Mar 13;27(1):18. doi: 10.1038/s41533-017-0019-9.
Bronchiectasis is a chronic lung disease characterised by recurrent infection, inflammation, persistent cough and sputum production. The disease is increasing in prevalence, requiring a greater awareness of the disease across primary and secondary care. Mild and moderate cases of bronchiectasis in adults can often be managed by primary care clinicians. Initial assessments and long-term treatment plans that include both pharmacological and non-pharmacological treatments, however, should be undertaken in collaboration with a secondary care team that includes physiotherapists and specialists in respiratory medicine. Bronchiectasis is often identified in patients with other lung diseases, such as chronic obstructive pulmonary disease, asthma, and in a lesser but not insignificant number of patients with other inflammatory diseases, such as rheumatoid arthritis and inflammatory bowel disease. Overall goals of therapy are to prevent exacerbations, improve symptoms, improve quality of life and preserve lung function. Prompt treatment of exacerbations with antibiotic therapy is important to limit the impact of exacerbations on quality of life and lung function decline. Patient education and cooperation with health-care providers to implement treatment plans are key to successful disease management. It is important for the primary care provider to work with secondary care providers to develop an individualised treatment plan to optimise care with the goal to delay disease progression. Here, we review the diagnosis and treatment of bronchiectasis with a focus on practical considerations that will be useful to primary care.
支气管扩张症是一种慢性肺部疾病，其特征为反复感染、炎症、持续咳嗽和咳痰。该病的患病率在增加，这就要求初级和二级保健都要提高对该病的认识。轻度和中度的成人支气管扩张症通常可以由初级保健临床医生进行管理。然而，初始评估和包括药物和非药物治疗在内的长期治疗计划应由包括物理治疗师和呼吸医学专家在内的二级保健团队共同制定。支气管扩张症通常在患有其他肺部疾病的患者中发现，例如慢性阻塞性肺疾病、哮喘，在数量较少但并非微不足道的患有其他炎症性疾病的患者中也发现，例如类风湿关节炎和炎症性肠病。治疗的总体目标是预防恶化、改善症状、提高生活质量和保护肺功能。及时用抗生素治疗恶化对限制恶化对生活质量和肺功能下降的影响很重要。患者教育和与医疗保健提供者合作实施治疗计划是成功管理疾病的关键。初级保健提供者与二级保健提供者合作制定个体化治疗计划以优化护理并延缓疾病进展非常重要。在这里，我们重点讨论支气管扩张症的诊断和治疗，其中包含对初级保健有用的实用注意事项。
