Prevention of bronchiectasis should be aimed primarily at preventing and managing the treatment of early childhood pneumonia, which is a separate issue of Pediatrics.
Treatment of bronchiectasis
Conservative treatment plays an important role in the treatment of patients with bronchiectasis. The main method is shown in patients with mild and clinically manifested little change in the bronchi, which is becoming more numerous, as well as in patients with common and are not clearly localized process, which can not perform radical surgery. In the first case of such treatment can prevent or arrest the rapid deterioration and, thus, support the clinical state of well-being of an indefinitely long time, and sometimes, mostly children, to achieve recovery, and practical, while the second goal of conservative therapy is the possible prevention of disease progression and development complications.
Supportive, but it is obligatory role played by conservative management in preparing patients for bronchoscopy and radical surgery.
The main element of the conservative treatment is the reorganization of the bronchial tree, which provides, on the one hand, emptying the last of purulent sputum, and on the other - the local impact of antimicrobial agents in the pyogenic microflora. Along with the readjustment with instillation into the affected bronchus through the catheter or by bronchoscopy antiseptic solutions, antibiotics, mucolytic drugs and so forth, and saved the essential aids to facilitate discharge of purulent sputum: a so-called postural drainage, breathing exercises, vibratory massage of the chest and so bring great benefit to the correct mode selected, restorative procedures, a full-fledged, high-protein diet, etc.
An important element in treating bronchiectasis, especially in children, is a reorganization of the upper respiratory tract, usually carried out by otolaryngology, whose participation in the examination and treatment is mandatory.
Radical surgery is not always shown, and can not cure all patients with bronchiectasis. The optimal age for intervention should be considered as 7-14 years, because at a younger age is not always possible to establish exactly the extent and limits of destruction.
All patients with a fairly pronounced and localized bronchiectasis departments affected lung may be removed only under the condition that after resection of the respiratory function will be provided with sufficient high-grade lung tissue.
When unilateral bronchiectasis can achieve a maximum of radicalism, leaving unaffected parts of the lungs, or, in extreme cases, resorting to pneumonectomy. When bilateral bronchiectasis with asymmetrical lesions of bronchial tree, in which one of the lung there are small individual segments of bronchiectasis, acceptable palliative resection of the lung on the side of a larger lesion. The condition of patients after these operations are usually much better and at obligatory observation of outpatient treatment and relapse is often possible to achieve clinical well-being, and changes in non-operated side, as a rule, do not progress.
With more or less symmetrical lesions of bronchi of both lungs shows bilateral resection, which most surgeons prefer to perform in two stages with an interval of 6-12 months. The possibility of such resection is determined by the amount of intact lung tissue. With extensive bilateral bronchiectasis with lesions of the upper segments of the lung surgery are usually not shown.
Unpromising lung resection in patients with bronchiectasis complicated by obstructive bronchitis, accompanied by persistent respiratory failure and, especially, pulmonary heart disease.
As we age, especially after 45 years, the number of patients subject to surgery, it becomes much smaller due to the progression of the pathological process and the appearance of complications. Forecast of bronchiectasis
In the natural outlook express, heavy, and the more complicated forms of bronchiectasis should be considered as very serious.