支气管扩张症 ◆Bronchiectasis Irreversible dilatation of the btomchial branches ◆先天性(少) +Katagener综合征 +免疫球旦白缺乏 +肺囊性纤维化 ·后天性(多) +继发于肺结核、慢性肺炎、肺间质纤维化、胸膜增厚 ·好发于两肺下叶、左舌叶和右中叶
Bronchiectasis ◆Congenital:支气管管壁平滑肌、腺体和 软骨减少或缺如 ◆Secondary:上皮脱落、管壁炎细胞浸润 、肿胀,周围纤维组织增生 ◆Symptoms: ◆咳嗽 +咯多量臭味的脓痰 ◆痰中带血→大量(百cc)咯血 +感染时发热 3
Bronchiectasis Plain radiograph ◆10%may be normal ·肺纹理增粗、模糊,集拢和排列紊乱 ·双轨征,蜂窝状阴影(0.5~3cm),液平 ·肺不张和支气管扩张同时存在(右中叶) ·感染:斑片状或大片状实变影,边缘模糊
Bronchography Confirm the existance of bronchiectasis Clarify the subtype and extent ◆Cylindrical:近端与远端宽度相似,柱状, 或远端稍大,末端截断,远端分支不易充 盈 ◆cystic:重者呈葡萄串状 ◆varicose:粗细不均,管腔形态不规整