Emphysema - causes, symptoms, diagnosis and treatment
Emphysema - A chronic nonspecific lung disease, which is based on a persistent, irreversible expansion pneumatic spaces and increased swelling of lung tissue distal to the terminal bronchioles. Emphysema appears expiratory dyspnea, cough with a small amount of mucous expectoration, signs of respiratory distress, recurrent spontaneous pneumothorax. Pathology Diagnosis is made based on the data auscultation, X-ray and CT scan, spirography, blood gas analysis. Conservative treatment of emphysema includes receiving bronchodilators, corticosteroids, oxygen therapy; in some cases shown resection surgery.
Emphysema
chronic obstructive pulmonary disease, especially after 60 years. Clinical and social significance of emphysema in pulmonology determined by a high percentage of cardiopulmonary complications, disability, disability of patients and increasing mortality.
bronchial asthma and chronic obstructive pulmonary disease;
Under the influence of these factors is damage to the lung tissue elastic, a decrease and loss of its ability to vozduhonapolneniyu and wears off. Crowded lungs lead to blocking small airways during exhalation and disorders of pulmonary ventilation on obstructive type. Formation of the valve mechanism in pulmonary emphysema causes bloating and hyperextension of lung tissue and the formation of cysts air - Bull. Breaks bulls can cause episodes of recurrent spontaneous pneumothorax.
Emphysema is accompanied by a significant increase in the amount of light that are macroscopically similar to a coarse sponge. In the study of emphysematous lung tissue under a microscope observed the destruction of alveolar walls.
bronchitis with obstructive syndrome).
In terms of prevalence of lung tissue release localized and diffuse forms of pulmonary emphysema.
According to the degree of involvement in the pathological process of the acinus (structural and functional unit of the lungs, providing gas exchange, and consisting of a branching terminal bronchioles to alveolar passages, alveolar sacks and alveoli) the following types of emphysema:
Highlights the inherent severally (lobar) pulmonary emphysema and McLeod syndrome - emphysema with an unclear etiology, strikes one lung.
respiratory failure. Patients with emphysema breathe out through closed lips, puffing out his cheeks at the same time (like "puff"). Shortness of breath accompanied by cough with scanty mucous expectoration. About pronounced degree of respiratory failure evidenced by cyanosis, facial puffiness, swelling of the neck veins.
Patients with pulmonary emphysema significantly lose weight, have a cachectic appearance. Weight loss with emphysema is due to large amounts of energy spent on the intensive work of the respiratory muscles. When bullosa form of emphysema occur recurrent episodes of spontaneous pneumothorax.
pulmonary hypertension and an increase in the load on the right heart. With the rise of right heart failure appear lower extremity edema, ascites, hepatomegaly. Emergency conditions when emphysema is the development of spontaneous pneumothorax requiring a chest tube and suction air.
hemoglobin.
When X-ray light is determined by increasing the transparency of the lung fields, depleted vascular pattern, limiting the mobility of the diaphragm dome and its low position (in the front below the rib VI), almost horizontal edges, narrowing of heart shadow expansion of the retrosternal space. With the help of CT scan clarified the presence and location of the bulls with bullous emphysema.
Highly informative with emphysema study of respiratory function:. Spirometry, peak flow meters, etc. In the early stages of emphysema revealed obstruction of distal airway segments. The test with inhalers, bronchodilators indicates irreversible obstruction characteristic of emphysema. Also, when ERF determined reduction VC and Tiffno sample.
Analysis of blood gas reveals hypoxemia and hypercapnia, clinical analysis - polycythemia (an increase of Hb, erythrocytes, blood viscosity). The survey plan should include an analysis on the α -1-trypsin inhibitor.
oxygen therapy, prescribed diuretics. In the complex treatment of pulmonary emphysema include breathing exercises.
Surgical treatment of emphysema is to conduct operations to reduce lung volume (thoracoscopic bullectomy). The method reduces to the resection of the peripheral areas of the lung tissue, causing "decompression" the rest of the lung. Observations of patients after undergoing bullectomy show improvement in lung function parameters. Patients with emphysema is a lung transplant.
pulmonologist.