Tracheobronchomalacia
Tracheobronchomalacia
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DOI：
10.1016/j.arbres.2009.10.011
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发表时间：
2010-04-01
影响因子：
8
通讯作者：
Ernst, Armin
中科院分区：
文献类型：
--
作者：
Majid, Adnan;Fernandez, Liliana;Ernst, Armin
气管支气管软化症是一种中央呼吸道疾病，其特征是管壁薄弱，气管腔和大支气管动态减少，特别是呼出时，中年人和有吸烟史的老年人更常见，它会导致慢性症状，如咳嗽。它通常与其他常见疾病如慢性阻塞性肺疾病(COPD)或哮喘相混淆，其原因可以是先天性的或获得性的，其诊断涉及通过体层摄影和纤维支气管镜对呼吸道进行动态评估。当呼气管理包括一个初级阶段时，根据呼吸道的塌陷程度将其分为轻、中、重度三种，在这一阶段中必须控制伴随的疾病，如COPD。弥漫性中到重度症状性气管软化症的哮喘或胃食道返流必须考虑气管-支气管成形术，同时加强后壁硅胶，“Y”形支干可用于确定哪些患者可能从手术治疗中受益，以及用于具有高手术风险的明确的对症治疗。需要进行更多的前瞻性研究，以标准化这种通常被低估的疾病的某些常见治疗标准。(C)2009年SEPAR由Elsevier Espana出版，S，版权所有
Tracheobronchomalacia is a central airway disease characterised by weakness of the wall and dynamic decrease in the tracheal lumen and the large bronchi, particularly while exhaling It is more common in middle age and the elderly with previous exposure to cigarettes It causes chronic symptoms such as cough. dyspnea, increase in recurrent infections, and poor secretion management, but it can also progress to chronic respiratory failure and death It is usually confused with other common diseases like chronic obstructive pulmonary disease (COPD) or asthma Its causes can be congenital or acquired and its diagnosis involves the dynamic assessment of the airway with tomography and fibrobronchoscopy It is classified as mild, moderate or severe depending on the degree of collapse of the airway when exhaling Management consists of a primary phase, in which concomitant diseases must be controlled, such as COPD. asthma or gastro-oesophageal reflux In diffuse moderate to severe symptomatic tracheobronchomalacia tracheobronchoplasty must be considered with strengthening of the posterior wall Silicone and "Y" stems can be used to identify patients who could potentially benefit from surgical treatment as well as being used for the definitive symptomatic treatment with high surgical risk More prospective studies need to be done in order to standardise certain common criteria for the management of this usually under-diagnosed disease (C) 2009 SEPAR Published by Elsevier Espana, S L All rights reserved