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find Keyword "支气管扩张" 45 results
  • Cardiovascular events after acute exacerbation of bronchiectasis

    Objective To investigate the cardiovascular events (CVE) and survival status of patients with bronchiectasis (BE) during follow-up after acute exacerbation. Methods Prospective cohort study was used. Clinical data of 134 BE patients with acute exacerbation who were hospitalized from July 2016 to September 2020 were collected. The patients were followed up after discharge by phone or respiratory clinic every 3 months until November 2022. CVE or death was the endpoint event. Result During the follow-up period, 41 patients developed CVE, while 93 patients did not. Fifty-one patients died during the follow-up period, with a mortality rate of 38.06%. Among them, 41 cases of CVE resulted in 21 deaths, with a mortality rate of 51.22%; 30 cases died in 93 non-CVE patients, with a mortality rate of 32.26%. Logistic regression results showed significant influencing factors for CVE in BE patients were age, hypertension, chronic obstructive pulmonary disease (COPD), and moderate to severe illness. The significant influencing factors for the death of BE patients were age, COPD, moderate and severe illness, and CVE events. The significant influencing factors for the death of CVE patients were age and receiving CVE treatment. The area under ROC curve (AUC) and 95%CI was 0.858 (0.729 - 0.970) for the warning model for CVE in BE patients. The AUC (95%CI) was 0.867 (0.800 - 0.927) for the warning model for death in BE patients. The AUC (95%CI) was 0.811 (0.640 - 0.976) for the warning model for death of CVE patients. Conclusions Population factors and comorbidities are risk factors for CVE in BE patients after acute exacerbation. The appearance of CVE worsens the long-term prognosis of BE patients. The corresponding warning models have high warning effectiveness with AUC>0.8.

    Release date:2023-12-07 04:39 Export PDF Favorites Scan
  • 噻托溴铵联合肺康复治疗轻中度支气管扩张症的疗效

    目的探讨噻托溴铵联合肺康复治疗轻中度稳定期支气管扩张症的有效性。方法纳入 2017 年 9 月至 12 月就诊于山东第一医科大学附属莱钢医院呼吸科支气管扩张严重程度指数(BSI)评分为轻中度的稳定期支气管扩张症患者 90 例,随机分为常规治疗组、噻托溴铵组和联合治疗组,各 30 例。规律治疗 1 年后,比较三组患者改良呼吸困难指数(mMRC)评分、BSI 评分和肺通气功能检查的变化。结果治疗后常规治疗组 mMRC 为(2.00±1.08)分,BSI 评分为(4.40±0.89)分,明显高于联合治疗组[(1.37±0.49)分、(2.37±1.13)分]和噻托溴铵组[(1.47±0.57)分、(3.40±1.16)分],差异均有统计学意义(均 P<0.05)。常规治疗组第 1 秒用力呼气容积占预计值百分比(FEV1%pred)为(71.70±6.46)%,用力肺活量占预计值百分比(FVC%pred)为(63.80±6.67)%,FEV1/FVC 为(74.00±5.47)%,明显低于噻托溴铵组[(74.97±5.33)%、(70.83±8.41)%、(79.47±4.90)%]和联合治疗组[(78.53±4.75)%、(74.23±5.19)%、(81.70±5.80)%],差异均有统计学意义(均 P<0.05)。联合治疗组 FEV1%pred 明显高于噻托溴铵组,而 BSI 评分明显低于噻托溴铵组,差异有统计学意义(P<0.05)。结论噻托溴铵粉吸入剂联合肺康复治疗能减轻支气管扩张症患者的呼吸困难,提高肺通气功能,改善预后。

    Release date:2020-09-27 06:38 Export PDF Favorites Scan
  • 支气管扩张合并显微镜下血管炎一例并文献复习

