How is bronchiectasis treated?

Written by Zou Zhong Lan
Pulmonology
Updated on September 11, 2024
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The treatment of bronchiectasis mainly includes medical treatment and surgical treatment. Medical treatment primarily aims to control infection and promote the drainage of sputum. Antibiotics are crucial for controlling infections, initially based on empirical therapy. Adjustments can be made accordingly if results from sputum culture and drug sensitivity tests are available. Secondly, to promote sputum drainage, we can use postural drainage or mechanical vibration to expel sputum. Expectorant medications such as ambroxol and bromhexine, or nebulized inhalation therapy may also be utilized. Thirdly, bronchodilators can be used to relieve asthma symptoms and ease the patient's discomfort. If the patient has hemoptysis, hemostatic treatment should be provided. Surgical treatment is primarily considered for patients with localized bronchiectasis and when medical treatment is ineffective, in which case surgical resection may be considered.

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Written by Yang Feng
Pulmonology
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What medicine is used for bronchiectasis?

Bronchiectasis is particularly common clinically. The choice of medication for bronchiectasis needs to be determined based on the specific conditions of the patient. Generally, the aggravation of bronchiectasis is caused by recurrent infections, so controlling infections is fundamental in treatment. As for the application of antibiotics, the principle we follow is to select medications based on the different bacterial spectrums in different regions, with the most scientific method being the use of sensitive antibiotics identified through sputum bacterial culture and drug susceptibility tests. Additionally, we also use expectorants like ambroxol and bromhexine. If there is concurrent respiratory distress or a decline in lung function, inhalants such as budesonide-formoterol powder may also be used.

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Written by Li Jian Wu
Pulmonology
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Is bronchiectasis easy to treat?

Bronchiectasis is a complication mainly caused by chronic inflammation of the respiratory tract and is clinically difficult to treat. Symptoms can be alleviated through certain medications or physical manipulations. First, it's important to maintain clear airways and choose medications that can dilute mucus. During the acute phase of inflammation, antibacterial drugs should be chosen for treatment, such as penicillin, which can be administered via muscle injection or intravenously. Surgery is the only curative treatment for bronchiectasis. (Medication use should be based on specific circumstances and under the guidance of a doctor.)

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Written by Zou Zhong Lan
Pulmonology
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The manifestations of bronchiectasis

Bronchiectasis refers to the destruction of bronchial wall tissues caused by chronic inflammation of the bronchi and surrounding lung tissues. The lumen undergoes irreversible dilation and deformation. Some patients have a history of recurrent respiratory tract infections, mainly presenting with chronic coughing and coughing up large amounts of thick sputum. Many patients have a history of repeated hemoptysis, although the amount of blood is usually small. There can be blood in the sputum or slight bleeding, and it can also manifest as a large amount of blood, potentially life-threatening. In the affected areas, fixed and persistent localized wet rales can be heard.

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Written by Zou Zhong Lan
Pulmonology
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The first choice for the diagnosis of bronchiectasis

For the diagnosis of bronchiectasis, we can rely on the symptoms of the patients such as chronic cough, coughing up large amounts of purulent sputum, repeated hemoptysis, and history of lung infections. Physical examination of the lungs may reveal fixed and persistent localized wet crackles. For auxiliary examinations, we can combine X-ray and CT scans to find imaging changes consistent with bronchiectasis and make a diagnosis. The preferred method for a definitive diagnosis of bronchiectasis is high-resolution CT, and the diagnosis can be made based on the results of a high-resolution CT scan.

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Written by Wang Xiang Yu
Pulmonology
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How long can one live with bronchiectasis?

This question is actually very difficult to answer because no doctor can predict exactly how long their patient will live. They can only provide a general prognosis of the disease. Bronchiectasis is relatively a benign condition. The prognosis for most patients depends mainly on the severity of the bronchiectasis and their comorbidities, among other factors. Generally, if a patient’s bronchiectasis is not very severe and mild, and does not affect lung function or is not compounded by other underlying diseases, they might experience long-term, recurrent coughing and sputum production, requiring long-term hospitalization. However, if they do not experience acute complications associated with bronchiectasis, such as asphyxiation caused by hemoptysis, then actually they can live for a long time. There are many patients who are in their seventies or eighties and frequently admitted to the hospital. When asked how long they have had bronchiectasis, their condition might span over forty or fifty years, or even longer. This means that patients with bronchiectasis can live for a long time, provided their condition is relatively stable and they don’t suffer from acute complications such as severe bleeding or asphyxiation. However, if the bronchiectasis is severe, or unfortunately, even if the bronchiectasis isn’t very severe, if a patient suffers from major hemoptysis, it can cause asphyxiation rapidly leading to death within minutes. Therefore, it is impossible for doctors to predict exactly how long each patient will live.