支气管哮喘合并支气管扩张患者临床特点及治疗方法分析

摘要

Objective To explore clinical characteristics and treatment methods of patients with bronchial asthma complicated with bronchiectasis.Methods 62 patients with asthma complicated with bronchiectasis were selected.Medical history,symptoms,signs,auxiliary examination and treatment methods were extracted from medical records of patients to carry on a summary analysis.Results Clinical characteristics of patients with bronchial asthma complicate with bronchiectasis were as follows:The frequency of personal allergic and family history of asthma was high.Clinical symptoms always showed the overlap symptoms of asthma and bronchiectasis and were atypical.Most patients had obviously seasonal regularity and attack frequency and hospitalization rate were high.The control of asthma symptoms was difficult.Bronchiectasis regions were not obviously regular on chest HRCT.The positive rate of bronchial provocation test was significantly higher than that of the bronchial dilation test.Positive rate of bacterial culture of sputum was not high.All patients were adopted comprehensive treatment measures of anti-asthma and anti-bronchiectasis and achieved good therapeutic effect.Conclusion Bronchial asthma complicated with bronchiectasis is a special clinical type,which can be differentiate from pure bronchiectasis or pure asthma by the clinical features,bronchial provocation tests,bronchial dilation test and chest HRCT. Comprehensive treatment measures of anti-asthma and anti-bronchiectasis are recommended.%目的：探讨支气管哮喘（简称哮喘）合并支气管扩张（简称支扩）的临床特点及治疗方法。方法选取62例哮喘合并支扩的住院患者，从病历中收集患者的病史、症状、体征、辅助检查、治疗方法等资料进行总结分析。结果（1）哮喘合并支扩患者临床特点为：①多有个人过敏性疾病史和哮喘家族史，症状多表现为哮喘和支扩症状的叠加，体征不典型，有明显的季节规律，发作次数频繁，住院率高，哮喘症状控制困难；②胸部高分辨率 CT（HRCT）发现肺部支气管扩张的部位无明显规律；③支气管激发试验比舒张试验阳性率明显增高；④痰的细菌培养阳性率不高。（2）采用抗感染、平喘等综合治疗措施，取得良好疗效。结论哮喘合并支扩是临床的一种特殊类型，可以通过临床表现、支气管激发和舒张试验、胸部 HRCT 检查来鉴别，治疗方案应采用两病兼顾的综合治疗措施。