Symptoms of lung adhesion

Pulmonary adhesion is a relatively common lung disease, which mainly refers to the phenomenon of adhesion of people's lung organs, which cannot function normally. Patients with severe lung adhesions often experience difficulty breathing and have great inconvenience in their daily lives. Patients with pulmonary adhesions must be careful about their food intake and try to avoid foods such as tobacco and alcohol. So, what are the symptoms of lung adhesions?

(1) Expiratory flow rate test

The expiratory flow rate is the highest expiratory flow rate that can be achieved within the first 10 milliseconds after the subject has inhaled forcefully to the total lung volume and then exhaled maximally. The expiratory flow rate of both normal people and asthma patients varies periodically during the day and night, with the lowest value in the morning and the highest value in the afternoon. However, the variation in normal people is small, and the expiratory flow rate fluctuation rate is mostly less than 10%; while the expiratory flow rate fluctuation rate of asthma patients is mostly more than 20%-30% or even 50%. The predicted value of expiratory flow rate is corrected according to height and age, while the actual measured value of expiratory flow rate mainly depends on the individual's effort and the strength of the respiratory muscles. Therefore, the actual measured value of expiratory flow rate of many patients is always higher or lower than the predicted value, with a certain range of deviation or varies from person to person. Therefore, some people recommend that the expiratory flow rate value used to evaluate treatment should be based on the patient's personal best value. The expiratory flow rate continued to remain above 80% of the personal best, indicating that asthma was well controlled.

Pulmonary capillary wedge pressure measurement method:

The pulmonary artery wedge pressure is usually measured by using a Swan-Ganz balloon floating catheter to float through the blood flow and wedge into the pulmonary arterioles to block the forward blood flow there. The pressure measured at the tip of the catheter is the pulmonary artery wedge pressure (PAWP).

When a pulmonary arteriole is blocked by a wedge, the blood in the blocked pulmonary artery segment and the corresponding pulmonary venule segment stagnates, forming a static blood flow column with equal internal pressure. Since the large pulmonary venous blood flow resistance can be ignored, PAWP is equal to pulmonary venous pressure or left atrial pressure.

Hematoporphyrin aerosol inhalation test:

(1) Experimental preparation is the same as conventional fiberoptic bronchoscopy, and the subjects are subjected to a hematoporphyrin allergy test.

(2) After inhaling the salbutamol aerosol, the subjects tried to cough out respiratory secretions and then inhaled 10% Hpd solution with a nebulized volume of 11ml-15ml (11-15mg), with an average of 14ml. Instruct the patient to take deep breaths, with a frequency of 8 to 24 times per minute and an average of 15 to 17 times per minute.

(3) 5h-6.5h (average 5.8h) after inhalation of HPD, first remove respiratory secretions under ordinary light and observe whether there is any lesion, its location and range. Then use argon laser to observe the presence or absence of fluorescence, fluorescence intensity, and boundaries with surrounding tissues in the lesion site and other parts of the bronchial tree to distinguish true wall fluorescence from secretion fluorescence. Record observations and take photos.

(4) Perform brushing and/or forceps biopsy on the fluorescent area (including the area above the tumor and abnormal areas observed under ordinary light) for pathological examination.

Results: The test was positive when true wall fluorescence (in the form of thin sheets, dots, or reticles) appeared in the lesion under argon laser observation. The secretion fluorescence is mostly in the form of long ribbons.