Planner: Chinese Medical Association Reviewer: Zhou Xin, Chief Physician, First People's Hospital, Shanghai Jiao Tong University School of Medicine A normal person's chest is flat, that is, the front-to-back diameter is smaller than the left-to-right diameter. Under the influence of certain diseases, the shape of the chest will change and gradually become like a bucket, which is professionally called "barrel chest". Barrel chest is a morphological abnormality of the chest, which is manifested by the gradual increase of the anterior-posterior diameter, which is sometimes almost equal to or even exceeds the left-right diameter, thus becoming cylindrical. This morphological abnormality is usually associated with chronic lung diseases, such as emphysema caused by chronic obstructive pulmonary disease, which can destroy the alveolar wall and cause the alveoli to gradually fuse into larger bullae. The amount of gas exchange in the lungs will decrease accordingly. At the same time, the elastic fibers of the alveoli are lost, and the lungs will gradually lose elasticity and be unable to retract effectively. In addition, airway inflammation and increased mucus will lead to increased airway resistance, making breathing more strenuous. In this way, the lungs will be in an over-expanded state, and in order to adapt to this state, the thorax will gradually expand outward, manifested as the ribs expanding outward and the sternum protruding forward, so that the anterior-posterior diameter of the thorax will gradually increase, approaching or exceeding the left-right diameter. In addition, in order to overcome dyspnea, patients will use more auxiliary respiratory muscles (such as trapezius, sternocleidomastoid, etc.), and excessive use of these muscles will also cause changes in the morphology of the thorax. Patients with barrel chest mainly experience dyspnea, cough, sputum, chest tightness, decreased mobility, bluish skin and lips (caused by hypoxia), etc. Treatment can include medication (such as using bronchodilators to improve breathing), oxygen inhalation, respiratory rehabilitation training, etc. to improve the patient's quality of life. |
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