23/08/2024
Current treatment prospects for bronchiolitis obliterans:
[Disease principle of bronchiolitis obliterans]
1)Failure to recover after infection causes continuous damage to the tracheal lining, which is repaired and proliferated, resulting in obstruction
2)Immune hyperplasia caused by transplantation, which is irreversible once hyperplasia occurs
[Treatment of bronchiolitis obliterans after infection]
1)Avoid sputum obstruction and tracheal adhesion caused by any interference from infants and young children, and insist on using acetylcysteine (Fluluc) nebulization. The best daily dose for adults and older children is 6 mg. It is necessary for 1 week after persistent infection and is safe for 3 months; nebulization is better than oral administration
2)In the case of atelectasis, consider using acetylcysteine, human deoxyribonucleic acid and other expectorant and re-expansion drugs, combined with high-frequency expiratory machine air shock re-expansion
3)After confirming that it is bronchiolitis obliterans, due to delayed proliferative obstruction, the currently commonly used Several drug therapies: azithromycin, erythromycin, glucocorticoids, methylprednisolone systemic hormone therapy (pulse method and low-dose long-term), cyclosporine
4)Keep the purifier during the period to avoid polluted air, electromagnetic radiation, radiation sources, dense crowds, and catering disinfection
5)Use ultraviolet rays to place photosensitizers at the obstruction site to cause fine tube hyperplasia, obstruction and gradual apoptosis (robot TPS therapy)
6)Stem cells: Try to use autologous placental stem cells. Autologous stem cells (especially lung cells) have a higher risk of immune rejection than allogeneic stem cells
6)Consider organ transplantation after complete loss of lung function
7)Do not be obese and try to exercise
8)Consider the use of machine organs (ECMO) and neural technology to maintain related neural tissues in organ transplantation
9)Finally, focus on organ regeneration engineering and obtain autologous cells to generate organ replacement
目前闭塞性细支气管炎的治疗展望： 【闭塞性细支气管炎的疾病原理】 1）感染后未能痊愈，造成气管内壁持续伤害不断修复增生而产的阻塞 2）移植后造成的免疫增生 一旦增生产生均为不可逆 【对于感染后的闭塞性细支气管炎的治疗】
1）避免任何婴幼儿干扰后产生的痰液性阻塞和气管粘连，坚持使用乙酰半胱氨酸（富露施）雾化，成人和大龄儿童每日最佳效果用量6mg，持续感染后1周是必须，3个月均为安全；雾化优于口服
2）出现肺不张情况，考虑使用乙酰半胱氨酸、类人脱氧核糖核酸等化痰复张药物，配合高频呼气机空气震荡复张
2）确定为闭塞性细支气管炎后，因延缓增生性阻塞，目前常用的几种药物疗法：阿奇霉素、红霉素、糖皮质激素、甲泼尼龙全身激素疗法（脉冲法和小剂量长期）、环孢素
3）保持期间净化器避免污染空气、电磁辐射、放射源、密集人群、餐饮消毒
4）采用超微机支气管机器人在阻塞部位布置光敏剂使用紫外线导致细致管增生阻塞逐渐凋亡（机器人TPS疗法）
5）干细胞：尽量使用自体胎盘干细胞，自体干细胞（尤其是肺部细胞）免疫排斥风险优于异基因干细胞
6）在完全丢失肺功能后再考虑器官移植问题
7）不要肥胖，尽量进行运动
8）器官移植中考虑使用机器器官（ECMO)和神经技术进行相关神经组织维护
9）最终关注于器官再造工程，获取自体细胞生成器官代换
