Pathologic _'s general knowledge of the elderly's bronchiectasis

Pathologic _'s general knowledge of the elderly's bronchiectasis
Pathology:General inflammation bronchiectasis take place in 1 the intersection of lung and section more, can also take place in dual the intersection of side and a plurality of the intersection of lung and piece, give much trouble bronchus mostly and guide smooth and relevantly, leaf at lower leaf exceed, the lower leaf bronchus of left is slender, it is big with the contained angle of main trachea, and receive the oppression of heart blood vessel, it is not smooth to guide, so lower leaf bronchiectasis is seen more on the left.
Left lower the intersection of leaf and bronchus open one's mouth, open one's mouth, near with the intersection of tongue and the intersection of leaf and bronchus, the former inflammation secretion involve the latter often, it is not rare that two leaves are expanded at the same time, the bronchus is slender in middle period in right, there are three groups of lymph nodes that are distributed inside and outside it, when infecting and taking place, the oppression middle period of enlargement of lymph nodes bronchus, one does not the lung takes place, often cause bronchiectasis, the position where bronchiectasis due to tuberculosis takes place is identical with the good hair position of pulmonary tuberculosis, see more the upper leaf back segment.
The bronchiectasis shape has bags and difference in post form, mix, store in often also. Bronchiectasis that stage produces of bronchus development is mostly bags in childhood, are mostly columns that inflammation continues expansion taking place after growing up, it is out of shape that typical pathology is changed into tube due to the destruction organized in bronchus wall, expand, and very sunken, contain the volume secretion in.
The cover is often urgent, chronic inflammation and ulcer on the tube wall, inflammation cells are soaked, the scale of leather cell grows at the column of bronchus mucous membrane cilium, cup cell and mucus gland hyperplasia. Every storey tissue of bronchus wall is destroyed in various degree, or rarely seen incomplete muscle and cartilage chip. Often accompany capillary expanding or bronchus artery and lung artery to end and prop up expanding and identical, form the hemangioma, can present big repeated hemoptysis. When bronchiectasis is infected with, inflammation can be involved and close to the lung to organize, cause bronchus pneumonia and change with the chronic bronchitis.
Pathologic physiology:The pathologic physiology of bronchiectasis changes, depend on quantity and complicated lung essence pathological change of bronchus pathological change. The breathing functions with the years of the elderly fail gradually. Vital capacity (VC) With exerting oneself the vital capacity (FVC) Obviously reduce, because the elasticity of the elderly's thoracic cage and lung is weakened, breathe the muscular strength the factor of failing etc. makes the peripheral air way fall into and close in early days. 70 -year-old VC reduces by 40%, 90 -year-old (MMVV) The great keeping in touch with amount of quantity is reduced by 50%, and function residual gas (FRc) Residual gas (RL) And/ the ratio of TLe is increasing constantly, the lung elasticity fails, airway resistance increases, enable the gas maldistribution, it is apt to result in keeping in touch with the blood flow (VA/Q) Imbalance, so and the limitation that even pathological change is light in early days, the breathing function can change, shown as the mixing slightly and kept in touch with the obstacle.
With the intersection of pathological change and enlargement of range, getting obstructive to keep in touch with obstacle, increase, seriously extensive to show as getting obstructive to keep in touch with obstacle for mixing of main fact as pathological change, because the secretion is held up in the bronchus and in charge of, make inflammation further aggravate, and can with bronchospasm, suck gas, distribute irregularity, bronchiectasis area lung organizes the keeping in touch with amount of alveolus to reduce, and the blood flow is seldom limited, make and is kept in touch with, the blood flow ratio is reduced, form the lung artery, vein to shunt, and the alveolus disperse function obstacle causes hypoxemia disease.
Develop further as pathological change, lung fiber take, aggravate gradually, alveolus capillary destroy extensively, the lung circulates resistance to increase, hypoxemia disease causes arteriolar convulsion of the lung, present the artery high pressure of lung, intravenous blood flow volume of flowing to the right heart of the bronchus increases too, the load of right heart is further aggravated, it is depleted to present the right heart function, lung source heart disease such as being plump of the right ventricle behaves.
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