The he alth of the respiratory system must be taken care of from a young age. The human body is constantly attacked by various bacteria, viruses, microbes. The risk of diseases increases especially during frosts and cold weather, which have replaced sunny warm days.
Air pollution, smoking aggravate the condition and allow the infection to penetrate much deeper into the respiratory canals. The disease affects the upper respiratory organs. Their weakness, combined with the inability of the immune system to withstand the attack of pathogenic microorganisms, leads to the development of serious pathologies in the lower sections. One of them is gangrene of the lungs.
What is an affliction? What are the symptoms of the disease? How to deal with it and is it possible to defeat this unpleasant pathology? First things first.
Characteristic of the disease
What isgangrene of the lungs? This is a pathology in which the collapse of the lung tissue occurs - necrosis. Such a process has a putrefactive character. Purulent fusion of tissue is not limited to one area. The pathological process is able to spread rapidly, covering new zones. The disease can affect several lobes, sometimes it spreads to the entire lung.
Affected tissue is brown. Inside is localized fetid pus. Necrosis does not have a strict outline, and, as mentioned above, has a tendency to grow.
Pathology is divided into 2 types:
- Common: localization of the disease is observed lobar.
- Limited: A segmental arrangement is detected. Often, such a process is characterized as an abscess, which is gangrenous in nature.
The disease is caused by pathogenic microflora. Abscess and gangrene of the lung are essentially stages of the same process. However, the first ailment is characterized by a limited purulent process in the tissues. Thoracic surgeons and pulmonologists classify these pathologies as the most severe and dangerous forms of destruction.
Most often the disease is diagnosed in middle-aged men.
Gangrene of the lungs is an extremely dangerous disease. It often leads to fatal complications:
- purulent destruction of the pleura;
- pulmonary hemorrhage;
- suppuration of the chest wall;
- sepsis;
- multiple organ failure.
About 60% of patients who experience these consequences die.
Causes of disease
Why does gangrene of the lung occur? The causes of the disease are hidden in one single factor - tissue damage by infection. Often, the disease-causing organisms are anaerobic bacteria.
An ailment can be an independent pathology or a consequence of intoxication of the body. Thus, there are several mechanisms for the development of such a painful disease as lung gangrene.
The etiology of the disease is as follows:
- Provoke the entry of microbes into the lungs and bronchi can diseases of the gums, teeth, nasopharynx. Under such conditions, pathogenic microflora is able to spread down the respiratory tract.
- Sometimes there is a penetration into the respiratory organs of a microscopic amount of discharge from the nasopharynx or stomach contents during reflux, dysphagia, during vomiting. The latter phenomenon is often provoked by traumatic brain injury or alcohol intoxication. The aggressive contents of the stomach that have penetrated into the bronchi cause a purulent-necrotic process in the tissues.
- Pathology may be the result of insufficient ventilation of the lungs. This condition often occurs when the bronchi are compressed by a foreign body or tumor. Germs grow in this area, and an abscess and gangrene begin to form.
- Purulent ailments of the bronchopulmonary system can become the cause of the development of pathology. We are talking about the following diseases: bronchiectasis, pneumonia, lung abscess.
- There is also a traumatic mechanism for the development of gangrene. Infection in the chest can be caused bypenetrating wounds.
- Pathogenic microflora can spread to the lungs through the system of lymphatic and blood vessels. This is observed in osteomyelitis, sepsis, mumps, tonsillitis and many other pathologies.
An important role in the development of the disease is played by the weakening of the immune system. In this case, the body is not able to fight microorganisms, and therefore cannot prevent the onset of gangrene.
The following risk factors are identified:
- smoking;
- alcoholism;
- addiction;
- HIV infection;
- old age;
- use of glucocorticoid hormones;
- diabetes.
Symptoms of the disease
Gangrene of the lung is quite rapidly developing. Symptoms are acute. The disease progresses rapidly and the patient's condition is seriously deteriorating. Consider what clinical signs manifest lung gangrene.
Symptoms that characterize the disease are as follows:
- Painful discomfort in the sternum. It increases significantly during coughing.
- Severe condition of the patient: high fever, chills, pronounced intoxication of the body.
- There is a lack of appetite, weight loss, up to anorexia, tachycardia, shortness of breath.
