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Bronchiectasis is caused by chronic suppurative inflammation and fibrosis of the bronchi and surrounding lung tissue, which destroys the muscle and elastic tissue of the bronchial wall, leading to bronchial deformation and persistent dilation. Typical symptoms include chronic cough, coughing up large amounts of purulent sputum, and repeated hemoptysis. The main pathogenic factors are bronchial infection, obstruction and traction, and some are congenital genetic factors. Most patients have a history of measles, whooping cough, or bronchopneumonia.

Bronchiectasis, also known as bronchial dilatation, refers to the irreversible dilation of the bronchi and bronchioles caused by repeated airway infection and inflammation, with chronic cough, coughing up large amounts of purulent sputum, and/or repeated hemoptysis as typical symptoms.

1. Infection: Infection is the most common cause of bronchiectasis. Pulmonary tuberculosis, whooping cough, and adenovirus pneumonia can cause bronchiectasis. Aspergillus and mycoplasma, as well as pathogens that can cause chronic necrotizing bronchopneumonia, can also cause bronchiectasis.

2. Congenital and hereditary diseases: The most common hereditary disease that causes bronchiectasis is cystic fibrosis. In addition, Marfan syndrome may also cause bronchiectasis due to weak connective tissue development.

3. Abnormal cilia: Abnormal cilia structure and function are important causes of bronchiectasis. Kartagener syndrome is manifested as a triad of situs inversus, sinusitis, and bronchiectasis. This disease is accompanied by abnormal cilia function.

4. Immunodeficiency: Deficiency of one or more immunoglobulins can cause bronchiectasis. Deficiency of one or more IgG subclasses is usually accompanied by recurrent respiratory tract infections, which can cause bronchiectasis. IgA deficiency is not often associated with bronchiectasis, but it can coexist with IgG2 subclass deficiency, causing recurrent suppurative lung infections and bronchiectasis.

5. Foreign body inhalation: The long-term presence of foreign bodies in the airway can lead to chronic obstruction and inflammation, and secondary bronchiectasis.

The course of bronchiectasis is mostly chronic and can occur at any age. The patient may have a history of measles, whooping cough or post-influenza pneumonia in childhood, or a history of pulmonary tuberculosis, endobronchial tuberculosis, pulmonary fibrosis, etc. Typical symptoms are chronic cough, coughing up a lot of purulent sputum and repeated hemoptysis. The sputum is most in the morning, evening and bedtime, and can reach 100-400ml per day. When the sputum is unobstructed, the patient feels relaxed; if the sputum is not drained smoothly, the patient feels chest tightness and systemic symptoms are significantly aggravated. The sputum is mostly yellow-green purulent, and it may smell bad when combined with anaerobic infection. The sputum collected throughout the day is placed in a glass bottle. After a few hours, the sputum is layered, with foam on the upper layer, pus components suspended below, turbid mucus in the middle, and necrotic tissue sediments at the bottom. 90% of patients often have hemoptysis, with varying degrees. For some patients, hemoptysis may be their first and only complaint, which is clinically called "dry bronchiectasis", which is common in tuberculous bronchiectasis, and the lesions are mostly in the upper lobe bronchi. If secondary infections occur repeatedly, patients may have fever, night sweats, fatigue, loss of appetite, weight loss, etc. When bronchiectasis is complicated by compensatory or obstructive emphysema, patients may have difficulty breathing, shortness of breath or cyanosis, and in the late stage, symptoms of cor pulmonale and cardiopulmonary failure may appear.

Bronchiectasis often causes pneumonia, lung abscess, lung gangrene, empyema, and pneumothorax due to concurrent pyogenic infection. When extensive fibrosis of the lung tissue occurs and the pulmonary capillary bed is severely damaged, it can lead to increased pulmonary artery circulation resistance, pulmonary hypertension, and chronic cor pulmonale.