Exudative pleurisy is a disease of the respiratory organs caused by a neoplasm or infection. The patient has a constant cough, it is difficult for him to breathe, the body temperature rises. The pulmonary and parietal sheets of the pleura become inflamed. The presented disease is characterized by the accumulation of fluid in the cavity of this membrane, therefore it is considered dangerous not only for he alth, but also for the life of the patient.
General characteristics of pathology
Exudative pleurisy is an independent disease or a complication of an existing inflammatory process that affects the lining of the lungs. When a large amount of fluid accumulates in it, which serous cells cannot absorb, the pathological process exacerbates. In this case, surgical intervention to remove the exudate is indispensable.
The pleural cavity is an enclosed space created by its inner and outer sheets. Pathology can be aseptic or infectious in nature. It all depends on the content type. The effusion may beclear and cloudy with bloody or purulent contents.
Fibrous fluid contains a large amount of inflammatory proteins, which causes scarring in the tissues of the pleura.
The disease proceeds in several phases:
- Exudations. It lasts 14-21 days. At this stage, the contents gradually accumulate in the pleural cavity. Its volume can reach 10 liters. There are no atypical symptoms.
- Stabilization. This stage is characterized by the cessation of effusion production, however, its absorption by the serous tissue has not yet begun. The clinical picture is somewhat stabilized. But fibrin deposits appear on the pleural sheets, the outflow of exudate is difficult.
- Resorption. Depending on the state of the body, this stage lasts from 2 to 12 weeks.
If the treatment is not carried out in a timely manner, tissue scarring occurs. In the future, spikes will provoke pain that can increase with weather changes. These scar fragments will prevent the spread of infection, however, the respiratory function will deteriorate.
Disease classification
Exudative pleurisy can be of different types:
- Depending on the composition of the effusion: serous, purulent, hemorrhagic.
- According to the area of accumulation of content: encysted (it is present in a strictly limited area of the pleural cavity), diffuse (fluid spreads without problems over different areas).
- By the nature of the course: subacute, acute and chronic pleurisy.
- By etiological factor:
- Aseptic (caused by lung disease).
- Allergic.
- Post-traumatic.
- Congestive (due to heart failure).
- Tuberculosis. It most often develops in children as well as young adults.
In order for the doctor to correctly prescribe the treatment of exudative pleurisy, he must not only consider the symptoms named by the patient, but also find out the cause of the development of the pathological process.
Reason for development
So, exudative pleurisy is most often provoked by infectious processes, is their complication. The following causes of the disease can be distinguished:
- Inflammation of the lungs.
- Abscess in the area of the diaphragm or respiratory organs.
- Pulmonary embolism.
- Lack of vitamins in the human body.
- Blood pathology.
- Pathogenic microorganisms: mycoplasma, fungi, brucella, streptococcus, pneumococcus.
- Allergic reaction.
- Worm infestation.
- Chemical or thermal burns of the respiratory organs.
- Systemic connective tissue pathologies: lupus erythematosus, scleroderma.
- Penetrating chest injury that damaged the pleura.
- Malignant tumor (metastases are considered especially dangerous).
- Glomerulonephritis or other kidney disease in which excess fluid accumulates in the body.
- Severe heart failure.
- Lung surgery.
- Myocardial or respiratory organ infarction.
Etiologyexudative pleurisy can be different, but it should be determined as accurately as possible. Only in this case it will be possible to get rid of the problem.
Symptoms and signs of pathology
What signs of exudative pleurisy will appear in a patient depends on how quickly the effusion will accumulate and what it will contain. The following symptoms of pathology can be distinguished:
- Pain in the chest area. This symptom is the most basic. Sensations depend on the degree of involvement of the pleural cavity in the pathological process. They are sharp or moderate. To reduce the intensity of pain, a person is forced to take a certain position.
- Shortness of breath. She has a mixed personality. The more fluid accumulates in the pleural cavity, the worse the lungs will be ventilated. Respiratory organs may be compressed or displaced.
- Persistent cough that exhausts the patient over time. It indicates the beginning of the development of the pathological process. In the early stages, it is not accompanied by sputum production.
- Change in body temperature.
- Feeling of heaviness in the affected area.
- Feeling short of breath.
- Swollen blood vessels in the neck.
- Protrusion of intercostal spaces.
- Increased perspiration.
- Lethargy, general weakness, decreased ability to work.
- Changing the shade of visible mucous membranes. They turn blue.
Intensity of presented symptoms of exudative pleurisyvaries depending on the severity of the disease. There are also visual signs of pathology: tension of the affected part of the chest during palpation, its asymmetry.
With a purulent form of the disease, the symptoms will be pronounced. In addition to high temperature, the patient has signs of intoxication of the body. Respiratory failure progresses. Exudative pleurisy is characterized by the formation of cicatricial tissue changes (if it has a chronic type of course).
Diagnosis of disease
Before the final diagnosis of exudative pleurisy is made, the patient requires a thorough differential examination, which will distinguish the presented disease from other pathological processes in the respiratory system. This requires the following research:
- Feeling the chest and listening to breathing. In the initial stages, the doctor may hear a pleural friction rub. Breathing will be weakened.
