North West Deanery, Health Education England, North West, UK.
North West Lung Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK.
Br J Hosp Med (Lond). 2021 Jul 2;82(7):1-9. doi: 10.12968/hmed.2020.0739. Epub 2021 Jul 13.
Bronchiectasis is a common respiratory condition, characterised by abnormal bronchial dilatation, that often leads to recurrent airway infection and inflammation. It is an increasingly recognised respiratory condition, both as a primary lung disease but also co-existing with other respiratory diseases, such as chronic obstructive pulmonary disease and asthma. Diagnosis can have important treatment implications. There are shared systematic approaches to treatment, such as sputum clearance techniques, prompt treatment of exacerbations and, in certain circumstances, regular antibiotic therapy. It is vital to target antibiotic therapy appropriately, and knowledge of the patient's airway microbiology can assist with this. Certain infective and colonising organisms, such as , cause worse patient outcomes and so need prompt treatment with appropriate antibiotics. In addition to this general management approach, there are many different underlying causes of bronchiectasis that should be identified wherever possible, to support more targeted therapy and prevent disease progression. This article provides a guide to the key principles of diagnosing and managing bronchiectasis, and outlines situations where more specialist respiratory support is required.
支气管扩张症是一种常见的呼吸道疾病，其特征为支气管异常扩张，常导致反复的呼吸道感染和炎症。它是一种日益被认识的呼吸道疾病，既是一种原发性肺部疾病，也与其他呼吸道疾病并存，如慢性阻塞性肺疾病和哮喘。诊断对治疗有重要意义。有一些共同的系统治疗方法，如痰液清除技术、及时治疗加重期以及在某些情况下定期使用抗生素治疗。适当地靶向抗生素治疗非常重要，了解患者的气道微生物学可以对此有所帮助。某些感染和定植的病原体，如 ，会导致更差的患者预后，因此需要及时使用适当的抗生素治疗。除了这种一般的管理方法外，支气管扩张症还有许多不同的潜在病因，尽可能确定这些病因有助于更有针对性的治疗和预防疾病进展。本文提供了诊断和管理支气管扩张症的关键原则指南，并概述了需要更多专业呼吸支持的情况。