- Intense cough accompanied by frothy sputum and pus. The secretions have a fetid odor. They have a brown tint and contain a foamy layer. With gangrene of the lung, particles may be found in the sputumdead tissue, blood.
- Patient begins to choke.
- Profuse sweating.
- Lack of oxygen leads to hypoxia, which is manifested by cyanosis of the fingers, skin, lips.
- The patient gets tired quickly.
- Sometimes there is confusion.
- Patient painfully takes a deep breath. Calm breathing does not cause discomfort.
The course of the disease
Consider how gangrene of the lung develops. The pathogenesis of the disease is very similar to the course of a lung abscess. Clinically, gangrene can be distinguished by a characteristic fetid odor and a high tendency to chronify the process.
The disease manifests itself in this way:
- Initially, the patient has a fever. The thermometer records high readings. However, this is typical for those patients who do not have immunodeficiency. The person's he alth deteriorates. He experiences severe weakness, nausea, lethargy. Often comes to vomiting. There is pain in the chest. Trying to take a deep breath causes extreme discomfort. If you press between the ribs, over the affected area, the person has pain.
- Cough usually comes on immediately. Initially it is dry. Then it gets wet. Sputum begins to be coughed up, which has an extremely unpleasant odor. If such a detachable is left in a container for a while, then it will be divided into 3 layers. In the upper - foam with mucus will be observed. The middle layer contains a clear liquid. Pus will precipitate.
- Symptomatic progresses very quickly. The patient develops shortness of breath, tachycardia appears, weakness is pronounced. The consciousness of the patient is oppressed. In some cases, a coma develops. The temperature may drop. Sometimes it drops below 38 C. This condition is quite critical, since a large amount of infected content is absorbed into the bloodstream.
- If the patient survives this period, then one or more abscesses form. Such cavities containing pus tend to rupture into the bronchus. This phenomenon signals the next period of development of the disease.
- The patient develops or intensifies a cough, in which a large amount of sputum is secreted. If abscesses are emptied through the large bronchi, then the patient immediately releases a lot of pus, in some cases with blood. The condition is improving quite quickly. But most often emptying occurs not in a direct way, but through small bronchi. This significantly delays the release of the abscess from pus, so the patient's condition continues to be severe. Sputum with gangrene of the lung has a rather fetid odor. Sometimes it contains small fragments of lung tissue - sequesters.
Diagnosis of disease
Physical examination plays an essential role in determining the pathology. The patient has a lag in the process of breathing of the affected part of the chest, the percussion sound is shortened. During auscultation, respiratory sounds are weakened, dry rales.
Also,diagnosis of lung gangrene includes instrumental and laboratory research methods:
- Blood test. It shows an increase in the number of leukocytes, a reduced level of red blood cells, an increase in ESR. There is a decrease in total blood protein.
- X-ray of the sternum. Gangrene and necrosis of the lung appear on the image as darkening of the tissue. Quite often, decay cavities with uneven or scalloped edges are found. Darkening has a tendency to spread rapidly and for several days can affect adjacent lobes, and sometimes the entire lung. X-ray shows pleural effusion.
- Computed tomography. This is a modern x-ray method. It is especially informative in this pathology. The tomogram allows you to detect all the decay cavities that correspond to the zones of fusion of the lungs.
- Fibrobronchoscopy. Endoscopic diagnostic method determines purulent endobronchitis, obturation. The study makes it possible to observe the dynamics of the pathological process.
- Sputum analysis. After bronchoscopy, the resulting contents and sputum are sent to laboratory tests. Diagnostic tests identify the causative agent of pathology and allow you to determine the sensitivity of microorganisms to antibiotics.
Possible Complications
Only a timely appeal to doctors can stop such a pathology as gangrene of the lung. Complications arise, as a rule, if the visit to the doctors is delayed.
There can be serious consequences in this situation:
- Dry,exudative pleurisy.
- A breakthrough in the pleura of the gangrenous cavity leads to pyopneumothorax. The patient has acute pain in the side, shortness of breath appears, and the heart is displaced. The patient's condition is rapidly deteriorating. Collapse phenomena occur.
- Profuse bleeding.
