In the chest cavity there is a special membrane - the pleura. It is designed to allow the lungs to move freely and maintain normal breathing. Between its layers is a wetting liquid.
Pleurisy is an inflammation of this membrane that limits the movement of the lungs. During the described process, a fibrous plaque forms on its surface. Pleurisy often occurs as a complication of other diseases.
General information
Pleuritis is an inflammation of the pleural sheets, characterized by excessive accumulation of fluid in the cavity of the membrane. Only in some cases, pleurisy can be an independent disease. As noted above, most often it acts as a complication of other diseases and disorders in the body.
Among the main symptoms are shortness of breath, shortness of breath, cough, fever. Infectious processes, chest injuries, neoplasms can provoke the occurrence of such a condition. Pleurisy often occurs in patients with pneumonia.
Regardless of shape andstage of the course, pleurisy is a rather serious pathology that can lead to serious consequences. The treatment is quite successful if the correct diagnosis was made in a timely manner and complex therapy was started, and the patient follows all the doctor's instructions.
Classification
There are several types of pleurisy disease, which are divided primarily by the nature of the inflammation. There are fibrinous and effusion pleurisy. The dry form is characterized by the deposition of fibrin on the pleura, which is a blood plasma protein. In this case, the liquid is present in a minimal amount, which significantly increases the friction of the pleura. This provokes the occurrence of painful sensations. Fibrous pleurisy refers to the initial stage of development of this pathology, after which the exudative form begins to develop.
Effusion pleurisy is characterized by a significant accumulation of fluid in the cavity of the lung membrane, which leads to excessive pressure on adjacent tissues and organs. This form of pathology is accompanied by an increase in the area of the lesion and inflammation. In addition, with effusion pleurisy, pleural pockets begin to form, in which pus accumulates after a while. As a result of a decrease in lung volume, respiratory failure gradually develops.
According to the etiology, pleurisy can be infectious and non-infectious. Infectious forms include:
- Bacterial.
- Parasitic.
- Fungal.
- Tuberculosis.
Non-infectious species aretumor, traumatic, enzymatic, and also provoked by certain diseases. Traumatic types are caused by significant hemorrhages when the sternum is injured, which provokes the accumulation of blood in the pleural cavity. In the absence of suppuration, dense connective tissue begins to form, limiting the functioning of the lungs.
In severe types of injuries, the blood in the lung cavity coagulates almost instantly. In some cases, mixed types of the disease may occur. According to the nature of the flow, pleurisy is divided into:
- Spicy.
- Subacute.
- Chronic.
According to the area of distribution, it can be diffuse or limited. In addition, differences may be in the nature of the effusion. In this case, doctors distinguish such forms of pleurisy:
- Fibrinous.
- Seropurulent.
- Serous.
- Purulent.
- Hillous.
- Hemorrhagic.
- Cholesterol.
The most mild is the fibrinous form, which is characterized by the accumulation of a small amount of fibrin and a minimum of fluid. The purulent form of the disease is quite acute and is characterized by the presence of pus between the pleural sheets, which is accompanied by signs of intoxication of the body. Such a condition poses a great threat to human life.
Development stages
There are several stages of pleurisy, which are characterized by different symptoms and pathogenesis features.
At the 1st stage, there is an increased production of pleuralliquids. This pathological process occurs due to the strong expansion of blood vessels. This occurs as a result of the activation of the corresponding cells and antibodies by the body's defense system in response to the penetration of infection. The lymphatic system at this stage is still able to remove the existing excess fluid, so its amount is still normal.
At the 2nd stage, fibrin begins to be deposited on the pleura, which has a sticky property. This provokes significant friction of the pleural sheets among themselves, resulting in the formation of adhesive processes. As a result, small pockets are formed, and the outflow of fluid from the pleural cavity is difficult. Due to the constant accumulation of pathological fluid, the process of suppuration begins, and the resulting pus provokes inflammation of nearby tissues. This disrupts the outflow of fluid through the lymphatic system.
At the 3rd stage, there is a recovery or transition to the chronic stage. The chronic form is characterized by a decrease in lung mobility, an increase in the thickness of the pleura, and a deterioration in the outflow of pathological fluid. In some cases, pleural adhesions form or complete replacement with fibrous fibers occurs.
