ʻO ka Bronchiectasis ka dilations a me ka luku ʻana o ka bronchi ma muli o ka maʻi a me ka mumū mau. ʻO nā kumu maʻamau e pili ana i ka cystic fibrosis, nā hemahema immune, a me nā maʻi hoʻomau. ʻO nā hōʻailona maʻamau ʻo ia ka maʻi maʻi maʻi, ka ʻāʻī ʻana o ka purulent sputum, ke kuni, a me ka dyspnea. ʻO ka mālama ʻana a me ka pale ʻana i nā hōʻeha koʻikoʻi e pili ana i ka hoʻohana ʻana i nā bronchodilators a me nā lāʻau antibiotic, ka wehe ʻana i nā mea huna, a me ka mālama ʻana i nā pilikia e like me ka hemoptysis a me nā ʻeha ʻeha ʻē aʻe ma muli o nā maʻi kūʻokoʻa a kūpono paha.

ʻO ka Bronchiectasias nā hoʻololi morphological hiki ʻole ke hoʻololi (ka hoʻonui, deformation) a me ka haʻahaʻa hana o ka bronchi, e alakaʻi ana i ka maʻi ʻōpū suppurative mau loa. ʻO ka paʻakikī holoʻokoʻa o ka pulmonary a me nā loli extrapulmonary i mua o ka bronchiectasis i kapa ʻia ʻo bronchiectasis.

Ua ʻike ʻia ʻo Bronchiectasis no ka manawa mua i ka makahiki 1819, e Kauka René-Théophile-Hyacinthe Laennec, ka mea nāna i hana i ka stethoscope. He ʻano hoʻomāhuahua ʻino kēia o kahi ʻāpana o ka bronchi, ma muli o ka pōʻino hiki ʻole ke hoʻihoʻi ʻia i nā paia o nā alaloa, e hoʻonui ai i ka maʻi o ka māmā. Hiki i kēia dilation o ka bronchi ke hoʻopili:

• nā ʻāpana he nui o ka māmā: ua kapa ʻia kēia diffuse bronchiectasis;
• hoʻokahi a ʻelua paha ʻāpana o ka māmā: kapa ʻia kēia ʻano bronchiectasis focal.

Hiki ke ulu ka Bronchiectasis i kēlā me kēia makahiki. Hoʻonui ʻia kona maʻi me ka makahiki a me ka wahine. ʻO nā makahiki āpau i hui pū ʻia, mai 53 a 556 mau hihia no 100 mau kānaka a ʻoi aku ma mua o 000 mau hihia no 200 mau kānaka ma waena o ka poʻe ma mua o 100 mau makahiki.

He ʻokoʻa ka wānana. Me ka mālama kūpono a me ka hahai ʻana, loaʻa i ka poʻe me ka bronchiectasis ke ola maʻamau. ʻO ka ʻokoʻa, ʻo ka poʻe me ka bronchiectasis koʻikoʻi, nā maʻi concomitant e like me ka maʻi bronchitis mau loa a i ʻole emphysema, a i ʻole nā ​​pilikia e like me ka pulmonary hypertension a i ʻole cor pulmonale e loaʻa i kahi prognosis maikaʻi ʻole. ʻO ka wānana no ka poʻe maʻi me ka cystic fibrosis ka mea maikaʻi ʻole, me ke ola ma waena o 36 mau makahiki.

ʻO nā lāʻau antibiotic a me nā papahana lāʻau lapaʻau ua hoʻemi nui i ka hiki ʻana mai o ka bronchiectasis ma nā ʻāina ʻoihana, ʻoiai ke mau nei kēia maʻi ma nā ʻāina ʻilihune.

ʻO Bronchiectasis, congenital a loaʻa

ʻO ka bronchiectasis congenital he mea kakaikahi a ulu ma muli o ka hoʻokumu ʻana o ka lāʻau bronchial. ʻO ka hōʻailona histological o ka congenital bronchiectasis kahi hoʻonohonoho ʻino o nā mea hoʻolālā o ka bronchi i loko o ko lākou pā.

