| Clinical Aspects of Bronchiectasis |
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Joong Keun Oh |
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Department of Chest Medicine, The National Medical Centre, Seoul, Korea. |
| 기관지 확장증의 임상적 관찰 |
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오중근 |
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| Abstract |
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During six years from January 1968 to December 1973, Wê observed and analyzed 79 bronchiectasis cases who where hospitalized to the chest department in N.M.C. Sex and age distribution of the 79 patients in this study was 52 males and 27 females, The peak was 20- 29 years of age group on female and 30- 39 on male.
The youngest in the group was 11 years old and the oldest 72. The duration of symptoms were 11-20 years 35.4%, 6- 10 years 16. 5%, more than 20 years 12. 7% , and less than one year was only 15.2% respectively.
Etiologic factors show the high incidence of measles, pulmonary tuberculosis and maxillary sinusitis is certainly striking. vVhooping cough, pneumonia and chronic bronchitis also, were found to be etiologic factors. An important group is the one for which no special cause is given. The chief symptoms of bronchiectasis were cough, sputum, hemoptysis, dyspnea, and chest pain. Almost all had cough and sputum. It is important to note that two.third of the patients had hemoptys is at some time during the course of the disease. There is no doubt that practically all pesrons with bronchiectasis expectorate blood at some time. The amount may vary from tiny streaks to massive hemorrhage. Dyspnea, foul sputum and chest pain were also frequent symptoms. Clubb ing of the finger, long considered a classical sign of bronchiectasis also was preseat.
Roentgen findings in bronchiectasis vary considerably and diagnosis based upon plain film may.be diffícult. Yet the disease should be suspected when the following are present: 1) promínent bronchial markíngs, 2) rounded areas of increased radiance, 3) cystic change, 4) lobar or lobular atelectasís and 5) areas of mottled densíties.
Bronchography is an important and reliable procedure of confirming the diagnosís and mapping out the diseased segments. It was cylindric 61 %, saccular 22% , cystic 8.5% , mixed 4.9% and undetermined 3.6% in this study. In 49 the disease was on the left, 18 on the right and 12 on both sides. Of the 49 on the left side 25 were in the lower lobe or in the lower lobe and língula 22 cases. Of the 18 on the ríght side 7 were in the lower and middle lobes. In the bilateral cases almost invariably on the left side the lower lobe and língula were involved.
The treatment, the possibility of operating depends on the extent of the ailment. Among 48 patients were surgícal indication, 27 had resection and 21 were refused. Medical treatment with anti-biotics chemotherapy depends upon the sensitivity results and püstular drainage also very important. |
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