Pulmonary emphysema remains one of the most common pathologies of the respiratory system for many years. According to various data, the disease affects from 0.5 to 5% of adults, primarily smokers and patients with chronic obstructive pulmonary disease. Emphysema is manifested by shortness of breath: with physical exertion, and then at rest. The disease gradually progresses, and if left untreated, patients eventually develop cardiopulmonary failure.
Causes of pulmonary emphysema
At the heart of the mechanism of development of pathology is the systematic destruction of lung tissues with a loss of elasticity and an increase in lung pressure. Among the probable causes that can contribute to the occurrence of pulmonary emphysema, include:
- Smoking, including passive smoking, as well as smoking electronic cigarettes and hookahs;
- inhalation of toxic vapors and harmful chemical compounds;
- congenital α-1 antitrypsin deficiency;
- various acute diseases of the lower respiratory tract with a severe course;
- bronchial asthma;
- microcirculation disorders in pulmonary structures.
Predisposing factors may include:
- occupational activity, during which the air pressure in the lung tissues is constantly increasing (singing glass blowers, musicians, etc.);
- work requiring close contact with harmful substances, household chemicals, industrial production;
- living in environmentally unfavorable areas.
An important role is also played by age: the older the patient, the less elastic and strong all the tissues, respectively, the higher the risk of developing pulmonary emphysema and other lung diseases.
Symptoms of pulmonary emphysema
With emphysema of a mild degree at the initial stages of the development of the disease, the clinical picture is unexpressed. Symptomatology increases with the development of structural changes in the lung tissues. The first signs of the disease are dyspnea with a characteristic difficult exhalation. Difficulties with breathing at first arise only with physical exertion, emotional excitement, but later begin to manifest themselves even at rest.
A characteristic symptom of pulmonary emphysema in adults can be called the manner of exhalation: the patient pushes out the air with almost closed lips, simultaneously inflating the cheeks.
Against the background of developing respiratory failure, there are other signs of pulmonary emphysema, in particular:
- persistent cough with little sputum;
- weight loss;
- swollen neck veins;
- swelling, puffiness of the face;
- thickening of the terminal phalanges of the fingers;
- pallor of the skin.
In severe forms of pathology may occur spontaneous pneumothoraxes – conditions in which air accumulates in the pleural cavity.
Against the background of a prolonged course of the disease, the patient may have an enlarged liver associated with stagnation in blood vessels, a slight lowering of the diaphragm, as well as the formation of a barrel-shaped sternum and a characteristic protrusion of the supraclavicular fossa.
Treatment of pulmonary emphysema
Unfortunately, there are no specific methods of therapy for this disease. The basis of treatment of pulmonary emphysema is the elimination of the root cause – the factor that served as a starting point in the development of pathology.
Specialists of the clinic strongly recommend patients:
- completely eliminate all forms of smoking;
- avoid the use of aggressive household and garden chemicals;
- change professional activity, if it in any way aggravates the course of the disease;
- do not self-medicate acute respiratory infections and other respiratory diseases.
Drug therapy of emphysema is reduced to symptomatic assistance. For each patient, an individual drug support regimen is developed, which, taking into account the indications, may include:
- bronchodilators;
- glucocorticosteroids;
- mucolytic and expectorant components.
In addition, inhalation therapy, breathing exercises, oxygen treatment in case of severe respiratory failure, as well as drugs that improve blood supply to the lungs and the cardiovascular system.
In complex cases, when conservative tactics are not justified or do not bring the desired result, the patient after all the necessary diagnostic measures are redirected to specialized medical institutions for intensive care or surgical treatment.
Surgical treatment of pulmonary emphysema
Surgical interventions are prescribed according to indications. The patient is recommended bullectomy – removal of bullae, in the following cases:
- marked dyspnea caused by compression of the lung by large bullae;
- pneumothorax;
- bleeding from a ruptured bulla;
- infection of the air cyst.
In upper lobe emphysema with dyspnea that cannot be treated, surgery to reduce lung volume, including removal of damaged areas, may be performed. Segmental bronchial occlusion is also used. An intrabronchial valve is placed to improve ventilation and sputum expectoration. In severe cases with dyspnea at rest, lung transplantation is possible.
Prevention
To reduce the risk of developing pulmonary emphysema, pulmonologists recommend:
- no smoking;
- devote sufficient time to exercise and physical activity;
- do not ignore medical check-ups and vaccination against potentially dangerous pathogens;
- treat infectious diseases promptly and correctly;
- do not use systemic antibiotics, hormonal drugs, etc. as a self-administered treatment;
- avoid contact with poisonous chemicals;
- use personal protective equipment when working with harmful substances.
Patients diagnosed with chronic lung disease should be seen regularly by a pulmonologist.
Conclusion
Pulmonary emphysema is a serious disease that requires careful attention to health and timely treatment. Despite the lack of specific therapy, proper diagnosis, elimination of the causes of the disease, medication and, if necessary, surgical intervention can significantly improve the patient’s condition and slow the progression of the disease. It is important to remember preventive measures, such as quitting smoking, protection from harmful factors and regular medical examinations. A comprehensive approach and compliance with doctors’ recommendations will help to reduce risks and improve the quality of life of people suffering from pulmonary emphysema.
