Treatment of dry pleurisy will help patients get rid of a rather dangerous reactive inflammation of the visceral and parietal pleura, in which fibrin is deposited on its surface. Typical symptoms of this disease are associated with chest pain, which is aggravated by breathing, as well as low-grade fever, dry cough, and general malaise. It is possible to diagnose this condition with the help of auscultatory and clinical data, ultrasound of the pleural cavity, X-ray. The main treatment of this disease is aimed at eliminating the primary pathology - as a rule, it is acute pneumonia or tuberculosis, as well as associated symptoms. With this disease, the doctor may prescribe anti-inflammatory, analgesic, antitussive drugs. The tactics of treatment, symptoms, diagnosis and features of the disease will be discussed in this article.
Varieties
Treatmentdry pleurisy is almost always prescribed strictly individually. A similar general term in pulmonology is used to designate a group of inflammatory lesions of the pleura of various origins.
In some cases, pleurisy may be independent or primary, but usually develop as a secondary disease against the background of chronic or acute processes occurring in the lungs.
Depending on the presence or absence of effusion, there are several types of pleurisy: they can be dry (or fibrinous), as well as exudative (serous-fibrinous, serous, purulent or hemorrhagic).
By their origin, there are bacterial pleurisy (they can be specific or nonspecific), as well as tumor, viral, traumatic.
Causes and mechanisms of disease development
Most often, fibrinous pleurisy in origin is associated with tuberculosis of the lymph nodes inside the chest or tuberculosis of the lungs. Having a tuberculous origin, dry pleurisy is formed when the foci are located subpleurally, as well as when they break into the pleural cavity, when it is seeded. It can also develop due to the hematogenous introduction of pathogens.
As the causes of pleurisy in this situation, all kinds of non-specific lung lesions are called. These could be bronchiectasis, pneumonia, abscesses, heart attacks, or lung cancer.
Possible Complications
With the development of extrapulmonarydry pleurisy, they can be complicated by diseases of the digestive system. For example, pancreatitis, cholecystitis, subphrenic abscesses.
In some cases, the disease can be complicated by infections (typhoid or typhoid fever, brucellosis, measles, whooping cough, influenza) or collagenoses (rheumatism, systemic lupus erythematosus, systemic vasculitis).
Sometimes dry pleurisy is accompanied by uremia or an eating disorder.
Pathogenesis
The pathogenic basis of this disease lies in the inflammatory reactions of the visceral and parietal pleura, which occur with edema, hyperemia, thickening of the pleural sheets. In this case, the amount of exudate will be so insignificant that it may begin to be reabsorbed by the pleura with the deposition of fibrin strands on the surface of the pleura. It is formed in the form of characteristic pleural overlays, which greatly complicate the sliding of the sheets.
In the future, this may lead to limited lung mobility and the appearance of massive moorings.
Most often, dry pleurisy (especially if left untreated) develops into exudative. But in some cases, everything can be resolved without a pleural effusion.
Symptoms
When the costal pleura is affected by dry pleurisy, characteristic pains begin in the corresponding half of the chest. To carry out effective treatment of dry pleurisy, the symptoms must be familiar to everyone. Then the disease can be quickly identified in order to consult a doctor for appropriate help.
With thispain pathologies will increase on exhalation, as well as when straining, coughing. All this forces the patient to lie only on the sore side, due to which the mobility of the chest is significantly limited. The need to start treatment of dry pleurisy by symptoms can easily be determined by any doctor.
With this disease, during the subsidence of the activity of the inflammatory process, there is a significant decrease in the sensitivity of the nerve endings of the pleura. All this is accompanied by the fact that the pain subsides.
Signs of inflammation
You can also learn about the symptoms and treatment of dry pleurisy of the lungs at a consultation with a pulmonologist. It would not be superfluous to know the characteristic signs of this pathology.
With inflammation of the diaphragmatic pleura, pain is concentrated in the abdominal region. In this case, pancreatitis, acute cholecystitis, appendicitis may appear. With dry apical pleurisy, pain is transferred to the projection of the trapezius muscle, and when the pericardium is involved in inflammation, pleuropericarditis is formed.
What are the signs of dry pleurisy of the lungs in adults noted by doctors? In fibrous pleurisy, the patient can observe the general symptoms of almost any inflammation - loss of appetite, malaise, sweating at night, and dry cough. At the same time, the patient's body temperature with such an ailment can be both normal and significantly high, reaching 38-39 degrees. The resulting fever is accompanied by tachycardia and chills.
The total duration of the course of the disease is from one tothree weeks, depending on the body's response to therapy, severity and many other related factors. In this case, the final outcome may be a complete cure or the transition of pleurisy into an exudative form. In some cases, the disease becomes chronic - then it is not possible to finally defeat it until the end of life. In the latter situation, pleurisy lasts for several months with occasional exacerbations.
