Refers to the irreversible dilation of one or more proximal bronchi and medium-sized bronchial walls due to tissue destruction. It is a common suppurative inflammation of the respiratory system. The main pathogenic factors include bronchial infection, obstruction, and traction, with some cases involving congenital genetic factors.

bubble_chart Diagnosis

1. Medical History and Symptoms:

In childhood, there may be a history of measles, whooping cough, bronchopneumonia, or pulmonary subcutaneous nodules. Symptoms include chronic cough, expectoration with varying amounts and characteristics of sputum; some may experience hemoptysis, with varying amounts and triggers; most patients exhibit intermittent fever, lack of strength, poor appetite, flusteredness, and shortness of breath.

2. Physical Examination Findings:

There may be chronic infection foci in the paranasal sinuses and oropharynx; early or mild cases may show no abnormal signs, but dry or moist rales and wheezing may be heard in the lungs after infection. Advanced stages may present with signs such as lung qi distension, pulmonary arterial hypertension, and clubbing of fingers (toes).

3. Auxiliary Examinations:

(1) Chest X-ray: Mild cases often show no abnormalities, while severe cases may exhibit increased, thickened, and disorganized lung markings in the affected area. Sometimes, cylindrical thickening of the bronchi or "tramline signs" can be observed, with typical honeycomb or curly hair-like shadows and cystic areas containing fluid levels.

(2) Bronchial iodized oil contrast: May reveal cystic, cylindrical, or mixed cystic-cylindrical changes, currently used only before surgical procedures.

(4) Sputum bacteriological culture: Provides guidance for the rational use of antibiotics.

4. Differential Diagnosis:

It should be differentiated from chronic bronchitis, lung cancer, and pulmonary subcutaneous nodules.

bubble_chart Treatment Measures

1. General treatment, drainage and expectoration, and immunotherapy: Refer to the section on bacterial pneumonia.

2. Infection control:

Select antibiotics based on symptoms, signs, sputum characteristics, and bacterial culture results. The treatment should also address fungal and anaerobic infections. In addition to oral and intravenous administration, antibiotics can be delivered via nebulization or through bronchoscopic instillation. (Refer to bacterial pneumonia.)

3. For patients with chronic sinusitis, gingivitis, or tonsillitis, active treatment should be provided concurrently.

4. Surgical intervention:

Surgical resection may be considered for patients with recurrent massive hemoptysis, persistent pulmonary infection unresponsive to long-term medical treatment, lesions confined to no more than two lung lobes, and no severe cardiac or pulmonary dysfunction.