Cheeks bulging and lips pursing as you exhale

Introduction Patients with emphysema of obstructive emphysema often take special postures, such as tall shoulders, double-armed beds, and buccal and contracted lips when exhaling. Patients often take special postures, such as tall shoulders, double-armed beds, and buccal and contracted lips when exhaling. X-ray chest radiographs increased transparency in both lungs. Although the ventilation function is also damaged, it is not as serious as the bronchitis type, the gas distribution is uniform, the residual gas accounts for the ratio of the total lung volume, the alveolar ventilation is normal or even the ventilation is excessive, so the arterial oxygen partial pressure is not significantly reduced, the carbon dioxide fraction The pressure is normal or reduced.

Cause

Obstructive ventilatory disorders caused by lung disease. More common in old age, physical weight loss, breathing difficulties, no purpura.

an examination

Related inspection

Lung ventilation function residual gas volume / lung total ratio (RV / TLC) one second forced exhalation / forced vital capacity ratio lung biopsy

Patients often take special postures, such as tall shoulders, double-armed beds, and buccal and contracted lips when exhaling. X-ray chest radiographs increased transparency in both lungs. Although the ventilation function is also damaged, it is not as serious as the bronchitis type, the gas distribution is uniform, the residual gas accounts for the ratio of the total lung volume, the alveolar ventilation is normal or even the ventilation is excessive, so the arterial oxygen partial pressure is not significantly reduced, the carbon dioxide fraction The pressure is normal or reduced.

The diagnosis of obstructive emphysema, especially early diagnosis is not easy, should be combined with medical history, physical signs, chest X-ray examination and pulmonary function tests. In the history of urgency, the lung function test shows that the residual gas and residual gas/pulmonary volume increase, the first second forced expiratory volume/forced vital capacity is reduced, the maximum ventilation is reduced, the gas distribution is uneven, and the diffusion function is reduced; Bronchodilator treatment, no significant improvement in lung function, diagnosis can be established.

Differential diagnosis

Attention should be paid to the differential diagnosis of tuberculosis, lung cancer and occupational lung disease. In addition, chronic bronchitis, bronchial asthma and obstructive emphysema are chronic obstructive pulmonary disease, and both chronic bronchitis and bronchial asthma can be complicated by obstructive emphysema. But the three have connections and differences, and they are not equivalent. Chronic bronchitis in the premalignant emphysema is mainly limited to the bronchial, may have obstructive ventilatory disorders, but to a lesser extent, the diffuse function is generally normal. The bronchial asthma manifested as obstructive ventilatory disorder and hyperinflation of the lungs, and the gas distribution may be severely uneven. However, the above changes are more reversible and better respond to inhaled bronchodilators. Diffusion dysfunction is also not obvious. Moreover, the airway responsiveness of bronchial asthma is significantly increased, and the fluctuation of lung function is also large, which is characterized by it.

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