Lung hyperinflation

Introduction The lungs are over-inflated, commonly known as emphysema. Emphysema refers to the airway elasticity of the distal bronchioles (breathing bronchioles, alveolar ducts, alveolar sacs, and alveoli), excessive expansion, inflation, and increased lung volume or pathological conditions associated with airway wall destruction. . According to the cause of the disease, emphysema has the following types: senile emphysema, compensatory emphysema, interstitial emphysema, focal emphysema, paraventricular emphysema, obstructive pulmonary qi swollen.

Cause

The pathogenesis of obstructive emphysema is not fully understood. It is generally thought to be associated with bronchial obstruction and protease-antiprotease imbalance. Smoking, infection, and air pollution cause bronchiolitis, narrowing or obstruction of the lumen. When inhaling, the bronchioles dilate and the air enters the alveoli; when exhaling, the lumen shrinks, the air stays, and the alveolar pressure increases, causing the alveoli to over-expand or even rupture. Loss of radial traction around the bronchioles causes the bronchioles to contract, causing the lumen to narrow. Pulmonary intima thickening, decreased blood supply to the alveolar wall, weakened alveolar elasticity, etc., contribute to the expansion of the alveolar rupture. In the case of infection, etc., the activity of protease in the body is increased, and the activity of the anti-protease system in normal humans is correspondingly increased to protect the lung tissue from damage. The 1 antitrypsin deficiency has a reduced ability to inhibit protease, so it is more prone to emphysema. Smoking also has an adverse effect on protease-antiprotease balance.

an examination

Related inspection

Electrocardiogram blood analyzer for bronchoscopy lung biopsy lung biopsy through chest wall acupuncture lung biopsy

First, X-ray examination: thoracic expansion, rib clearance widened, ribs parallel, activity weakened, sputum reduced and flattened, the transparency of the two lung fields increased.

Second, ECG examination: generally no abnormalities, sometimes can be low voltage.

Third, respiratory function check: It is important to diagnose obstructive emphysema.

Fourth, blood gas analysis: If there is obvious hypoxic carbon dioxide retention, the arterial partial pressure of oxygen (PaO2) decreases, the partial pressure of carbon dioxide (PaCO2) increases, and decompensated respiratory acidosis can occur, and the pH value decreases. .

Fifth, blood and sputum examination: generally no abnormalities, secondary infections like acute episodes of acute episodes.

Diagnosis can be diagnosed based on medical history, physical examination, X-ray examination and lung function tests. X-ray examination showed an increase in anterior and posterior diameter of the thoracic cavity, sternal protrusion, widening of the posterior sternal space, lower squat level, decreased lung texture, increased lung field transmittance, overhanging heart, widening of pulmonary artery and main branches, peripheral blood vessels small. Pulmonary function was measured as residual gas, increased total lung volume, increased residual gas/lung volume ratio, markedly lower 1 second rate, and decreased diffuse function.

Differential diagnosis

Pulmonary hyperinflation is differentiated from the following symptoms:

1, lung pressure injury: refers to the alveolar pressure is too high to cause alveolar damage, gas leakage into the alveolar tissue.

2, alveolar ventilation blood flow imbalance: There are two basic forms: partial alveolar V / Q ratio decreased and some alveolar V / Q ratio increased. Effective ventilation depends not only on the alveolar membrane area and thickness, alveolar total ventilation and blood flow, but also on the coordination of alveolar ventilation and blood flow. In the case of lung disease, the total ventilation and total blood flow of the lungs may be normal, but the uneven distribution of ventilation and blood flow and the proportional ventilation-perfusion imbalance may prevent the patient from performing effective ventilation. This is the most common mechanism of respiratory failure caused by lung disease.

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