ʻO ka kumu kumu nui o ka bronchiectasis i loaʻa he genetically i hoʻoholo ʻia i ka inferiority o ka lāʻau bronchial (underdevelopment o nā mea o ka pā bronchial), i hui pū ʻia me ka impaired bronchial patency a me ke ʻano o ka mumū, alakaʻi i ka deformation mau o ka bronchi.

Hoʻoikaika nui ʻia ka hoʻokumu ʻana o ka bronchiectasis e ka ʻū ʻana, nā maʻi ʻeha o ka hanu, ka ʻāʻī, ka bronchitis, ka maʻi pneumonia, nā ʻōpū o ka māmā, ka maʻi maʻi, nā kino haole i ka lāʻau tracheobronchial.

ʻO nā hoʻopiʻi nui: ʻo ka ʻū me ka nui o ka purulent sputum, hemoptysis, ʻeha o ka umauma, pōkole o ka hanu, ke kuni, ka hoʻoulu ʻana, ka pohō kaumaha a me ka emi ʻana o ka hana. ʻO ka nui a me ke ʻano o ka sputum e pili ana i ke ʻano o ka pōʻino bronchial. Loaʻa paha i nā haumia o ke koko a me ka pus, kahi ʻala maikaʻi ʻole.

Hōʻike ʻia ka maʻi e nā exacerbations a me nā kala ʻana. I ka wā o ka exacerbations, piʻi ka mahana, pōkole o ka hanu, wheezing ma ka umauma, a ʻike ʻia nā lehelehe uliuli. E kūʻē i ke kua o ka papa lōʻihi, loaʻa i nā manamana lima o ka mea maʻi ke ʻano o nā pahu pahu, a me nā kui - o ke aniani wati. Me ka liʻiliʻi, piʻi ka maʻi maʻamau o ka mea maʻi.

Paʻakikī pinepine ʻia ka Bronchiectasis e ka pulmonary bleeding, abscess formation, development of pulmonary fibrosis and emphysema, "cor pulmonale", amyloidosis.

He ʻokoʻa loa nā kumu kumu o ka bronchiectasis. ʻO ke kumu maʻamau, ʻo ia ka maʻi maʻi mau a i ʻole ka maʻi hou, ma muli o nā maʻi ʻōnaehana immune a i ʻole nā ​​​​hemahema hānau e pili ana i ke ʻano a i ʻole ka hana o nā alaloa a kōkua i ko lākou keakea.

Nā maʻi hanu (diffuse a focal bronchiectasis)

Keia mau puke:

• ʻū ʻūlū ;
• ʻāʻī ;
• maʻi palū;
• puʻupuʻu;
• respiratory syncytial virus infections, etc.

ʻO nā mea keakea mīkini o nā ala ea (focal bronchiectasis)

As:

• ʻaʻa koko;
• broncholithiasis;
• ka hoʻonui mau ʻana o ka lymphatic glands;
• kino haole inhaled;
• nā hoʻololi ma hope o ka ʻoki ʻana i ka māmā;
• mucus etc.

Nā maʻi genetic (diffuse bronchiectasis)

E `ike :

• Cystic fibrosis ;
• ʻO ka dyskinesia ciliary mua (PCD), he maʻi maʻi i hōʻike ʻia e ka ulu ʻana o ka māmā maʻamau mai ka hānau ʻana;
• alpha-1-antitrypsin deficiency, he maʻi e pili ana i ka māmā a me ke ake.

Immunodeficiencies (diffuse a focal bronchiectasis)

As:

• nā maʻi maʻi ʻole e like me AIDS;
• l'hypogammaglobulinemia, etc.

ʻO nā maʻi maʻi (diffuse bronchiectasis)

Keia mau puke:

• rheumatoid arthritis;
• ulcerative colitis;
• Maʻi ʻo Crohn;
• ka maʻi Sjögren;
• systemic lupus erythematosus, etc.

Immun-allergic (diffuse a focal bronchiectasis)

E `ike :

• allergic bronchopulmonary aspergillosis (ABPA), he hopena maʻi i ka haʻo i kapa ʻia ʻO Aspergillus, ka mea maʻamau i loaʻa i ka poʻe me ka hānō a i ʻole ka cystic fibrosis, hiki ke hoʻoulu i nā pulu mucus e ālai i nā alaloa.