What causes disease
Among the main causes of pleurisy of the lungs are the following:
- Infections.
- Neoplasms.
- Injury to the sternum.
- Allergic reactions.
- The effects of toxins on the body.
- Tuberculosis.
There are certainprovoking factors contributing to the development of pathology:
- Presence of respiratory diseases.
- Alcohol abuse and smoking.
- Decrease in the functioning of the immune system.
- Gastric reflux.
Basically, the disease develops when pathogens penetrate into the pleural region. Infection occurs by airborne droplets, through the lymphatic system, blood.
Key Features
Symptoms of pleurisy largely depend on the form of the pathology. The dry type of the disease manifests itself in the form of a sharp, stabbing pain in the sternum, which is aggravated by sneezing, coughing, movement and too active breathing. To reduce pain, the patient lies down on the area of pain to limit the mobility of the chest.
With the apical type of the disease, which is characteristic of the course of tuberculosis, you can hear the sounds of pleural friction. Muscles become tense and painful. Among the main symptoms of pleurisy are the following:
- Temperature increase.
- Increased sweating at night.
- Weakness.
- Chills.
When tuberculosis occurs, pleurisy lasts a very long time and is often accompanied by the release of fluid into the pleural cavity. With the diaphragmatic location of the disease, the signs of pleurisy of the lungs are quite specific and manifest themselves in the form of painful sensations under the ribs, in the abdominal cavity and in the sternum region. The abdominal press is somewhat tense, flatulence occursand hiccups.
With the exudative type of the course of the disease, there are dull painful sensations in the affected area, as well as a painful cough. In addition, a characteristic noise is heard, a feeling of heaviness in the side, shortness of breath, cyanosis of the skin. There are also common symptoms of pleurisy:
- Loss of appetite.
- Excessive sweating.
- Temperature increase.
- Severe weakness.
Empyema of the pleura occurs with chills, and with a serous type of illness, blood is released. If the disease was provoked by lupus erythematosus, then inflammation of the joints and kidneys, pericarditis join the common signs. In the presence of metastases, the pathological fluid accumulates rather slowly, so the pathology is almost asymptomatic.
Chylous pleurisy is characterized by the fact that the fluid between the pleural lobes is more like milk. It develops mainly due to the formation of a malignant tumor of the lymph nodes. Their integrity is broken, lymph penetrates into the pleural cavity. Among the main symptoms of pleurisy are persistent fever, pain under the ribs, rapid breathing, cough, which is initially dry, and then passes with sputum.
Diagnostics
Diagnosis of pleurisy is established on the basis of a comprehensive examination. Diagnosis involves the following actions of physicians:
- Patient interview.
- External inspection.
- Listening to the lungs and heart.
- Urine and blood tests.
- X-raystudy.
- Sputum analysis.
- Examination of pleural fluid.
After a comprehensive diagnosis, the doctor selects a treatment method.
Therapy Methods
When pleurisy is detected, clinical recommendations must be followed very strictly to prevent the development of complications. The methods of therapy largely depend on the initial cause that provoked the onset of the pathological process. Initially, the course of treatment should be aimed at stopping the primary disease and improving well-being. Among the main methods of treating pleurisy, the following should be distinguished:
- Drug therapy.
- Folk techniques.
- Surgical intervention.
- Following a diet.
After resorption of the accumulated exudate, the patient is prescribed physiotherapeutic methods of treatment, breathing exercises and physiotherapy exercises. Of great importance is exercise therapy for pleurisy, as special exercises will help ease coughing.
Using drug therapy
Treatment of pleurisy must be comprehensive. Medications are of primary importance, but before using them, you should definitely consult with your doctor. Since the disease in most cases occurs due to the penetration of pathogens into the pleura, drugs are prescribed to eliminate the infection.
Antibiotics for pleurisy are prescribed, because most often in the patient's biomaterials taken forresearches, pathogenic bacteria are found. First, doctors prescribe broad-spectrum antibacterial drugs, and after conducting a study and determining the infection, they prescribe a specific drug.
The dosage and course of therapy depends on the diagnosis and the complexity of the pathology. The most common antibiotics for pleurisy are Ampicillin, Clindamycin, Imipenem, Ceftriaxone.
