What are Some Walking Pneumonia Symptoms?

Clinical manifestations depend on the severity of the condition. COPD can be asymptomatic or feel short of breath only during labor and exercise, and it is gradually difficult to perform the original job. As the disease progresses, the degree of dyspnea worsens, and even shortness of breath occurs even after a little activity or even complete rest. In addition, fatigue, weight loss, loss of appetite, and fullness in the upper abdomen may be felt. The main cause of chronic obstructive pulmonary disease is chronic bronchitis, so in addition to shortness of breath, there are cough, sputum and other symptoms. Only early expiration or no abnormality. Typical COPD patients have an enlarged anteroposterior and anterior thoracic diameter, barrel-shaped chest, weakened breathing movements, weakened speech tremor, percussive overvoicing, reduced heart dullness, lowered liver dullness, and reduced respiratory sounds, sometimes dry and wet Luo Yin, the heart rate increases, the heart sound is low and far, and the second heart sound of the pulmonary artery is hyperactive.

Chronic obstructive pneumonia

Obstructive pulmonary emphysema, also known as obstructive emphysema, is an expansion of the distal part of the terminal bronchi (including respiratory bronchioles, alveolar ducts, alveolar sacs, and alveoli), with destruction of the air cavity wall . The incidence of obstructive emphysema has increased significantly in recent decades. This is due to chronic bronchitis induced by air pollution, smoking, and chronic lung infections, which has further evolved as a disease.

Chronic obstructive pneumonia

Clinical manifestations depend on the severity of the condition. COPD can be asymptomatic or feel short of breath only during labor and exercise, and it is gradually difficult to perform the original job. As the disease progresses, the degree of dyspnea worsens, and even shortness of breath occurs even after a little activity or even complete rest. In addition, fatigue, weight loss, loss of appetite, and fullness in the upper abdomen may be felt. The main cause of chronic obstructive pulmonary disease is chronic bronchitis, so in addition to shortness of breath, there are cough, sputum and other symptoms. Only early expiration or no abnormality. Typical COPD patients have an enlarged anteroposterior and anterior thoracic diameter, barrel-shaped chest, weakened breathing movements, weakened speech tremor, percussive overvoicing, reduced heart dullness, lowered liver dullness, and reduced respiratory sounds, sometimes dry and wet Luo Yin, the heart rate increases, the heart sound is low and far, and the second heart sound of the pulmonary artery is hyperactive.

Chronic obstructive pneumonia

Obstructive pulmonary emphysema is an expansion of the distal part of the bronchi (including respiratory bronchioles, alveolar ducts, alveolar sacs, and alveoli), with the destruction of the air cavity wall. The incidence of obstructive emphysema has increased significantly in recent decades. This is due to chronic bronchitis induced by air pollution, smoking, and chronic lung infections, which has further evolved as a disease. According to a census of more than 60 million people in China, the prevalence of chronic bronchitis is 3.9%, and 15% or more are over 50 years old. The prevalence of obstructive emphysema is inconsistent across the country, with a minimum of 0.6% and a maximum of 4.3%. This disease is a chronic disease with a long course of disease, affecting health and labor, and causing huge losses to social production and the economy. In the United States, for example, medical costs and absenteeism for obstructive emphysema cost billions of dollars each year.

Diagnosis of chronic obstructive pneumonia

Chronic obstructive pneumonia

The diagnosis of obstructive emphysema, especially early diagnosis, is not easy. It should be combined with medical history, physical signs, chest X-ray examination and pulmonary function examination. Where there is a history of increasing shortness of breath, lung function tests show increased residual gas and residual gas / total lung volume, reduced forced expiratory volume / forced vital capacity in the first second, reduced maximum ventilation, uneven gas distribution, and reduced diffuse function; With bronchodilator treatment, no significant improvement in lung function can be established.

Treatment of chronic obstructive pneumonia

Chronic obstructive pneumonia

Obstructive emphysema is mainly secondary to chronic bronchitis. There are many causes of chronic bronchitis. Chemical factories should deal with harmful gases, and factories that produce dust should improve their operating methods, such as using wet operations, confining dust sources, strengthening ventilation and personal protection. These should be strictly implemented by the labor department. Quitting smoking is a practical way for individuals, and health departments should vigorously publicize the harms of smoking. After quitting smoking, cough and sputum were alleviated, and the expiratory volume of forced expiratory volume in the first second decreased year by year compared to before quitting.

