Qhov txawv ntawm Interstitial Lung Disease thiab Bronchiectasis yog tias cov kab mob ntsws interstitial yog cov kab mob ntsws uas txwv tsis pub muaj tus kab mob bronchiectasis yog kab mob ntsws.
Cov kab mob ntsws Interstitial (ILD) yog ib pawg ntawm cov kab mob sib txawv uas cuam tshuam nrog lub ntsws parenchyma - alveolar hauv ob sab phlu, alveolar phab ntsa, capillary endothelium thiab cov ntaub so ntswg txuas. Tib yam kev hloov pauv pathological tshwm sim los ntawm cov kab mob sib kis tsis suav tias yog kab mob ntsws interstitial. Bronchiectasis yog ib hom kab mob pathological ntawm cov kab mob ua pa uas tshwm sim los ntawm qhov muaj qhov txawv txav thiab mus tas li dilated airways.
Tus kab mob ntsws Interstitial yog dab tsi?
Cov kab mob ntsws Interstitial (ILD) yog ib pawg ntawm cov kab mob sib txawv uas cuam tshuam nrog lub ntsws parenchyma - alveolar hauv ob sab phlu, alveolar phab ntsa, capillary endothelium thiab cov ntaub so ntswg txuas. Tib yam kev hloov pauv pathological tshwm sim los ntawm cov kab mob sib kis tsis suav tias yog cov kab mob ntsws interstitial. Hauv yuav luag txhua tus neeg mob muaj fibrosis ntawm lub ntsws parenchyma qee zaum nrog kev mob o. Thaum kawg lub alveolar septae tau thickened impairing diffusion ntawm oxygen hla lawv.
Nyob rau theem siab tshaj plaws ntawm tus kab mob, muaj cov kab mob sib kis ntawm lub ntsws ua rau muaj cov yam ntxwv zoo li honeycomb hauv CT radiographs. Tus neeg mob yuav muaj kev cuam tshuam loj ntawm kev ua haujlwm ntawm lub ntsws, pulmonary hypertension, thiab cor pulmonale.
Cov Khoom Kho Mob Zoo Tshaj Plaws
Cov chaw kho mob feem ntau ntawm cov kab mob ntsws interstitial suav nrog;
- Kev nce qib dysnoea thiab tachypnoea
- End ua pa tawg (feem ntau tsis muaj hawb pob lossis lwm yam pov thawj ntawm kev ua pa ntawm txoj hlab pas)
- cyanosis
Daim duab 01: Ib qho alveolus hauv lub ntsws
Lung Function Tests
- Txo tag nrho lub ntsws muaj peev xwm vim txo qis ua raws - txwv hom kab mob ntsws
- Txo CO diffusing peev
- lub hauv siab X-ray
Diffuse infiltrative qauv - me me nodules, irregular kab los yog av iav duab ntxoov ntxoo
Qhov laj thawj tiag tiag ntawm, feem ntau ntawm cov kab mob hauv lub ntsws tseem tsis tau txheeb xyuas. Tab sis lawv ntseeg tias muaj kev koom tes nrog cov kev pheej hmoo hauv qab no.
- Kev cuam tshuam rau ib puag ncig kev phom sij (feem ntau haus luam yeeb, lwm tus: kev cuam tshuam kev lag luam)
- Sarcoidosis
- Collagen vascular kab mob
- Granulomatous vasculitis (piv txwv li, Wegener's, Churg - Strauss)
- Hypersensitivity pneumonitis (organic plua plav)
- raug rau cov hmoov av inorganic - beryllium, silica (feem ntau nyob rau hauv industrial exposures)
Histological Subtypes of Interstitial Lung Diseases
- Usual interstitial pneumpnia (UIP)
- Organizing pneumonia (OP) [lub sij hawm qub-Bronchioloitisobliterance with organize pneumonia (BOOP)
- Desquamative interstitial pneumonia (DIP)
- Diffuse alveolar puas (DAD)
- Nonspecific interstitial pneumonia (NSIP)
Kev tshawb nrhiav
Tus kab mob ntsws Interstitial tuaj yeem tshawb xyuas los ntawm;
- Chest Xray - ob tog reticular qauv. Nyob rau hauv granulomatous hom yuav yog nodular opacities
- HRCT - Kev ntsuas zoo dua ntawm qhov ntau thiab kev faib cov kab mob
- Kev ntsuas pulmonary muaj nuj nqi - qhov ntsuas pulmonary kev koom tes yog ntsuas
- Diffusing peev - txo qhov muaj peev xwm ntawm lub ntsws rau CO
- Arterial blood gas
- Lung biopsy
- Lwm yam:
- In CTDs - ANA, anti-dsDNA, rheumatoid factor
- LDH - qhov kev tshawb pom tsis tshwj xeeb hauv ILDs
YBronchoscopy thiab bronchoalveolar lavage
Kev tswj hwm
Txoj kev tswj hwm tuaj yeem sib txawv nyob ntawm qhov ua rau ntawm tus kab mob ntsws interstitial
- Corticosteroids tau muab los ntes cov txheej txheem inflammatory tsis tu ncua
- Kev siv cov tshuaj tiv thaiv kab mob kuj tau tawm tswv yim rau qee kis thaum tsis muaj kev txhim kho ntawm tus neeg mob tus mob nrog cov tshuaj corticosteroids ib leeg.
- Txawm li cas los xij, nyob rau hauv cov xwm txheej zoo tshaj plaws, kev hloov pauv ntsws tsuas yog qhov kev xaiv xwb
YBronchiectasis yog dab tsi?
