Q: What is pulmonary maculopathy? A: Pulmonary alveolus refers to large alveolar emphysema, which is a type of restrictive emphysema. They are formed when the alveoli are highly inflated and the alveolar walls rupture and fuse with each other, and are usually caused by a live-valve obstruction of the small bronchi. Q: How can I check for pulmonary emphysema? A: CT chest examination is the best way to diagnose pulmonary bullae. Fluoroscopy and expiratory phase chest radiographs can help detect pulmonary blisters. CT examinations can detect subpleural pulmonary blisters less than 1 cm in diameter that are not easily shown on regular chest films. Pulmonary angiography can accurately show the degree of damage to the pulmonary vessels and the compression of the blood vessels around the pulmonary blisters. Q: What are the signs of pulmonary blisters? A: Small pulmonary blisters themselves do not cause symptoms, and patients with simple pulmonary blisters are often asymptomatic. The enlargement of pulmonary blisters or the appearance of new pulmonary blisters in other areas can cause pulmonary dysfunction and gradually develop symptoms. Large pulmonary blisters can cause chest tightness and shortness of breath. The sudden enlargement and rupture of a pulmonary blister can produce a spontaneous pneumothorax, which can cause severe dyspnea and chest pain similar to angina pectoris. Patients with pulmonary blisters are often combined with chronic bronchitis, bronchial asthma, and emphysema, and clinical symptoms are also mainly caused by these diseases, only that they are further aggravated after the formation of pulmonary blisters. Secondary infection of pulmonary herpes can cause cough, cough, chills and fever, and in severe cases, cyanosis. If the draining bronchus is obstructed and the lung blister cavity is filled with inflammatory material, the cavity may disappear. It may occur clinically that the symptoms of infection disappear after treatment, while the shadow of pulmonary blister on chest X-ray persists for weeks or months without resolving. Q: What are the complications of pneumomediastinum? A: Spontaneous pneumothorax is the most common complication of pneumomediastinum, followed by infection and spontaneous hemopneumothorax. Q: How is pulmonary herpes treated? A: Asymptomatic pulmonary blisters do not require treatment. Patients with chronic bronchitis or emphysema are treated primarily for the primary lesion. In case of secondary infection, antibiotics are applied. In patients with large pulmonary blisters, occupying 70% to 100% of one side of the chest cavity, clinically symptomatic and without other lung lesions, surgical removal of pulmonary blisters can result in reopening of the compressed lung tissue, increase in respiratory area, disappearance of intrapulmonary shunts, increase in arterial partial pressure of oxygen, decrease in airway resistance, increase in ventilation, and improvement in the patient’s symptoms of dyspnea such as chest tightness and shortness of breath. As much healthy lung tissue as possible should be preserved during surgery, and strive to perform only pulmonary bulla excision and suture, or local wedge resection of lung tissue to avoid unnecessary loss of lung function. Spontaneous pneumothorax caused by ruptured pulmonary blisters can be cured by non-surgical treatments such as thoracentesis and closed thoracic flow, but spontaneous pneumothorax that occurs repeatedly should be treated by surgical methods. During surgery, ligation or suturing of the pulmonary herpes can be performed, while tetracycline or 2% iodine or talcum powder can be used to spray the chest cavity to fix the pleural adhesions and prevent the recurrence of pneumothorax. Patients with combined hemopneumothorax sometimes have heavy clinical symptoms, often with chest pain and dyspnea, and also a series of manifestations of internal bleeding. Clinically, changes in the condition should be closely observed, and non-operative measures, such as blood transfusion and thoracentesis, should be taken within a short period of time, and when the symptoms do not improve significantly, open-chest exploration should be performed decisively. At this time, there is often a large active bleeding, and the prognosis is not as good as surgical hemostasis due to the long observation time of non-surgical treatment often delaying the disease. Q: What is the introduction of minimally invasive surgery for pulmonary maculoplasty? A: Under general anesthesia with double lumen intubation, TV thoracoscopic technique is applied to remove pulmonary herpes using cutting sutures and staple clips. The main points are: small trauma, only three small 0.5-1cm holes are used to enter the chest cavity; no blood, no significant bleeding, including the process of lung cutting, all using disposable minimally invasive instruments; fast, eliminating the need for switching the chest and lung cutting edge sutures, saving more time.