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Abstract: 67-year-old Liu suddenly developed a cough, yellow mucus sputum, large sputum volume, foul-smelling sputum and symptoms of wheezing, sore throat and weakness after activity more than half a month ago, and the diagnosis of bronchiectasis was clarified after related examination in our hospital.
Basic information】Male, 67 years old
Disease Type】Bronchiectasis
Hospital】The First Hospital of China Medical University
Date of consultation】June 2021
Treatment plan】Intravenous injection (gentamicin sulfate injection) + oral medication (tranylcypromine oral solution) + nebulized inhalation (ipratropium bromide aerosol, fluticasone propionate inhalation aerosol)
Treatment period】Inpatient medication for 2 weeks, review 1 month after discharge
Treatment effect】Cough and sputum symptoms disappeared and the condition was stable.
I. Initial consultation
The 67-year-old Liu suddenly developed frequent cough and yellow mucus sputum more than half a month ago, and the sputum volume was very large, with foul odor, and symptoms of wheezing, weakness and sore throat after activity. CT examination revealed bronchial dilatation in both lungs and thickening of the bronchial wall, which led to the diagnosis of bronchial dilatation, and the patient was admitted to our hospital as an outpatient. As this time was urgent with bronchial dilatation, other diseases would be treated after the treatment was completed.
II. Treatment history
After the diagnosis of bronchiectasis, the presence of infection in the respiratory tract was considered, and abscesses appeared in the lungs under the action of pathogenic bacteria, so they could cause cavitation shadow in the lungs. After effective communication with the patient, gentamicin sulfate injection was taken to suppress the infection based on the results of antibiotic sensitivity test. Since the patient had a high sputum cough, amiloride oral solution was taken to reduce the sputum and stop the cough. At the same time, the patient could be treated with ipratropium bromide aerosol and fluticasone propionate inhalation aerosol by nebulized inhalation, of which ipratropium bromide aerosol helps to increase the ventilation and fluticasone propionate inhalation aerosol can be used for anti-inflammation. After 2 weeks of treatment, the condition was stabilized and discharged, and the patient returned to the hospital for a review after 1 month.
III. Treatment effect
After 2 weeks of treatment with drugs, the patient’s cough, yellow mucus sputum, large sputum volume and foul smell in the sputum disappeared, and the symptoms of wheezing, weakness and sore throat after activity also disappeared, and the improvement of chest CT examination found that the cavity shadow in the lung disappeared, and the routine blood test found normal blood sedimentation results, and no bronchial dilatation was found by lung CT examination. The above results were combined and the drug was discontinued. 1 month later, the patient returned to the hospital for a review and no significant abnormality was found.
IV. Precautions
I am glad that the patient’s condition has improved after receiving medication, but after discharge from the hospital, we should pay attention to breathing more fresh air and going out for physical exercise, such as jogging, tai chi and other low to medium intensity exercises to promote blood circulation throughout the body while exercising. You can also do appropriate abdominal breathing or lip reduction breathing and other activities that have an exercise effect on respiratory function, which can help improve the function of respiratory muscles and increase ventilation. Be careful not to go to crowded environment with poor air quality. If symptoms such as shortness of breath and breath-holding occur after discharge, it is recommended to return to the hospital promptly for treatment.
V. Personal insight
Bronchiectasis is mostly caused by airway inflammation and infection. Patients should pay attention to avoid getting cold and excessive fatigue in their daily lives to avoid affecting the immune defense function of the airway and causing airway infections to occur. Bronchiectasis is relatively difficult to treat in the early stage, so once coughing, coughing, hemoptysis and other uncomfortable symptoms appear, you should seek active treatment from a doctor in a timely manner. After receiving treatment and stabilization, it is also necessary to exercise regularly to increase the resistance to disease in order to prevent the disease from recurring.