Bronchiectasis支气管扩张 Si Ting Wang Faculty of Nursing GuangXi Traditional Chinese Medical University Pathophysiology Bronchiectasis支气管扩张 is a disorder characterized by permanent, abnormal dilatation扩张of one or more medium-sized and diameter greater than 2mm proximal bronchi近端支气管. Pathophysiologic change that result in dilatation is destruction of the elastic tissue弹性组织and muscular structures of the bronchial wall支气管壁. Etiology病因 The disease process is often believed to start in childhood as an acquired disorder, beginning with plications secondary to influenza流行性感冒, measles麻疹, or whooping cough百日咳. Infant bronchial - lung infection婴幼儿期支气管-肺组织感染is the mon cause of bronchiectasis. Recurring lower respiratory tract infections are another pattern of disease in childhood that may predispose an individual to bronchiectasis. This pattern is typically seen in the individual who has cystic fibrosis囊肿性纤维化, asthma哮喘, a-1 aitirypsin deficiency 抗胰蛋白酶不足, or immunodeficiency diseases免疫缺陷疾病. Pathologic types病理类型 ular bronchiectasis囊状支气管扩张: occurs mainly in large bronchi and is characterized by cavity-like dilatations. The affected bronchi end in large sacs. Cylindrical bronchiectasis圆柱支气管扩张: involve in medium-sized bronchi that are mildly to moderately dilated. Pathophysiology病理生理 Almost all forms of bronchiectasis are associated with bacterial infection细菌感染. Infections cause the bronchial walls to be weaken, and pockets of infection begin to form. When the walls of the bronchial system are injured, the mucocilliary mechanism 粘膜-纤毛防御机制 is damaged, allowing bacteria and mucus to accumulate within the pockets. The infection es worse and results in bronchiectasis. Classification分类 Localized bronchiectasis局部支气管扩张: results from focal airway obstruction, or from necrotizing坏死性or lobar pneumonia大叶性肺炎whose bronchiectatic sequelae后遗症are limited to one area of the lung. Obstructive processes of any kind can predispose an individual to bronchiectasis. The obstruction causes the