BRONCHIECTASIS IN ADULT PATIENTS: CLINICAL PECULIARITIES AND APPROACHES TO THE TREATMENT.

Abstract

The aim: To perform a clinical analysis of bronchiectasis in adults, to analyze the effectiveness of nebulizer therapy with hypertonic NaCl solution with hyaluronic acid. Materials and methods: All patients were performed clinical-functional examination (MRC dyspnea index, Sp O2, 6-minute walking test, external respiration function); calculated the index BODE, analyzed the SGRQ, studied the results of sputum. Statistical data analysis was performed using the Microsoft Excel for Microsoft 365 MSO 16.0.13530.2040418 package of statistical functions. Results: The main symptom in 100% of cases was chronic cough with production of sputum. Patients were concerned about shortness of breath (91.7%), episodic hemoptysis (29.2%), systemic symptoms (fatigue, weight loss). Hypertonic NaCl solution has a direct mucolytic effect, osmotic and anti-edematous effect. Protection of the mucous membrane of the respiratory tract makes hyaluronic acid an ideal additional component of hypertonic saline solution. All patients showed a positive effect of treatment immediately. After 2 weeks, the respiratory rate decreased, the FEV1 index increased at 8.6 (p<0.05), SpO2 increased up to 93.75 ± 7.13%, the number of points according to the SGRQ decreased, BODE index also decreased. Conclusions: Leading clinical signs of bronchiectasis were: a chronic cough with daily sputum production (100% of patients), shortness of breath (91.7%). The use of nebulizer inhalations decreased shortness of breath at 17.6% (р<0.05), improved external respiratory function indices (FVCL increased at 9.7% (р<0.01), FEV1 at 8.6% (р<0.01)) and blood oxygen saturation increased at 4.9% (р<0.05)). The offered complex increased tolerance to physical exertion (the 6-minute walk test and 4-year survival (BODE prognostic index).