- Septicopyemia. Pathology occurs against the background of destruction in the lungs of a large vessel.
- Kidney amyloidosis. It develops in the case of a chronic form of the disease.
In addition, with gangrene of the lungs, the risk of death is very high.
Conservative treatment
Therapy is carried out in a hospital setting.
Treatment of lung gangrene consists of the following activities:
- Intensive body detoxification. For these purposes, the patient is injected intravenously with plasma-substituting low-molecular solutions: Hemodez, Reopoliglyukin, Neocompensan. Assign plasma, water-electrolyte mixtures, albumin. Glucose solutions (5%, 10%) with insulin are administered, as well as proteolysis inhibitors "Trasilol", "Kontrykal".
- Antibacterial therapy. This is the most important link, without which the treatment of lung gangrene is simply impossible. Initially, antibiotics are recommended, which have a wide spectrum of effects. As a rule, these are the following drugs: Fortum, Cefepim, Meropenem, Tienam. Often, patients are prescribed 2 antibiotics at once. After determining the pathogen, a more accurate treatment regimen is selected. Quite effective is the combination of the drug "Ampicillin" with the drugs "Tseporin", "Gentamicin", "Kefzol",Tetraolean.
- Desensitization of the body. The patient is prescribed medications "Suprastin", "Dimedrol", "Pipolfen".
- Recommended vitamin complexes "Retinol acetate", "Riboflavin", "Cyanocobalamin", "Thiamin", "Pyridoxine", "Ascorbic acid".
- If there is a high blood clotting, then the patient is injected intravenously with the drug "Heparin".
- To ensure adequate breathing, periodically or constantly carry out inhalations of humidified oxygen.
- If necessary, take the fight against paresis of the intestines, sanitation of the tracheobronchial tree.
- Prescribe sputum-thinning drugs. These funds are administered intravenously and used for inhalation. The patient may be recommended medications Ambroxol, Lazolvan, Ambrobene, Halixol, ACC Inject.
During therapy, the patient's condition is strictly controlled. The functioning of the cardiovascular system, liver, kidneys is observed. The last organs are given special attention, because they ensure the removal of infected material and medicines.
Treatment of abscess and gangrene of the lung involves drainage of the cavity. Such an event is taken if the abscess is localized near the surface covered with the pleura.
Surgical treatment
If the process cannot be stabilized by conservative therapy, then there are all indications for radical intervention. To do this, hemodynamic, metabolic disorders are corrected, the patient's condition is assessed (is it possibleperform the operation).
Surgery involves the removal of gangrenous lung tissue:
- lobectomy;
- bilobectomy;
- pulmonectomy.
Care of the sick
The disease is hard enough for the patients themselves and for the people caring for them. The constantly present putrid smell is very burdensome.
Providing the necessary care to the patient, you should consider:
- Using deodorants. Creosote can play this role.
- A spittoon should always be near the patient's bed. To reduce the unpleasant odor, it is recommended to pour a little deodorant solution into it. In addition, it must be closed with a lid.
- A patient who is diagnosed with gangrene of the lung is prone to profuse sweating. Therefore, the patient will need frequent change of bed and underwear.
- Sometimes a person's condition deteriorates so much that he is not even able to eat on his own. Therefore, those who care for such a patient need to spoon-feed the patient.
- It is important to ensure complete physical and mental rest.
- When hemoptysis, the patient should be in a semi-sitting position.
- The patient is not allowed to talk, consume hot drinks or food.
Life forecast
What awaits those patients diagnosed with gangrene of the lungs? The prognosis is disappointing only if there is no timely treatment. After all, the disease is growing very quickly,covering he althy areas. If conservative therapy does not help, and surgical treatment is not carried out, then the patient dies.
With timely access to doctors, a completely different picture is observed. Statistics say that in 70-80% of all cases, patients overcome gangrene and recover. A course of complete and adequate treatment returns a person to a full life.
Complications such as sepsis, pulmonary hemorrhage, multiple organ failure need special attention. With these ailments, the patient needs emergency help. If for some reason it is not provided, then there is a high risk of developing irreversible consequences in the body.
That is why it is worth emphasizing the following once again: in order to cope with this pathology, you must consult a doctor in a timely manner and fully comply with all the recommendations of doctors.