Emphysema patients are susceptible to respiratory infections in winter, and antibacterials, expectorants, and bronchodilators should be used as appropriate. For the treatment of concurrent respiratory failure and right heart failure, refer to the relevant section.

Patients with obstructive emphysema should continue to treat during the remission period to reduce symptoms, prevent acute attacks, reduce the number of outpatient and emergency visits and hospitalizations, maintain lung function and improve quality of life. Medical personnel provide necessary education and guidance to family members and patients, and insist on outpatient or family follow-up. The specific content of remission treatment is as follows.

(1) Improving the general condition of patients Every time emphysema patients' symptoms worsen due to respiratory infections, their lung function also tends to decrease. Therefore, it is important to improve the body's resistance and prevent colds and lower respiratory tract infections. Cold hard exercises, intramuscular injection of nuclear casein or BCG, etc. can be taken.

In patients with obstructive emphysema, respiratory load increases, respiratory function increases, and energy consumption increases. However, due to shortness of breath, hypoxia, right heart failure, or use of drugs, the dietary intake cannot be increased or even decreased accordingly, so malnutrition is often combined. Malnutrition not only damages lung function and respiratory muscle function, but also weakens the body's immune mechanism. Therefore, attention should be paid to the intake of nutrients to improve nutritional status.

Whole body exercises such as walking, treadmilling, exercise flats, radio exercises, Tai Chi, etc. not only increase muscle activity, but also exercise breathing and circulation functions.

(B) breathing training to guide patients to deep and slow abdominal breathing and retinal exhalation

Emphysema patients often breathe shallowly and have poor breathing efficiency. Instruct patients to make deep and slow abdominal breathing, reduce respiratory resistance, increase tidal volume, reduce dead space ventilation ratio, uniform gas distribution, and improve ventilation / blood imbalance.

In patients with emphysema, due to reduced alveolar elastic retraction, increased small airway resistance, isobaric pressure points move toward the peripheral small airways, and the small airways close early during exhalation, resulting in gas retention in the lungs and aggravated ventilation / blood flow ratio imbalance. Reducing lip exhalation increases the resistance of the outer part of the airway, so that the isobaric point moves to the central airway, which prevents the airway from closing prematurely.

(3) Respiratory muscle exercise Emphysema patients have adverse effects on respiratory muscles due to factors such as excessive lung inflation, malnutrition and hypoxia. In the case of lung infection, respiratory load is further increased, which can cause respiratory muscle fatigue, which is one of the causes of respiratory failure. Respiratory muscle function can be improved through resistance breathing or exercises such as carbon dioxide hyperventilation.

Chronic obstructive pneumonia

(4) Home oxygen therapy After anti-infection, expectorant and bronchial spasmolytic treatment, those with arterial partial oxygen pressure in the remission stage still below 7.33kPa (55mmHg) should undergo home oxygen therapy. For those with emphysema of secondary erythrocytosis or refractory right heart failure, the indications for oxygen therapy can be appropriately relaxed. Oxygen therapy can improve patient symptoms, improve work efficiency, increase activity intensity, and expand activity range. Persisting in oxygen for 15 hours is better than intermittent oxygen. In order to prevent the high concentration of oxygen from inhibiting the ventilation, low flow oxygen should be used. Oxygen supply equipment has also been improved. Conventional use of compressed gas steel cylinders is not convenient in homes because of its large size and bulkiness, and inconvenient handling. The oxygen concentrator can concentrate the oxygen in the air and is easy to use. The liquid oxygen container stores oxygen in a liquid state at ultra-low temperature, so it is small in size and light in weight, and can be carried with it as its advantage. The synchronous oxygen inhalation device triggers oxygen supply by the patient's inhalation, and does not supply oxygen during the exhalation phase, which can save oxygen. In recent years, there have been reports of oxygen inhalation through the indwelling catheter through the ciliary membrane.

