Respiratory system >>>> Bronchiectasis
Bronchiectasis.
Bronchiectasis is a local expansion of the lumen of the bronchi, irreversible and accompanied by deformation of the bronchi. Deformation of the bronchi can take different forms: spindle-shaped, cylindrical (large and medium-sized bronchi), saccular (small-sized bronchi). By the area occupied by bronchiectasis, one can judge the prevalence of the process: a separate segment or lobe of the lung is affected. Sometimes bronchiectasis is accompanied by atelectasis. Multiple bronchiectasis indicate the danger of developing disease.
The causes of bronchiectasis are directly related to chronic diseases of the bronchi and lungs, but sometimes bronchiectasis occurs as congenital malformations of the bronchial structure (for example, underdevelopment of the bronchial wall).
The onset of bronchiectasis can be accompanied by many chronic diseases or frequent infections of the bronchi and lungs:
- Chronic bronchitis,
- Bronchopneumonia,
- Pleurisy,
- Asthma,
- Pneumofibrosis
- Infectious diseases affecting the respiratory tract: measles, tuberculosis, whooping cough, legionellosis, etc.,
- Violations of the tone of the bronchial wall,
- Injuries to the walls of the bronchi with chemical or thermal burns,
- Chest trauma (including as a result of surgical interventions).
Bronchiectasis, which is the result of bronchiectasis, originates mainly at a young age (from childhood to 25-30 years). Frequent respiratory infections, relapses of chronic diseases of the respiratory tract trigger the mechanism of development of bronchiectasis, when bronchiectasis as a result of infection or inflammation is filled with sputum, often of purulent origin, causes bronchial obstruction, and disrupts the mechanism of sputum discharge. The structure of the bronchial wall changes, accompanied by degeneration of the mucous membrane and the cartilaginous plates of the bronchi themselves.
Signs of bronchiectasis:
- Cough with profuse expectoration,
- Purulent discharge when coughing up,
- Hoarse breathing,
- Shortness of breath,
- Auscultation (listening) reveals foci of voiced wheezing,
- Often bronchospasm is similar to asthmatic,
- Sometimes the cough is accompanied by hemoptysis due to bursting blood vessels,
- The phenomenon of respiratory failure may gradually develop .
Bronchiectasis is a recurrent disease, with its mild form, relapses occur no more than once or twice a year with prolonged remissions. More severe forms of bronchiectasis are accompanied by frequent relapses and a short period of remission.
The most accurate diagnosis of bronchiectasis is carried out on the basis of radiography using a radiopaque substance (bronchography). The procedure is performed under local (for adults) and general (for children) anesthesia. Through the inserted catheter, the lumens of the bronchi are filled with a substance and give a visual picture of the state of the bronchial tree in the pictures.
Treatment of bronchiectasis is directed to:
- to eliminate factors that support the exacerbation of bronchiectasis (allergies - antihistamines, respiratory infections - antimicrobial agents, chronic inflammatory diseases of the respiratory tract - anti-inflammatory drugs and immunostimulants);
- to eliminate obstruction (clogging) of the bronchi;
- to establish the process of sputum discharge (thinning sputum and expectorants, bronchoalveolar lavage - washing).
For health reasons and / or in the absence of contraindications, it is possible to treat bronchiectasis by surgical intervention (removal of the affected segment of the lung). Surgical treatment is indicated when drug and physiotherapy are ineffective.
Along with therapeutic drug treatment, breathing exercises, chest massage, inhalations, and chest electrophoresis are performed.
Prevention of attacks of bronchiectasis is aimed at preventing and timely treatment of diseases of the upper respiratory tract ( sinusitis, pharyngitis, tonsillitis), and also includes smoking cessation, protection from hypothermia, and the use of protective devices in dust-generating industries.
Bronchiectasis is dangerous with complications in the form of not only severe diseases of the respiratory system (emphysema, diffuse pneumosclerosis, lung abscess, pulmonary edema, lung loss), but it contributes to damage to the cardiovascular system (tachycardia, arterial hypertension, heart failure) and affects work kidney (nephritis, amyloidosis), liver (amyloidosis), can lead to the development of ascites or pleurisy.
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