    目的报道一例支气管扩张合并显微镜下血管炎的诊治经过并进行文献复习,提高临床医生对此类疾病的认识及诊治水平。方法报道 1 例支气管扩张合并显微镜下血管炎的病史、临床表现及诊治经过,并复习国内外相关文献报道。结果患者女性,68 岁,因“间断咯血 10 余年,乏力 1 个月,发热 3 d”入院,胸部 CT 示支气管扩张合并感染,ANCA 过筛试验阳性(1∶320),抗髓过氧化物酶抗体阳性(++),肾穿刺病理符合显微镜下血管炎。入院后病情进展,出现严重的弥漫性肺泡出血,经气管插管机械通气、糖皮质激素冲击联合环磷酰胺、血浆置换、丙种球蛋白及抗感染等治疗,病情好转出院,随访 1 年病情稳定。国内外文献显示,支气管扩张是显微镜下血管炎患者肺部累及的常见表现,部分患者在血管炎发病之前存在多年的支气管扩张病史,慢性气道感染可能与血管炎的发病有关,合并支气管扩张的血管炎患者出现弥漫性肺出血风险较高。结论支气管扩张与显微镜下血管炎可能存在一定的内在关系。

    Release date:2021-02-08 08:11 Export PDF Favorites Scan
  • Risk factors for acute exacerbation in patients with bronchiectasis

    ObjectiveTo explorer the risk factors for acute exacerbation in patients with bronchiectasis within one year.MethodsFour hundred and twenty-two patients with non-cystic fibrosis bronchiectasis hospitalized were enrolled in The East Region of the People’s hospital of Sichuan between October 2014 and October 2016. The patients’ clinical data were collected, and follow-up began at the time of discharged. The study endpoint was the first acute exacerbation, all patients were followed-up for one year after discharged. The patients were classified into two groups by the occurrence of acute exacerbation or no occurrence. Logistic regression analysis was used to explore the risk factors for acute exacerbation with bronchiectasis.ResultsThe age, sick time, body mass index (BMI) less than 18.5 kg/m2, smoking index, expectoration, hemoptysis, dyspnea, moist sounds, wheezing sounds, types of imaging, CT scores, lung lesion site, sputum culture, whether infected Pseudomonas aeruginosa, level of serum C-reactive protein (CRP), level of serum PCT, serum albumin, arterial carbon dioxide partial pressure, types of respiratory failure, combined with chronic cor pulmonale differed significantly between the two groups (P<0.05), while gender, history of Infection, smoking, cough, chest pain, fever, clubbed-finger, white blood cell counts, neutrophil counts, erythrocyte sedimentation rate, serum globulins, arterial oxygen partial pressure did not significantly differ (P>0.05). Multivariate Logistic regression analysis found that infection with Pseudomonas aeruginosa, BMI<18.5 kg/m2, high level of serum CRP, high level of arterial carbon dioxide partial pressure (PaCO2), high CT score with bronchiectasis, combination with chronic cor pulmonale were risk factors for acute exacerbation in patients with bronchiectasis (P<0.05).ConclusionsInfection with pseudomonas aeruginosa, BMI < 18.5 kg/m2, high serum CRP level, high arterial blood PaCO2 level, high CT score with bronchiectasis and combination of chronic cor pulmonale are risk factors for acute aggravation within 1 year for patients with bronchiectasis. Doctors can identify these risk factors and intervene early, so as to reduce the acute exacerbation of bronchiectasis.

    Release date:2021-01-26 05:01 Export PDF Favorites Scan
  • 无创正压机械通气治疗支气管扩张症合并呼吸衰竭的回顾性分析

