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- 苏雷副主任医师 副教授
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医院:
首都医科大学宣武医院
科室:
胸外科
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- 咯血的常见病因-----支气管扩张 The common cause of bronchiectasis hemoptysis.
- 作者:苏雷|发布时间:2013-06-20|浏览量:2002次
1.什么是支气管扩张?What is the bronchiectasis?
支气管扩张是支气管及邻近肺组织的慢性化脓性疾病,使支气管管壁的组织结构受到破坏,导致其管腔扩张变形。引起感染的常见病原体为铜绿假单胞菌、金黄色葡萄球菌、流感嗜血杆菌、肺炎链球菌和卡他莫拉菌。可在任何年龄发病,但以儿童和青年多见。Bronchiectasis is a chronic disease of purulent bronchial and adjacent lung tissue, the organizational structure of the bronchial wall damage, leading to its lumen expansion deformation.Caused by common pathogens were Pseudomonas aeruginosa, Staphylococcus aureus, Streptococcus pneumoniae, Haemophilus influenzae and Moraxella bacteria Mora.Can occur at any age, but in children and youth.
2.支气管扩张的临床表现有哪些?What are the clinical manifestations of bronchiectasis?
典型的支气管扩张症表现为咳痰、咯血和反复发作的呼吸道感染。痰量多(感染时痰液收集于玻璃瓶中静置后出现分层的特征:上层为泡沫及脓性成分,中层为混浊黏液,下层为坏死组织沉淀物)、有恶臭(厌氧菌感染)、且与体位有关(起床时可诱发咳嗽、咳痰)、痰中带血或大量咯血。部分患者平时无咳嗽、咳脓痰等症状,而以反复咯血为唯一症状,临床上称为“干性支气管扩张症”。Bronchiectasis typical manifestations were recurrent expectoration, hemoptysis and respiratory tract infection.Sputum quantity (infection sputum collection in glass bottles after standing appears layered features: upper foam and purulent components, turbid mucus layer, layer of necrotic tissue deposits), fetid (anaerobic infection), and the position and relevant (get up can cause cough, sputum, sputum) blood or massive hemoptysis.Some patients usually no symptoms such as cough, vomica, and repeated hemoptysis is the only symptom, clinical on call "dry bronchiectasis".
3.支气管扩张怎样治疗?Bronchodilator treatment。
支气管扩张症的治疗首先应加强全身支持、合理安排休息、痰液引流、治疗原发病、有效抗菌素控制感染。症状严重或疗效不满意者可以考虑手术治疗。The treatment of bronchiectasis should first strengthen systemic support, reasonable arrangements for rest, sputum drainage, treatment of the primary disease, effective antibiotics to control infection.Severe symptoms or efficacy not satisfied can consider operation treatment.
1、手术适应证:一般情况好、心肝肾功能正常、病变范围局限于一侧肺,可考虑肺段、肺叶或全肺切除;双侧肺病变,考虑较重一侧的肺段或肺叶切除。1, operation indications: good general condition, liver and normal renal function, pathological changes in lung, can consider to lung, lobectomy or pneumonectomy; bilateral pulmonary lesions, consider the heavier side of the lung segment or lobe resection.
2、手术禁忌证:一般情况差、心肝肾功能不全;病变范围广或伴有严重呼吸功能障碍者。2, operation contraindication: poor general condition, liver and renal insufficiency; lesion range or with severe respiratory dysfunction.
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