What disease is bilateral multiple pulmonary bullae?

Pulmonary bulla refers to bullous emphysema, which is a localized emphysema. The alveoli are highly dilated, and the alveolar walls are ruptured and fused with each other, which is generally caused by bronchiolar valve obstruction.

1, asymptomatic pulmonary bullae need not be treated, and patients with chronic bronchitis or emphysema are mainly treated with primary lesions. Antibiotics should be used when secondary infection occurs.

2. Pulmonary bullae are large, accounting for 70% ~ 100% of a chest cavity. For patients with clinical symptoms and no other lung diseases, surgical resection of pulmonary bullae can make the compressed lung tissue expand again, increase the breathing area, eliminate intrapulmonary shunt, increase the arterial oxygen partial pressure, reduce airway resistance, increase ventilation, and improve dyspnea symptoms such as chest tightness and shortness of breath.

Guiding opinions:

Healthy lung tissue should be preserved as much as possible during the operation, and only bullae resection and local lung tissue suture or wedge resection should be done to avoid unnecessary loss of lung function. Spontaneous pneumothorax caused by pulmonary bullae rupture can be cured by non-surgical treatments such as thoracic puncture and closed thoracic drainage, but recurrent spontaneous pneumothorax needs surgical treatment. Pulmonary bullae can be ligated or sutured during the operation, and pleural adhesion can be fixed by tetracycline or 2% iodine in the chest to prevent the recurrence of pneumothorax. Patients with hemopneumothorax sometimes have serious clinical symptoms, such as chest pain, dyspnea and internal bleeding. Clinically, we should closely observe the changes of the disease and take non-surgical measures in a short time, such as blood transfusion and thoracic puncture. When there is no obvious improvement in symptoms, exploratory thoracotomy should be carried out decisively. At this time, there is often large active bleeding, and the observation time of non-surgical treatment often delays the condition, and the prognosis is not as good as that of surgical hemostasis.