    目的观察支气管扩张症合并呼吸衰竭患者应用无创正压机械通气(NPPV)治疗前后各项生理指标的变化,评价其疗效。 方法选择2010年1月至2011年12月华北油田公司总医院收治的应用无创正压机械通气治疗的支气管扩张症合并呼吸衰竭患者36例,比较治疗前后患者的心率、呼吸频率(RR)、pH值、动脉血二氧化碳分压(PaCO2)、动脉血氧分压(PaO2)、氧合指数(PaO2/FiO2)、辅助呼吸肌评分、呼吸困难分级、第1秒用力呼气容积占预计值百分比(FEV1%pred)、第1秒用力呼气容积/用力肺活量比值(FEV1/FVC)、插管率和病死率。 结果经无创正压机械通气治疗后,患者的心率、RR、PaCO2、辅助呼吸肌评分和呼吸困难分级均明显下降,pH值、PaO2、PaO2/FiO2、FEV1%pred、FEV1/FVC均明显上升,与治疗前比较差异具有统计学意义(P<0.05)。2例患者因病情恶化行有创机械通气治疗,插管率5.56%,其中1例患者死亡。 结论合理选择应用NPPV可以改善支气管扩张症合并呼吸衰竭患者的肺通气功能。

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  • Efficacy and safety of ciprofloxacin for non-cystic fibrosis bronchiectasis: a meta-analysis

    ObjectivesTo systematically review the efficacy and safety of ciprofloxacin for non-cystic fibrosis bronchiectasis.MethodsDatabases including PubMed, EMbase, The Cochrane Library, CBM, VIP, CNKI and WanFang Data were electronically searched from inception to August 2018 to collect randomized controlled trials (RCTs) on ciprofloxacin in the treatment of non-cystic fibrosis bronchiectasis. Two reviewers independently screened literature, extracted data, and assessed risk of bias of included studies. Then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 9 RCTs involving 1 666 patients were included. The results of meta-analysis showed that: compared with control group, the ciprofloxacin more efficiently eradicate bacteria from sputum (RR=4.34, 95%CI 2.04 to 9.23, P=0.000 1), decrease risk of the exacerbations (RR=0.81, 95%CI 0.71 to 0.93, P=0.002) and the mean bacterial load (MD=–4.08, 95%CI –6.29 to –1.87, P=0.001). However, there were no significant differences between two groups in clinical efficiency and adverse events.ConclusionsThe current evidence shows that, ciprofloxacin can decrease the mean bacterial load and risk of the exacerbation, and more efficiently eradicate bacteria from sputum in non-cystic fibrosis bronchiectasis patients. Due to limited quality and quantity of the included studies, more studies are required to verify the conclusions.

    Release date:2019-06-24 09:18 Export PDF Favorites Scan
  • Application of video-assisted thoracoscopic anatomic segmentectomy in single-stage bilateral thoracic surgery for the treatment of bilateral localized bronchiectasis

    ObjectiveTo explore the safety and feasibility of the application of video-assisted thoracic surgery (VATS) anatomic segmentectomy in single-stage bilateral thoracic surgery for the treatment of bilateral localized bronchiectasis.MethodsFrom June 2014 to June 2018, 19 patients with bilateral localized bronchiectasis underwent single-stage bilateral thoracic surgery with VATS anatomic segmentectomy, including 11 males and 8 females aged 38.0±12.5 years. The clinical efficacy of the surgery was evaluated.ResultsAll surgeries were successfully completed, of which 17 were bilateral VATS, 2 were unilateral VATS with the other lateral converted to thoracotomy. The average number of bilateral resected segments was 4-8 (5.9±1.2). Mean operation time was 330.0±40.0 min and mean blood loss was 150.0±60.0 mL. Mean ventilator-assisted breathing time was 6.0±1.8 h, mean duration of chest-tube placement was 4.0±1.0 d and mean hospital stay time was 14.0±1.5 d. Three patients suffered pulmonary infection and 1 patient received tracheotomy. No perioperative death occurred. Arterial oxygen pressures on postoperative day (POD) 1 (F=340.18, P<0.05) and POD 3 (F=131.26, P<0.05) were significantly lower than that before operation, arterial carbon dioxide pressures on POD 1 (F=46.62, P<0.05) and POD 3 (F=48.21, P<0.05) were significantly higher than that before operation, and pulse oximeter saturation on POD 1 was significantly lower than that before operation (F=210.82, P<0.05). The patients were followed up for one to five years without recurrence.ConclusionApplication of VATS anatomic segmentectomy in single-stage bilateral thoracic surgery for the treatment of bilateral localized bronchiectasis is safe and feasible with strictly selected patients. Postoperative airway management is very important. The surgery is worthy of wide clinical practice.

