Bronchiectasis is pathologically enlarged bronchial lumens with a change in the structure of the bronchial wall, which can be congenital or acquired. Bronchiectasis can be formed as a result of respiratory infections caused by various bacteria (Staphylococcus aureus, Klebsiella pneumoniae, Haemophilus influenzae), adenoviruses, influenza viruses, fungi (histoplasma, aspergillus), mycobacteria, etc.
Often bronchiectasis is formed in various conditions characterized by narrowing of the bronchial lumen (bronchial obstruction). These include:
- foreign bodies of bronchi,
- tumor processes that narrow the airway lumen,
- damage to the lymph nodes of the roots of the lungs in various diseases (tuberculosis, sarcoidosis, etc.).
- obstructive changes in COPD
Bronchiectasis can develop with various malformations and abnormalities of the development of respiratory organs and pulmonary vessels: bronchomalacia, Munier-Kuhn syndrome, bronchogenic cysts, pulmonary artery aneurysm, etc. In addition, bronchiectasis is detected in the pathology of cartilage tissue with damage to the trachea and large bronchi, amyloidosis, in the postoperative period, various immune and autoimmune diseases, genetically determined conditions (alpha-1-antitrypsin deficiency, cystic fibrosis, primary ciliary dyskinesia syndrome)
Possible causes of bronchiectasis may be inhalation of ammonium, nitrogen dioxide, talc, silicates, tobacco smoke, gastroesophageal reflux.
The risk group includes:
- Patients with abnormalities of the respiratory tract and pulmonary vessels
- Patients with COPD, chronic infectious lung diseases
- Patients with immunodeficiency of various etiologies and hereditary diseases
- Patients who have long-term contact with harmful occupational factors
- Patients often suffering from respiratory infections
- Patients suffering from autoimmune diseases,
- Patients with GERD
- Patients who have undergone lung and heart transplantation
You can suspect the disease if the following symptoms occur:
- chronic cough with sputum;
- weight loss, fatigue, poor exercise tolerance;
- shortness of breath during physical exertion;
- frequent pneumonia.
If one or more of these signs are detected, it is recommended to consult a doctor. The specialist will assess the situation and appoint a follow-up examination.
To diagnose bronchiectasis, laboratory tests are carried out: general and biochemical blood tests to determine the level of leukocytes, inflammatory markers, immunological blood tests (determination of alpha-1-antitrypsin, antibodies to bacterial and viral pathogens, etc.) cytological and bacteriological studies of sputum and bronchial flushes / lavage, in some cases genetic studies; and instrumental studies: examination of the function of external respiration, multispiral computed tomography, according to indications - with intravenous bolus contrast, bronchoscopy with examination of bronchial flushes or bronchial lavage.
Treatment of patients with bronchiectasis is complex, including the fight against an existing infection, prevention of the development of infectious complications, as well as improving sputum drainage and restoring the body's defenses.
Indications for surgical treatment are:
1) Bronchiectasis, located in one lobe of the lung with frequent exacerbations
2) Constantly expanding areas of bronchiectasis with frequent exacerbations
3) Bleeding or hemoptysis of more than 200 ml / day from local bronchiectasis, not amenable to drug therapy.
After surgical treatment, clinical recovery occurs in 75% of patients, the remaining 25% have a significant improvement in their condition.
In the Moscow Clinical Scientific and Practical Center named after A.S. Loginov, bronchiectasis treatment is carried out by the efforts of pulmonologists using modern methods of diagnosis and treatment. Do not delay your visit to the specialists of our Center. This will help to diagnose the disease in a timely manner and choose the right treatment tactics. Doctors of GBUZ MCSC named after A.S. Loginov DZM are always ready to help you.