Hiki i ka Bronchiectasis ke hopena ma muli o ka hoʻohu ʻana i nā mea ʻawaʻawa e hōʻino ai i ka bronchi:

• nā mahu o nā kinoea ʻino, uahi (me ka uahi paka) a i ʻole ka lepo ʻino e like me ka silica a i ʻole ka lepo kalapona;
• meaʻai a i ʻole ka ʻakika ʻōpū.

Hoʻomaka maʻamau nā hōʻailona me ka liʻiliʻi o ka ulu ʻana i nā makahiki, i hele pū ʻia me nā ʻāpana o ka ʻinoʻino.

Keia mau puke:

• ʻO ka maʻi maʻi maʻamau, ʻo ka hōʻailona maʻamau, ʻike pinepine ʻia i nā hola mua o ke kakahiaka a i ka hopena o ka lā a hoʻopuka i ka sputum mānoanoa, nui a purulent pinepine. Hiki ke ʻokoʻa ka nui o kēia sputum, a me kona kala (keʻokeʻo, melemele, ʻōmaʻomaʻo, ʻeleʻele ʻōmaʻomaʻo a ʻeleʻele paha);
• pilikia ka hanu (dyspnea);
• pokole o ka hanu;
• he leo uwē i hana ʻia e ka neʻe ʻana o ka ea ma nā alaloa (wheezing);
• pleural-like umauma ʻeha;
• ke kuni hou;
• luhi nui;
• ka emi ʻana o ka nui o ka oxygen i lawe ʻia i loko o ke koko (hypoxemia);
• ke koko kiʻekiʻe o ka pulmonary arterial;
• ʻaʻohe puʻuwai ʻākau;
• ʻāke koko (hemoptysis).

He mea maʻamau ka exacerbations a ma muli paha o kahi maʻi hou a i ʻole ka piʻi ʻana o ka maʻi e kū nei. Hōʻike ʻia nā maʻi lapalapa o ka maʻi e ka ulu ʻana o ka ʻū, hoʻonui i ka dyspnea, a me ka nui a me ka purulence o ka sputum. Inā koʻikoʻi ka maʻi bronchiectasis a maʻamau, maʻamau ka pohō kaumaha.

Me ka mālama pono ʻana, hiki i ka poʻe me ka bronchiectasis ke noho paʻa no nā makahiki he nui a mālama pono i kā lākou mau hōʻailona. ʻO ka mālama ʻana i ka bronchiectasis ka mea e:

• pale i ka exacerbations;
• mālama i nā hōʻailona;
• hoʻomaikaʻi i ka maikaʻi o ke ola;
• pale i ka hoʻonui ʻana o ka maʻi.

Kāohi i nā exacerbations

• nā lāʻau lapaʻau maʻamau e like me ka maʻi influenza makahiki a me ka maʻi pneumococcal e hāʻawi i ka pale mai ka maʻi bacteria maʻamau o ka pneumonia;
• nā ana hoʻomaʻemaʻe ea;
• nā lāʻau lapaʻau macrolide.

Lapaʻau o nā hōʻailona

• antibiotic;
• bronchodilators inhaled;
• nā ana hoʻomaʻemaʻe ea (mau lāʻau mucolytic);
• inhaled a waha corticosteroids;
• i nā hihia koʻikoʻi, ka wehe ʻana i kahi ʻāpana o ke akemāmā inā pili ka bronchiectasis i kahi ʻāpana liʻiliʻi wale nō o ka māmā a i ʻole kekahi hapa o ke akemāmā i nā ʻeha koʻikoʻi e alakaʻi ai i nā maʻi hou a i ʻole e hoʻokuʻu i ka nui o ke koko i ka wā e ʻū ai;
• ka oxygen therapy inā pono e pale i nā pilikia e like me ka cor pulmonale;
• embolization o ka bronchial arteries i ka hanana hemoptysis.

