Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
Curr Opin Pulm Med. 2019 Mar;25(2):192-200. doi: 10.1097/MCP.0000000000000562.
Noncystic fibrosis bronchiectasis is a challenging disease which carries a heavy healthcare burden and significant mortality and morbidity. This review highlights the challenges in the diagnosis of bronchiectasis and discusses the management strategies and research opportunities in this field.
The challenges in the management of bronchiectasis appear to be multifactorial, arising from both etiological heterogeneity and disease-specific management. Frequent inflammation and infections not only lead to progressive respiratory failure but also increase the risk of cardiovascular complications. No therapies are approved specifically for adult bronchiectasis, but new guidelines and recent studies outline strategies for control of infection and inflammation and for prevention of frequent exacerbations to improve overall prognosis.
Recent studies in the management of bronchiectasis are encouraging. Advances have been made in understanding both disease heterogeneity and best practices for care; interventions such as daily mucociliary clearance, eradication of colonized microbial organisms, and control of inflammation may result in favorable outcomes.
非囊性纤维化性支气管扩张症是一种具有挑战性的疾病,它给医疗保健带来了沉重的负担,且具有较高的死亡率和发病率。本综述强调了支气管扩张症诊断中的挑战,并讨论了该领域的管理策略和研究机会。
支气管扩张症的管理挑战似乎是多因素的,源于病因学的异质性和疾病特异性的管理。频繁的炎症和感染不仅导致进行性呼吸衰竭,而且增加了心血管并发症的风险。目前尚无专门针对成人支气管扩张症的治疗方法,但新的指南和最近的研究概述了控制感染和炎症以及预防频繁恶化的策略,以改善整体预后。
支气管扩张症管理的最近研究令人鼓舞。在理解疾病异质性和最佳护理实践方面取得了进展;诸如每日黏液清除、定植微生物的清除以及炎症控制等干预措施可能会带来有利的结果。