    Release date:2020-07-30 02:32 Export PDF Favorites Scan
  • Kartagener Syndrome: Three Cases Report and Literature Review

    Objective To improve the knowledge of kartagener syndrome and the understanding of primary ciliary dyskinesia ( PCD) . Methods Three cases of Kartagener syndrome were reported and analyzed on clinical manifestations, symptoms, imaging appearances of chest, and family history. Meanwhile the related literatures were reviewed. Results The three patients deserved special recognition because of recurrent upper and lower respiratory tract infection. Of them, the third case showed mainly the symptoms of nasosinusitis at an early age, and the distinct pulmonary symptoms appeared in his adulthood. Further examination showed that the triad of chronic sinusitis, bronchiectasis, and situs inversus is present in all cases. The parents of the two cases were consanguineous marriaged. Examination of the bronchial mucosal biopsy specimen of the first case under transmission electron microscopy showed cilia with the absence of inner dynein arms. The three cases got improvement after treatment of anti-infection and expectorant. Conclusion For patients with recurring infection in the upper and lower respiratory tract from infancy, the possibility of PCD should be considered no matter whether a situs inversus exists.

    Release date:2016-09-13 04:07 Export PDF Favorites Scan
  • Microbiological characteristics of airway bacteria in adult patients with bronchiectasis and their correlation with the clinical features

    ObjectiveTo analyze the microbiological characteristics of airway bacteria in adult patients with bronchiectasis and to analyze their correlation with the clinical features. MethodsPatients diagnosed with bronchiectasis in the Department of Respiratory and Critical Care Medicine of West China Hospital of Sichuan University from October 2017 to April 2018 were classified into the bronchiectasis group, while the control group was those who were found to have pulmonary nodules (diameter less than 10 mm) requiring bronchoscopy by physical examination. All subjects in both groups had not used antibiotics or hormones within 4 weeks and had no other respiratory diseases. Bronchoalveolar lavage fluid (BALF) from the lesion site of the branchial expansion group was collected, and BALF from the basal segment of the contralateral inferior bronchial lobe of the pulmonary nodule was collected in the control group. Bacterial culture and 16S rRNA gene sequencing were performed in both groups. ResultsSeventeen cases and six controls were enrolled in this study and the BALF specimens were collected. Eight cases were in stable period and nine cases were in acute period. The case group was divided into the bacteria-positive group and negative group based on bacterial culture of BALF. Shannon index in the bacteria-positive group was significantly lower than the bacteria-negative group and the control group. And Shannon index showed a negative correlation with positive bacterial culture in BALF. When Shannon index ≤4.5 was used to predict positive bacterial culture, the sensitivity and specificity were 83.3% and 90.9% respectively. The average relative abundance of bacteria was higher and the average sample distribution uniformity was lower in patients with acute period, compared with those in patients with stable period. Shannon index was negatively correlated with the acute exacerbation in patients. When Shannon index <5.0 was used to predict acute exacerbation, the sensitivity and specificity were 77.8% and 100.0%, respectively. ConclusionsShannon index in 16S rRNA gene sequencing results has certain predictive value for acute exacerbation stage. 16S rRNA gene sequencing combined with bacterial culture results can help guide clinicians to provide more precise treatment plans.

    Release date:2023-09-22 05:51 Export PDF Favorites Scan
  • 支气管镜灌洗治疗支气管扩张伴感染临床疗效分析

    Release date:2016-09-08 09:27 Export PDF Favorites Scan
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