Emphysema of the lungs: treatment of the disease and methods of prevention

Pulmonary emphysema: symptoms, causes, diagnosis, treatment

Pulmonary emphysema is a pathological condition characterized by the expansion of alveoli and destructive changes in their walls. There is a distinction between primary (idiopathic) emphysema - an independent nosological form that develops without previous bronchopulmonary pathology, and secondary (obstructive) emphysema, which occurs against the background of other respiratory diseases. The frequency of pathology increases significantly in patients over 60 years of age. The disease belongs to COPD (chronic obstructive pulmonary disease). It is important to know what pulmonary emphysema is and how to treat it.

Symptoms of pulmonary emphysema, causes of the disease

Symptoms of pulmonary emphysema:

1. Shortness of breath. At the first stage, the disease is disturbing only with significant physical exertion. As emphysema progresses, shortness of breath becomes permanent.
2. Cough. Usually overseeded, unproductive.
3. Cyanosis. Characteristic for patients with secondary emphysema of the lungs.
4. Loss of body weight. Patients are subtle, may look cachectic.

Signs of emphysema of the lungs during examination - barrel-shaped chest, hyperfunction of auxiliary respiratory muscles (shoulder, neck, abdominal muscles).

X-ray examination reveals a low location of the dome of the diaphragm, an increase in the retrosternal (intrasternal) space (Sokolov's sign), a filamentous nature of the vascular pattern. The most characteristic feature is a decrease in VLDL (vital lung capacity) with an increase in total capacity (ULL). The ECG shows a deviation of the electrical axis of the heart to the right. Data from laboratory studies of lung disease emphysema - increased level of hemoglobin and number of erythrocytes.

Causes of the disease

Secondary emphysema is a consequence of COPD. In primary emphysema of the lungs, the causes may be:

1. Ecology. Pollution of the external environment causes damage to the alveolar walls, which leads to the development of emphysema.
2. Smoking. Tobacco smoke causes the migration of neutrophils, which produce proteolytic enzymes that destroy the walls of the alveoli.
3. Genetically determined deficiency of alpha-1-antitrypsin, shift towards proteolysis and damage to alveolar walls.
4. Professional harmful environment, for example, among miners.
5. Old age.

In case of bullous emphysema of the lungs, there are bullae in the tissues of the organ - swollen areas over 10 mm in size. A decrease in the content of alpha-1-antitrypsin in the blood is also noted. This type of pulmonary emphysema is characterized by the development of spontaneous pneumothorax (air accumulation in the pleural cavity).

Pulmonary emphysema: treatment

There is no specific treatment for emphysema, so general therapeutic programs are used for all COPD patients. It is important to eliminate all the factors that caused the development of emphysema (smoking, chronic infectious process, exposure to polluted air).

Treatment of pulmonary emphysema:

1. Drugs of choice – bronchodilators: β2-adrenomimetics, m-cholinergic blockers, long-acting theophylline drugs.
2. Glucocorticosteroids are prescribed orally in short courses. In the absence of an effect, hormone therapy is no longer prescribed. With a positive result, the treatment is continued with inhaled hormonal drugs.
3. Long-term use of acetylcysteine ​​reduces the frequency of exacerbations of COPD and the progression of secondary emphysema.
4. Thoracoscopic bullectomy – surgical reduction of lung volume by resection of peripheral areas. After the operation, the functional state of the lungs improves significantly.
5. When spontaneous pneumothorax develops, the pleural cavity is drained and air is removed.
6. In severe respiratory failure, oxygen therapy is prescribed.
7. A group of American researchers reported that regular intake of acetylsalicylic acid (aspirin) slows the progression of emphysema and COPD.
8. Respiratory gymnastics for emphysema of the lungs is aimed at training the respiratory muscles.

Prevention consists of quitting smoking, preventing respiratory diseases, vaccination against influenza and pneumococcal disease, adequate therapy of chronic inflammatory diseases of the respiratory tract, improving working conditions, and resort treatment of patients with COPD.

Vaccination against pneumococcal disease is important for patients with COPD, especially if the patient is over 65 years old. Vaccination can be carried out with the vaccines Vaxnewans or Prevenar 13.

Read more about prevention of pulmonary emphysema on our website.

Article author - Bayda Viktoriia Oleksandrivna

Article reviewer - Anikeeva Tetyana Volodymyrivna