The course of the disease is accompanied by painful sensations. To eliminate pain, the use of anti-inflammatory drugs (Ibuprofen, Meloxicam, Diclofenac, Nimesil.) and glucocorticoids is indicated. The main drug prescribed to patients is Prednisolone.
When pleurisy, bacteria poison the human body with toxic substances. They provoke the processes of decay in the body. To remove toxins and dead bacteria, detoxification therapy is used, which includes:
- Intravenous glucose infusion.
- Detoxifying drugs "Albumin" or "Atoxil".
- Diuretics ("Furosemide").
Heavy drinking is not prescribed, as excessive fluid leads to increased effusion. If there is a temperature with pleurisy, the use of antipyretic drugs is required.
The development of the disease is associated with a weakening of the immune system, since it is she who is responsible for resisting pathogens. Immunomodulators are prescribed to strengthen the immune system"Timogen", "Imudon". Additionally, you can take vitamin complexes.
Cough with pleurisy is treated with special antitussive drugs, as well as expectorants. The doctor selects the medicine purely individually, depending on the nature of the cough.
When taking antibacterial drugs, the intestinal microflora is disturbed. To restore it, probiotics are prescribed. There are many of them, but most often doctors prescribe Acipol, Linex, Bifiform.
Methods of traditional medicine
Traditional medicine has a good effect. You can take chopped horseradish root mixed with lemon juice. Onion inhalations are widely used to combat diseases of the respiratory system. You need to make a slurry from a medium-sized onion and transfer it to a large container. Then close your eyes, tilt your head to the gruel and inhale the vapors through your mouth.
For faster removal of accumulated fluid from the body, you need to grind the ginseng root, transfer it to compression paper with small holes, then wrap it with gauze and apply as a compress to the stomach area. Then wrap it all up with a warm cloth.
To facilitate expectoration and restore the alveoli, the patient is shown a pulmonary collection, as well as a decoction prepared on the basis of licorice root, ledum, plantain leaves. Fresh beetroot juice is a good remedy. It is also recommended to regularly eat boiled beets.
Reduce swelling and remove excess fluid from the bodya decoction of chamomile and horsetail will help. Folk remedies will not be able to cure diseases on their own, but will be a good addition to drug therapy.
Surgery
With pleurisy of the lungs, surgery is performed in case of a severe course of the disease. A pleural puncture is often prescribed. Its essence lies in the introduction of a thick needle into the pleural cavity under local anesthesia, through which a certain part of the fluid is taken.
As a result of such manipulation, excessive pressure in the lungs can be eliminated, which normalizes the patient's respiratory mobility and well-being. A similar procedure is indicated for the ineffectiveness of drug therapy, as well as as a complex therapy. In the case of a severe course of the pathology, competent nursing care for pleurisy is required. It includes taking the necessary tests by he alth workers, performing procedures, providing the patient with a semi-bed rest and diet (table No. 15), as well as applying a bandage to the chest and dry heat on the side of the lungs that is affected (performed when the temperature readings are normal).
Follow your diet
When pleurisy occurs, clinical recommendations include strict adherence to the diet. It is prescribed, depending on the disease that provoked the pathology in the pleura.
Food must necessarily consist of foods enriched with vitamins and useful microelements. This will strengthen the immune system and the whole body. In addition, you must avoidconsumption of heavy food. It is also important to adjust the drinking regimen.
Possible Complications
The consequences of pleurisy can be quite dangerous. If shortness of breath appears after a course of therapy, this may indicate that adhesions have formed between the pleura sheets, limiting lung mobility during breathing.
Carrying out preventive measures
To prevent the occurrence of pleurisy, it is necessary to take preventive measures, which include:
- Timely seeking help from a doctor.
- Compliance with post-surgical rehabilitation.
- Prevention of hypothermia.
- Compliance with hygiene rules.
- Normalization of the daily routine.
- Frequent ventilation of the room.
- Quit alcohol and tobacco.
It is important to treat all existing diseases of the respiratory system in a timely and comprehensive manner. These preventive measures will help prevent pleurisy and improve overall well-being.
After discharge from the hospital, the patient needs to perform breathing exercises prescribed by the doctor to restore the full functioning of the lungs. Minor exercise, yoga and outdoor walks are shown.