Hoʻonui ka maikaʻi o ke ola

• ka physiotherapy o ka hanu (postural drainage, chest percussion) e hoʻoikaika i ka hoʻokahe ʻana o nā mea huna a me ka mucus;
• hoʻoikaika kino maʻamau e hoʻopau i ka sputum a hoʻoikaika i ka hana o ka māmā;
• ʻAi maikaʻi ;
• ka hoʻohaʻahaʻa ʻana i ka ea a me ka hoʻohu ʻana i ka wai paʻakai e hoʻomaha ai i ka ʻāʻī a me ke kūkulu ʻana o ka mucus;
• nā manawa hoʻoponopono hanu e hoʻomaikaʻi i ke kūpaʻa kino a hōʻemi i nā hopena o nā hōʻailona a me ka hopena kino a me ka naʻau i ke ola o kēlā me kēia lā.

Kāohi i ka piʻi ʻana o ka maʻi

• nā mea kōkua hoʻopau puhi;
• lāʻau lapaʻau ;
• nā lāʻauʻokoʻa.

Hiki ke mālama ʻia ka bronchiectasis kiʻekiʻe i kekahi poʻe, ʻo ka poʻe nui me ka cystic fibrosis kiʻekiʻe, me ka hoʻololi ʻana i ka māmā. ʻO ka helu ola 5 makahiki ma waena o 65% a me 75% no ka hoʻololi ʻana i ka puʻuwai-māmā a i ʻole ka hoʻololi ʻana o nā pūmāmā ʻelua. Hoʻomaikaʻi maʻamau ka hana o ka māmā i loko o 6 mau mahina a hiki ke hoʻomau ʻia ka hoʻomaikaʻi ʻana no 5 mau makahiki.

Nā hana lapaʻau o kēia wā

При нажкактакнавы Мстия иазолевторни ктитор бротиа споля Также эффективны муколитики, разжижающие слизь и облегчающие ее откашливание. Чтобы купировать воспаление, при лечении бронхоэктаза показаны гормональные средства. Для активизации собственных защитных сил организма в терапевтическую схему включают иммуностимуляторы.

Ключевая процедура консервативного лечения бронхоэктаза — санация бронхиального древа. При признаках кислородной недостаточности назначают кислородотерапию. Больному также назначают комплекс упражнений, способствующих эвакуации бронхиальной мокроты, и вныслатимкин Для общего укрепления организма показаны:

• ka meaʻai nui-calorie - 3000 kcal i kēlā me kēia lā;
• meaʻai meaʻai - ka meaʻai waiwai nui i nā meaʻai;
• lāʻau lapaʻau vitamina.

Hāʻawi ʻia i ka hiki ʻole o ke kaʻina hana, a, no laila, ʻaʻohe mea ʻole o ka conservative therapy, ʻo ke ʻano radical wale nō o ka mālama ʻana i ka bronchiectasis pono e noʻonoʻo ʻia he ʻokiʻoki, ʻo ka nui o ia mea ma muli o ka hoʻolaha ʻana o ka bronchiectasis.

Hoʻoponopono, pale, hiki ke pilikia

ʻO kahi mea nui o ka hoʻoponopono paʻakikī no ka bronchiectasis ʻo ka hoʻoponopono ʻana i ke ola. Pono ka mea maʻi e hele i ka ea hou, hoʻōki i ka puhi paka a pale i ka puhi paka, ʻai i ka meaʻai kaulike, hoʻoikaika kino, a hana mau i nā hana hanu.

He mea nui e hoʻopaʻa inoa me ka pulmonologist, e hele i nā koho pale me ka alapine i kuhikuhi ʻia e ke kauka, a, inā pono, e lawe i nā papa o ka physiotherapy. Hāʻawi ka pale ʻana i ka mālama ʻana i nā maʻi hanu a me ka paʻakikī.

Me ka loaʻa ʻole o ka mālama pono ʻana i ka bronchiectasis, ka maʻi maʻi bronchitis, ka pulmonary a me ka pau ʻole o ka naʻau, cor pulmonale, a me ka hānō bronchial. ʻIke nā poʻe maʻi i ka emi ʻana o ka hana a me ka maikaʻi ʻole o ke ola. He mea koʻikoʻi loa ke kamaʻilio ʻana i ke kauka i ka manawa kūpono i mea e hoʻokō ai i kahi kala kūpaʻa lōʻihi.