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Abstract: A 60-year-old male patient with a previous history of bronchiectasis described in this article presented with a cough and yellow pus sputum after a cold 4 days ago, accompanied by chest tightness and wheezing discomfort after activity and exertion, left-sided chest pain and occasional panic attacks when the cough was intense. The patient’s symptoms improved and he recovered well after being treated with oxygen, sputum and medication.
Basic information】Male, 60 years old
Disease Type】Bronchiectasis with infection and respiratory failure
Hospital】Wuhan University People’s Hospital
Date of consultation】April 2022
Treatment plan] Oxygen + bronchoscopic aspiration + medication (ceftazidime + moxifloxacin hydrochloride sodium chloride anti-infection, amiloride sputum treatment) + nebulization (budesonide suspension + ipratropium bromide + acetylcysteine solution)
Treatment period】Inpatient treatment for 10 days, outpatient follow up
Treatment effect】The disease has been controlled, and all indicators are improving
I. Initial consultation
The patient reported that he had a cough 4 days ago after getting cold, and the cough was obvious in the morning, with yellow pus sputum and more sputum, accompanied by chest tightness and wheezing discomfort after activity and exertion, and chest pain on the left side when the cough was intense, with occasional panic, and no other discomfort such as fever and night sweats. The patient was thin, with cyanotic lips and shortness of breath when speaking rapidly. He had a previous history of bronchiectasis for more than 20 years and was intermittently hospitalized, but his cough and sputum were good and bad at times. She was admitted to the hospital with bronchiectasis.
II. Treatment history
After admission, the patient was further arranged to undergo chest CT, which indicated bronchiectasis, and blood gas analysis, blood routine, calcitoninogen, liver and kidney function, and pulmonary function were also performed on the patient. Based on the patient’s history, physical signs and the results of the ancillary tests, the patient was finally diagnosed with bronchiectasis with infection and respiratory failure. The patient and family members were informed of the patient’s condition, and a treatment plan was selected based on the examination results. First, the patient was advised to improve respiratory failure with oxygen, and then the patient and family members were fully informed of the risks and necessity of bronchoscopy. The patient was also given ceftazidime + moxifloxacin hydrochloride sodium chloride anti-infection treatment, amiloride to reduce sputum, and budesonide suspension + ipratropium bromide + acetylcysteine solution for nebulization.
Treatment effect
Through the combination of oxygen, bronchoscopic aspiration, anti-infection treatment, sputum chemotherapy and nebulization, the patient’s cough and sputum symptoms were significantly reduced, the sputum volume was significantly reduced, the color of the mouth and lips was restored, the rhythm of breathing was calmed down, the blood gas analysis on the review indicated that the respiratory failure was significantly improved, and the inflammation index on the review also basically returned to normal, and the patient’s mobility was significantly better than before, and the quality of life was significantly improved. At 10 days of hospitalization, the patient was discharged from the hospital and was instructed to follow up regularly in the outpatient clinic.
IV. Notes
We are glad that the patient’s condition was effectively controlled by the treatment, and all the indexes were improved and discharged successfully, but the following points should be noted.
1, it is recommended that patients should pay attention to rest in daily life, do not strain, keep a happy mood, pay attention to warmth, avoid getting cold, cold, so as not to aggravate the disease, and need to pay attention to avoid inhaling cold air and toxic and harmful irritant gases.
2, the diet should strengthen nutrition, eat high protein, high vitamin food, more intake of fresh fruits, vegetables, avoid eating spicy, stimulating food.
3, usually can be more aerobic exercise, such as walking, jogging, etc., can improve their immunity, enhance physical fitness, but also help the recovery of the disease.
4.Patients should also pay attention to sputum discharge after discharge, and do more deep breathing to help sputum discharge, which can effectively prevent lung infection and delay the deterioration of lung function.
V. Personal insight
Bronchiectasis is a common disease of the respiratory system. Due to chronic inflammation and fibrosis of the bronchi and surrounding lung tissues, the muscles and elastic tissues of the bronchial walls are destroyed, resulting in deformation and expansion of the bronchi. Typical symptoms of bronchiectasis include chronic cough, coughing up large amounts of pus sputum, and sometimes hemoptysis. If patients with bronchiectasis develop these symptoms, they need active anti-infection, sputumification and symptomatic treatment to keep the airway drainage open and avoid deterioration or aggravation of lung function. In addition, patients with bronchiectasis need to pay attention to a healthy lifestyle, drink more water, prevent respiratory infections, and take medication on time as prescribed by the doctor, all of which have a positive effect on the treatment of bronchiectasis.