Bronchiectasis yog ib qho mob ntawm cov kab mob ua pa uas tshwm sim los ntawm qhov muaj qhov txawv txav thiab ua pa mus tas li. Raws li qhov tshwm sim ntawm qhov mob ntev, cov phab ntsa bronchial tau thickened thiab irreversibly puas. Kev puas tsuaj ntawm mucociliary thauj mechanism ua rau muaj kev pheej hmoo ntawm cov kab mob superimposed.
Etiology
Qhov ua rau bronchiectasis yog;
- Congenital defects xws li deficiency ntawm bronchial phab ntsa thiab pulmonary sequestration
- Kev cuam tshuam ntawm phab ntsa bronchial vim yog cov khoom siv xws li qog
- Postinfective bronchial puas
- Granuloma tsim nyob rau hauv cov xwm txheej xws li tuberculosis thiab sarcoidosis
- Diffuse kab mob ntawm lub ntsws parenchyma xws li pulmonary fibrosis
- Immunological overresponse nyob rau hauv tej yam kev mob xws li post ntsws transplant
- Immune deficiencies
- Mucociliary clearance defects nyob rau hauv cov kab mob xws li cystic fibrosis
Daim duab 02: Bronchiectasis
Tshuaj Kho Mob
Cov yam ntxwv kho mob ntawm bronchiectasis suav nrog;
- Kev tsim cov hnoos qeev ntsuab lossis daj xim yog qhov kev kho mob nkaus xwb hauv me me bronchiectasis
- Nrog rau tus kab mob no zuj zus, tus neeg mob tuaj yeem tau txais lwm cov tsos mob hnyav xws li mob halitosis tsis tu ncua, rov tshwm sim febrile ntu nrog malaise thiab rov tshwm sim ntawm mob ntsws.
- Nkauj ntiv tes
- Thaum lub sijhawm auscultation, ntxhib ntxhib tuaj yeem hnov dhau ntawm thaj chaw muaj kab mob
- Hemoptysis
Kev tshawb nrhiav
Kev tshawb nrhiav ntawm bronchiectasis suav nrog;
- X-ray lub hauv siab - qhov no feem ntau qhia pom muaj cov kab mob dilated nrog cov phab ntsa tuab. Qee lub sij hawm ntau lub hlwv uas muaj cov kua dej tuaj yeem pom.
- High-resolution CT scanning
- Kev kuaj thiab kab lis kev cai ntawm cov hnoos qeev yog qhov tseem ceeb rau kev txheeb xyuas tus neeg sawv cev etiological nrog rau kev txiav txim siab ntawm cov tshuaj tua kab mob tsim nyog uas yuav tsum tau sau tseg hauv kev tswj hwm tus kab mob superimposed.
- Sinus X -rays - feem ntau ntawm cov neeg mob tuaj yeem muaj tus mob rhinosinusitis thiab
- Serum immunoglobulins - qhov kev sim no tau ua los txheeb xyuas cov tshuaj tiv thaiv kab mob
- hws electrolytes ntsuas yog tias xav tias cystic fibrosis
Kev kho mob
Kev kho thiab tswj ntawm bronchiectasis yog;
- Postural drainage
- Tshuaj tua kab mob - hom tshuaj tua kab mob siv nyob ntawm tus neeg ua haujlwm
- Nws yog ib qho tsim nyog yuav tsum siv cov tshuaj bronchodilators qee zaum kom tsis txhob muaj kev txwv rau cov cua
- tshuaj tiv thaiv kab mob xws li qhov ncauj lossis qhov ntswg corticosteroids tuaj yeem ntes tus kab mob kis mus
Kev nyuaj siab
- Pneumonia
- Pneumothorax
- Nyob zoo
- Metastatic cerebral abscesses
Dab tsi yog qhov zoo sib xws ntawm Interstitial Lung Disease thiab Bronchiectasis?
Ob leeg mob yog kab mob ntsws
Dab tsi yog qhov txawv ntawm Cov Kab Mob Ntshav Qab Zib thiab Bronchiectasis?
Cov kab mob ntsws Interstitial (ILD) yog ib pawg ntawm cov kab mob sib txawv uas cuam tshuam nrog lub ntsws parenchyma - alveolar hauv ob sab phlu, alveolar phab ntsa, capillary endothelium thiab cov ntaub so ntswg sib txuas thaum Bronchiectasis yog ib qho mob ntawm lub ntsws ua pa uas ua rau muaj qhov txawv txav. thiab mus tas li dilated airways. Qhov no yog qhov sib txawv tseem ceeb ntawm Interstitial interstitial ntsws kab mob thiab bronchiectasis. Tsis tas li, muaj lwm qhov sib txawv ntawm cov kab mob ntsws interstitial thiab bronchiectasis raws li qhov ua rau, kev kho mob, cov txheej txheem tshawb nrhiav, kev kho mob thiab kev tswj hwm, uas tau teev tseg hauv qab no.
Summary – Interstitial Lung Disease vs Bronchiectasis
Cov kab mob ntsws Interstitial (ILD) yog ib pawg ntawm cov kab mob sib txawv uas cuam tshuam nrog lub ntsws parenchyma - alveolar hauv ob sab phlu, alveolar phab ntsa, capillary endothelium thiab cov ntaub so ntswg sib txuas whereas bronchiectasis yog ib yam mob ntawm lub ntsws ua pa uas ua rau muaj qhov txawv txav. thiab mus tas li dilated airways. Bronchiectasis yog kab mob ntsws obstructive tab sis cov kab mob hauv lub ntsws interstitial yog txwv nyob rau hauv qhov xwm txheej. Qhov no yog qhov txawv ntawm Interstitial Lung Disease thiab Bronchiectasis.