(5) The development of other non-traumatic mechanical ventilation provided conditions for home mechanical ventilation in patients with obstructive emphysema. Generally connected through a nasal or oronasal mask or ventilator, a negative pressure ventilator can also be used. Intermittent mechanical ventilation at home can make respiratory muscles rest, relieve respiratory muscle fatigue, and improve respiratory muscle function

Almitrine bismesglate vectarin can not only stimulate breathing and improve ventilation, but also improve ventilation / blood flow imbalance, increase arterial blood oxygen pressure, and can be used in the treatment of obstructive emphysema.

In recent years, foreign countries have developed lung transplantation to treat patients with advanced emphysema. Single lung transplantation is simpler and has lower complications and mortality.

Preventive measures for chronic obstructive pneumonia

Chronic obstructive pneumonia

No disease prevention, disease prevention. The prevention and treatment of COPD should be based on the early stage. Quitting smoking, smoking cessation can slow the progression of the disease. Prevent colds and colds; improve body resistance. Pay attention to clothing protection when doing outdoor sports, and keep the front and back chests warm; don't reduce your clothes prematurely when the weather turns warm.

Avoid excessive physical and mental exertion.

Stay optimistic.

If you have respiratory symptoms, such as cough, expectoration, shortness of breath, yellow phlegm, etc., diagnose and treat as soon as possible.

Acute COPD is closely related to the season. With the weather turning cold, when the human body is fatigued and cold, it will be induced by the decline in resistance. When the lung infection is severe, it will lead to respiratory failure and heart failure, which endangers the patient's life.

Pneumococcus is the main pathogen that causes "coronary obstruction." Due to the extensive use of antibiotics, pneumococcus is resistant to many antibiotics, making it difficult to treat COPD. To this end, organizations such as the World Health Organization and the Advisory Committee on Immunization in the United States recommend that pneumococcal vaccines be given to patients with COPD to prevent acute attacks. Usually 3 weeks after vaccination, specific antibodies in the body will be produced, and the immunity obtained can last for more than 5 years.

Experts remind that in the autumn and winter seasons, the elderly should pay attention to keep warm, prevent colds, and avoid the stimulation of cigarette smoke and environmental pollution. Seek medical attention if you have sputum and cough symptoms.

Complications of chronic obstructive pneumonia

(1) Autopsy of gastric ulcer confirmed that about 18% -30% of patients with obstructive emphysema had gastric ulcer. Its pathogenesis is not completely clear.

(2) Respiratory failure and obstructive emphysema often have severely impaired respiratory function. Under the influence of certain incentives such as respiratory infections, dry secretion retention, improper oxygen therapy, application of intravenous overdose, surgery, etc., ventilation and replacement Air dysfunction is further exacerbated and can induce respiratory failure.

(3) Spontaneous pneumothorax Spontaneous pneumothorax is not uncommon in patients with obstructive emphysema, mostly due to rupture of the bullous bullae and air leakage into the pleural cavity. If the patient's basal lung function is poor, and the pneumothorax is tonic, even if the amount of gas is not large, the clinical manifestations are also serious. Active rescue must not be taken lightly. In patients with emphysema, the pulmonary field has high luminosity, and there are often bullae, and the signs are not typical, which brings some difficulties to the diagnosis of local pneumothorax.

(D) Ventilation during sleep can be slightly reduced in normal people with sleep disordered breathing, while ventilation in patients with obstructive emphysema decreases significantly during sleep. Especially when the patient's awake arterial blood oxygen pressure is already as low as about 8.00kPa (60mmHg), the further decrease in sleep is more dangerous. The patient's sleep quality is reduced, and heart rhythm disturbances and pulmonary hypertension can occur.

(5) Chronic pulmonary heart disease, hypoxemia, right carbon dioxide retention, and destruction of the alveolar capillary bed of right heart failure can cause pulmonary hypertension. There was no manifestation of right heart failure during the period of cardiac function compensation. When the respiratory disease is further aggravated and the arterial blood gas is deteriorated, the pulmonary artery pressure is significantly increased, the heart load is increased, and factors such as myocardial hypoxia and metabolic disorders can induce right heart failure.