Current Status Of Diagnosis And Treatment Of Bronchiectasis

ObjectiveBronchiectasis is one of the chronic irreversible respiratory diseases,andcharacterized by bronchial wall muscle tissue and elastic support tissue destructionwhich are associated with recurrent airway damage, and the prevalence ofbronchiectasis is high in developing countries.In our country, bronchiectasis istreated as a general inflammation with purulent sputum of the airway, furtherresearch of the etiology, pathogenesis, and targeted treatment is little.It will beessential for the treatment after understanding the etiology and pathogenesis ofbronchiectasis,improving the ability of evaluating the basic cause of BE.With thedevelopment of auxiliary examination technology, early diagnosis has got certainimprovement.New research of the treatment methods helps to improve the quality oflife and prognosis of the patients’.But there are still questions such as whetherantibiotics should be a maintenance treatment,and corticosteroids inhaled could beapplied to BE.This article summarizes what is currently known about bronchiectasis,in order to give convenience for improving clinical doctors’ understanding ofbronchiectasis.Methods:In order to make the analysis，139literatures have been retrieved through PubMedand CNKI et.al,of which the Chinese and English ratio is1:6approximately,and thenumber of last10years is88.This paper reviews these studies,summarizing thecontent of the progress of epidemiology, etiology and pathogenesis, diagnosis,management strategies,for getting certain guiding significance to the clinical work.ResultsWith the improvement of population growth and diagnostic technology,bronchiectasis became more well known, but the domestic relevant epidemiologicalstudies are lagged.The related research of Cystic fibrosis is relatively clearer, and theunderstanding of the non-cystic fibrosis bronchiectasis is still iinsufficient,the BritishThoracic Society guideline for non-CF bronchiectasis published by British ThoracicSociety is the first global professional guidelines for bronchiectasis,which is the firstone that put forward the standardization in diagnosis and treatment of bronchiectasis.The diagnosis of pathogeny is very important for treatment and prognosis of patients, but the understanding of the epidemiology of BE is insufficient.The domesticliterature indicated that lung infection was the most common cause, while there isshort of diagnosis means of the other causes such as congenital diseases.People with bronchiectasis often has typical clinical manifestations, but there arestill some patients in the stable period don’t have obvious symptoms, only in the acutestage showed discomfort.The development of the imaging technology played a key role in the BE diagnosis,and part of the clinical studies shwed thatCT, especially HRCT may hint certaincauses of BE, but there is still lack of large-scale clinical trials.Now the separation of mycobacterium tuberculosis rate has risen in recentyears,while the most common bacteria in patients of BE with sputum culture isPseudomonas aeruginosa. There are more and more drug-resistant bacteria along withthe rational use of antibiotics,which put forward the big challenge of the therapeuticstrategy with choices of antibiotics, including the necessity of the long-term use ofantibiotics etc.More and more clinical literatures stressed the importance of clearance of airwaysecretions and chest physical therapy.Few support of evidence-based medicine for thelong-term application of macrolides or glucocorticoid is delivered.Some factors such as chronic obstructive pulmonary disease, the patient’s emotionalstate, environmental pollution, etc. should take charge of the prognosis of BE.