Recent literature has highlighted the importance of transition from paediatric to adult care for children with chronic conditions. Non-cystic fibrosis bronchiectasis is an important cause of respiratory morbidity in low-income countries and in indigenous children from affluent countries; however, there is little information about adult outcomes of childhood bronchiectasis. We reviewed the clinical course of 31 Alaska Native adults 20-40 years of age from Alaska's Yukon Kuskokwim Delta with childhood bronchiectasis. In patients with chronic suppurative lung disease, a diagnosis of bronchiectasis was made at a median age of 4.5 years by computerised tomography (68%), bronchogram (26%), and radiographs (6%). The patients had a median of 75 lifetime respiratory ambulatory visits and 4.5 hospitalisations. As children, 6 (19%) experienced developmental delay; as adults 9 (29%) experienced mental illness or handicap. Four (13%) patients were deceased, four (13%) had severe pulmonary impairment in adulthood, 17 (54%) had persistent or intermittent respiratory symptoms, and seven (23%) were asymptomatic. In adulthood, only five were seen by adult pulmonologists and most had no documentation of a bronchiectasis diagnosis. Lack of provider continuity, remote location and co-morbidities can contribute to increased adult morbidity. Improving the transition to adult care starting in adolescence and educating adult providers may improve care of adults with childhood bronchiectasis.

中文翻译：

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儿童支气管扩张的成人结局。


最近的文献强调了慢性病儿童从儿科护理过渡到成人护理的重要性。非囊性纤维化支气管扩张是低收入国家和富裕国家土著儿童呼吸道疾病的重要原因；然而，关于儿童支气管扩张的成人后果的信息很少。我们回顾了来自阿拉斯加育空库斯科奎姆三角洲的 31 名 20-40 岁阿拉斯加原住民成年人的临床病程，他们患有儿童期支气管扩张症。在慢性化脓性肺病患者中，通过计算机断层扫描 (68%)、支气管造影 (26%) 和 X 光片 (6%) 诊断支气管扩张，中位年龄为 4.5 岁。这些患者一生中平均有 75 次呼吸门诊就诊和 4.5 次住院治疗。儿童时期，6 人（19%）经历过发育迟缓； 9 名 (29%) 成年后患有精神疾病或残障。 4 名患者 (13%) 死亡，4 名患者 (13%) 成年后出现严重肺损伤，17 名患者 (54%) 出现持续或间歇性呼吸道症状，7 名患者 (23%) 无症状。成年后，只有五名患者接受了成人肺科医生的检查，而且大多数患者没有支气管扩张诊断的记录。缺乏提供者连续性、偏远地区和合并症可能导致成人发病率增加。从青春期开始改善向成人护理的过渡并对成人提供者进行教育可能会改善对患有儿童支气管扩张的成人的护理。