Effect and Safety of Bronchoscopy Based on Imaging Evaluation in Patients With Acute Exacerbation of Bronchiectasis

To evaluate the efficacy and safety of imaging-assisted bronchoscopic interventions in acute bronchiectasis exacerbations and analyze their effects on pulmonary function, inflammation, and quality of life for evidence-based clinical support.

A total of 80 inpatients with acute bronchiectasis exacerbations were randomized into a control group (n = 40), receiving conventional anti-infective and symptomatic treatment, and an intervention group (n = 40), receiving additional imaging-assisted bronchoscopic intervention. Pulmonary function, inflammatory markers (C-reactive protein [CRP], procalcitonin [PCT], and white blood cell count [WBC]), and St George's Respiratory Questionnaire (SGRQ) quality of life scores were assessed preintervention and at 1, 2, and 4 weeks. Adverse events (e.g., hemoptysis, pneumothorax, and infection spread) and overall effectiveness were recorded.

No significant intergroup differences were observed in baseline characteristics, preintervention pulmonary function (forced expiratory volume in the first second [FEV₁], forced vital capacity [FVC], and FEV₁/FVC), inflammatory markers (CRP, PCT, and WBC), or SGRQ scores (p > 0.05). After 1, 2, and 4 weeks, the intervention group demonstrated significantly greater improvements: higher FEV₁, lower CRP and PCT levels, and reduced SGRQ scores compared with the control group (p < 0.05). The generalized estimation equation (GEE) model revealed that the improvement magnitude in the intervention group increased over time (p < 0.001). The overall adverse event rate in the intervention group was 10.00% (4/40), significantly lower than the control group's 37.50% (15/40); the total effective rate was 92.50% (37/40), surpassing the control group's 70.00% (28/40) (p < 0.05).

Bronchoscopy intervention guided by imaging improves lung function, reduces inflammation and adverse events, enhances quality of life, and demonstrates good safety with high clinical value in acute bronchiectasis exacerbations. The therapeutic benefit is likely attributable to the bronchoscopic procedure itself, including targeted pathogen identification and subsequent antibiotic modification, rather than solely to transient sputum clearance.