- General and biochemical blood tests.
- Examination of pleural fluid. It allows not only to establish an accurate diagnosis, but also to understand the nature of the content.
- X-ray. Such a diagnosis is informative only if there is a large amount of fluid in the pleura (more than 300 ml). In the picture, the contents are a dark area (uniform), and the chest organs are displaced.
- Ultrasound examination of the pleural cavities. It will detect even the smallest accumulationliquid.
- CT or MRI. These studies will help determine not only the amount of effusion, but also assess the condition of the soft tissues in the affected area. Such diagnostics will make it possible to detect changes in tissues at the early stages of the development of the disease.
Only correct and timely diagnosis of exudative pleurisy will help create an effective treatment regimen.
Traditional treatment
Treatment of exudative pleurisy largely depends on the causes that caused it. At the first stages of the development of pathology, the patient is prescribed drug therapy, which involves taking the following drugs:
- Antibiotics: "Clindamycin". They are prescribed if the inflammatory process is caused by microbes. The cause of pleurisy here is tuberculosis, pneumonia.
- Analgesics. They will help eliminate pain.
- Drugs to improve the functioning of the heart and blood vessels.
- Means to fight tuberculosis.
- Cytostatics. Medicines that depress the immune system are necessary if pleurisy is provoked by an oncological process.
- Means to increase the body's resistance to pathogens.
- NSAIDs: Voltaren. These funds reduce the intensity of the inflammatory process, the rate of exudate production.
After signs of exudate resorption appear, additional treatments may be used: oxygen therapy, infusion of plasma replacement complexes,physiotherapy procedures. To make breathing easier for the patient, he is prescribed an electro-vibration massage of the chest.
The success of drug therapy depends on how quickly the diagnosis is made.
Need for puncture
With exudative pleurisy, puncture allows you to get rid of excess fluid. In one procedure, no more than 1.5 liters of effusion can be eliminated, therefore, in some cases, its repetition is required. Otherwise, the lungs will expand too quickly, causing cardiovascular complications.
If the disease is accompanied by a purulent process, then, in addition to pumping out the exudate, additional washing of the pleural cavity with antiseptics, antibiotics and even hormonal agents will be required.
To prevent the re-development of the pathology, special medicines containing talc are introduced into the cavity, which prevent the sheets from sticking together. The procedure itself involves the use of a special needle that is inserted into the pleural cavity. The puncture must be carried out under strict sterility. During the operation, the patient is given local anesthesia.
The puncture is carried out between the 7th and 8th ribs (if it is necessary to eliminate excess air, the instrument is inserted into the 2nd or 3rd intercostal space). The fluid that was removed is being sent to a lab for a thorough examination.
How to care for the sick
Care for suchthe patient also has certain characteristics. For example, he needs to organize high-calorie meals. It should not be heavy on the digestive system. It is better to eat fractionally. It is also important to monitor the drinking regime.
The patient is provided with bed rest, a calm environment. Pleurisy of the exudative type requires surgical intervention, so the person will have to stay in the hospital. He must follow all the recommendations that the doctor gives. And this should be done regularly.
If a person has severe pain after removing the effusion, you should immediately consult a doctor. The specialist will prescribe the pain medications allowed to the patient. During the postoperative recovery period, it is imperative to control the heart rate, blood pressure, and breathing.
Complications of pleurisy
In most cases, timely detection, as well as proper therapy, allows you to quickly get rid of the pathology. However, ignoring the recommendations of doctors or late seeking professional help is fraught with complications of exudative pleurisy, among which are the following:
- Adhesion process.
- Compaction of pleural sheets.
- Pneumosclerosis leading to respiratory failure.
- Development of a purulent process.
Complications can also occur during the operation to remove fluid. For example, bleeding may develop, air entering the pleural cavity, which requiresre-draining this area. Failure to comply with the rules of sterility is fraught with the development of infection in the wound. The actions of an inexperienced surgeon can lead to damage to adjacent internal organs or a sharp decrease in blood pressure.
In some cases, getting rid of complications is much more difficult than getting rid of the underlying disease, so you can’t delay a visit to the doctor.
Preventive measures
No one knows how the disease will progress if left untreated. However, it is better to prevent its development altogether. To do this, it is important to follow preventive measures:
- In the presence of acute respiratory diseases, you should not self-medicate, since in this case the development of complications is not excluded. It is impossible to allow the penetration of pathogenic microflora into the pleural cavity. It is better to entrust the treatment of these pathologies to professionals.
- If there is a suspicion of pneumonia, it is better to immediately take an x-ray.
- Periodically make trips to the sea, especially if a person often recurs with colds.
- Strengthen immunity through multivitamin complexes, observing the daily routine, taking walks in the fresh air and proper rational nutrition.
- Perform breathing exercises.
- Stop smoking. This bad habit often leads to the development of cancer or exudative tuberculous pleurisy.
In most cases, proper treatment and compliance with medical recommendations is enough to get rid of the pathology. But even after that, you need to carefully monitorwith their he alth to avoid a relapse.
