Gudmundsson Gunnar, Juliusson Gunnar
Department of Respiratory Medicine, Landspítali University Hospital, Reykjavik, Iceland, Faculty of Medicine, University of Iceland.
Department of Radiology Karolinska University Hospital Stockholm, Sweden.
Laeknabladid. 2020 Jul;106(7):352-361. doi: 10.17992/lbl.2020.0708.592.
Bronchiectasis is a disease that is characterized by permanent bronchial dilation. This can be localized or diffuse in the lungs. The disease can occur at any age and causes cough, sputum production and repeated infections. It is more common in women and incidence increases with age. Bronchiectasis is characterized by repeated episodes of worsening symptoms that are usually caused by respiratory infections. The cause of bronchiectasis can be unknown but it can be caused by respiratory diseases and diseases outside the chest. Examples of such diseases are asthma, chronic obstructive pulmonary disease, rheumatoid arthritis in addition to immune deficiency. Disease profile is therefore different for each patient. Bronchiectasis is diagnosed with computerized tomography of the chest in addition to clinical symptoms. Workup to diagnose other diseases that could be causing it is therefore important. For that detailed history, physical examination and additional investigations are appropriate. Patients with bronchiectasis have decreased health related quality of life and increased mortality. Treatment focuses on treatment of underlying diseases, airway clearance and treatment of infections. Pulmonary rehabilititation is also important. Regular follow-up is important. This is a review on bronchiectasis that is intended for a spectrum of physicians, because bronchiectasis can be seen in primary care, hospitals and out of hospital.
支气管扩张症是一种以永久性支气管扩张为特征的疾病。这种扩张在肺部可以是局限性的,也可以是弥漫性的。该疾病可发生于任何年龄,会导致咳嗽、咳痰及反复感染。它在女性中更为常见,且发病率随年龄增长而升高。支气管扩张症的特征是症状反复加重,通常由呼吸道感染引起。支气管扩张症的病因可能不明,但可由呼吸道疾病及胸部以外的疾病引发。这类疾病包括哮喘、慢性阻塞性肺疾病、类风湿关节炎以及免疫缺陷等。因此,每个患者的疾病情况各不相同。除临床症状外,支气管扩张症通过胸部计算机断层扫描进行诊断。所以,排查可能导致该病的其他疾病很重要。为此,详细的病史、体格检查及其他检查是必要的。支气管扩张症患者的健康相关生活质量下降,死亡率增加。治疗重点在于治疗基础疾病、清理气道及治疗感染。肺康复也很重要。定期随访同样重要。这是一篇针对各类医生的支气管扩张症综述,因为在初级保健、医院及院外均可发现支气管扩张症患者。