Diagnosis
It is worth noting that formal diagnostics for determining dry pleurisy is considered insufficient. It is always necessary for a doctor to establish the cause of the disease, and not just eliminate its symptoms. Therefore, if there is a suspicion of this disease, the patient should consult with a number of specialists. This is a rheumatologist, pulmonologist, gastroenterologist, phthisiatrician, infectious disease specialist.
The auscultatory, that is, physical, signs of this disease include a significant weakening of breathing on the affected side, extensive or localized pleural friction noises during listening. It should be noted that the pleural friction noise occurs when the rough pleural sheets come into direct contact with each other. It can be almost invisible. In some cases - sharply expressed. On palpation, the doctor manages to establish the soreness and stiffness of the muscles.
Research
To start the treatment of dry pleurisy of the lungs, various studies are being carried out. For example, on X-ray of the lungs and fluoroscopythere is an obliteration of the sinuses, a restriction of the excursion of the diaphragm on the side affected by the disease, as well as a change in its contour or high standing. In particular, the contour of the diaphragm may become atypical - for example, with seals, bumps, bulges. To exclude the presence of exudate, an ultrasound examination of the pleural plane is prescribed. This is an important diagnostic procedure that allows you to determine at what stage of development the disease is.
It is important to differentiate dry pleurisy from myositis, intercostal neuralgia, angina attack, rib fracture, myocardial infarction. The latter options can be excluded using an electrocardiogram. All of these diseases may have similar symptoms and signs. It is important to establish what kind of problem the patient has, for which he should be treated. This can only be done by a professional doctor based on the results of a full diagnostic examination. So self-medication is strictly prohibited when the first such signs appear. Only a doctor can make an accurate diagnosis and prescribe an effective treatment for dry pleurisy.
Treatment methods
For the reason that in most cases dry pleurisy is a secondary process, the root cause should be established. Moreover, the main treatment of dry pleurisy is actually aimed at eliminating just the primary disease.
If the patient has a fibrous form of this disease, which is of tuberculosis origin, then anti-tuberculosis therapy is recommendedwith the help of drugs. It can be "Tubazid", "Streptomycin", "Rifampicin", as well as many others. If non-specific inflammations of extrapulmonary and pulmonary localization appear, in addition to anti-inflammatory, the patient will also need antibiotic therapy.
In the medical treatment of dry pleurisy of the lungs, it is important to relieve pain syndromes. To do this, in addition to taking the appropriate drugs, you should apply a pressure tight bandage on the chest, strictly observe bed rest, put mustard plasters, warming compresses. To stop the cough, which, as a rule, greatly torments the patient, classic antitussive drugs are used. These are Ethylmorphine, Codeine and others.
If a patient has a recurrence of dry pleurisy, doctors perform a pleurectomy, removing the visceral and parietal pleura, which together begin to form a purulent cavity.
Drugs for the infectious nature of the disease
Often, conservative treatment of dry pleurisy of the lungs is sufficient. Drug treatment is possible with its infectious nature. In this case, antibacterial drugs are prescribed, the choice of which depends on the patient's sensitivity to a particular antibiotic and the type of pathogen.
Depending on the nature of the pathogenic flora, medicines can act as:
- cephalosporins ("Ceftriaxone", "Mefoxin", "Latamoxef", "Katen", "Cefepim", "Cefpirome", "Ceftolosan","Zefter");
- penicillins ("Oxamp", "Sultasin", "Amoxiclav");
- glycopeptides ("Targocid", "Vancomycin", "Vibative").
Also drugs in the form of fluoroquinolones, carbapenems, macrolides, aminoglycosides, ansamycins, lincosamides, amphenicols, tetracyclines, other antibacterial synthetic agents can be used as therapy.
Development of exudative pleurisy
As we have already noted, dry pleurisy often flows into exudative. In this case, the patient has both objective and subjective complaints. The latter include a feeling of heaviness in the chest, dry cough, sweating, high fever, headache.
In the treatment of dry and exudative pleurisy, Traube's space, which had practically disappeared before, begins to recover. It occurs in the lower chest on the left side.
How to deal with exudative pleurisy?
It is worth noting that the treatment of exudative and dry pleurisy is somewhat similar, although it has some differences.
For example, in the latter case, pathogenetic therapy, exudate evacuation is required. Etiological treatment consists in influencing the primary source of the disease.
Also in the treatment of dry and exudative pleurisy in a wedge. recommendations are advised to use diet therapy. You should include more proteins, vitamins in the diet, limit the intake of water and s alt. General strengthening gymnastics has a beneficial effect. When the sharp ones passmanifestations of the disease, you can do breathing exercises and light chest massage. It is important to understand that any manipulations should be performed only after consultation with the treating specialist.
