Inflammation of the lungs is a disease of the respiratory system that occurs with intraalveolar exudation and is accompanied by typical clinical and radiological properties.
Among the mortality factors of residents, pneumonia is in fourth place after heart and vascular diseases, malignant neoplasms, injuries and intestinal infections. Depending on the severity of pneumonia, the disease can progress in exhausted patients, with heart failure, with oncological diseases, cerebrovascular pathologies, and complicate the outcome of past diseases. In AIDS patients, pneumonia is considered the leading cause of death.
Symptoms
Complaints with pneumonia are diverse. The following signs of pneumonia are distinguished:
- rapid rise in temperature, up to 39-40 degrees;
- intense cough with sputum;
- chest pain when coughing.
Signs
The causative agent of the described traditional pneumonia is pneumococcus. An atypical form is capable of having other signsdiseases:
- dry cough;
- muscle pain;
- feeling sore throat;
- general weakness.
Such a course is more characteristic of mycoplasma and chlamydial pneumonia.
Diagnosis
Diagnosis is based on the patient's complaints. The characteristic diagnostic aspect of pneumonia is the presence of infiltration in the lung tissue. For this reason, electroradiography of the lungs is considered an important diagnostic method, while infiltration is detected as a darkening in the lung tissue.
But with atypical pneumonia, in some cases, sources of infiltration can only be detected with the support of computed tomography. Of the laboratory methods of research, a general blood test is of particular importance.
For ordinary bacterial pneumonia, it is common to force the erythrocyte sedimentation rate (ESR), neutrophilic leukocytosis with a shift to the left side (an increase in the number of stab - young forms of neutrophils), an increase in the number of monocytes and a decrease in lymphocytes.
Viral pneumonia is characterized by an accelerated ESR, a normal total white blood cell count, a decrease in the number of neutrophils with an increase in the number of monocytes and lymphocytes.
In order to make a diagnosis of chlamydial or mycoplasmal pneumonia, detection of an increase in the titer of specific antibodies in the initial 2 weeks of illness is essential. When sowing, an irritant is detected and its susceptibility to antibiotics is determined. It must not be forgotten that sowing must be done before the startantibiotic therapy.
Classification of pneumonia
Criteria for the severity of pneumonia depend on the type of disease.
The epidemiological data are based on:
- out-of-hospital (out-of-hospital);
- hospital (hospital).
According to the etiological condition with specification of the pathogen:
- infectious;
- fungal;
- combined.
According to the adaptation of the formation, there are pneumonia:
- primary, emerging as an independent pathology;
- secondary, formed as an aggravation of concomitant diseases, for example, congestive disease;
- aspiration, formed when foreign bodies enter the bronchi (food items, vomit, etc.);
- post-traumatic postoperative infarction-pneumonia, which is formed due to thromboembolism of small venous branches of the pulmonary artery.
According to localization in the lungs, they are distinguished:
- unilateral with damage to the right or left-sided lung;
- bilateral total, lobular, segmental, sublobular, hilar (main).
By the nature of the direction of pneumonia can be:
- spicy;
- acute lingering;
- chronic.
Given the formation of multifunctional pathologies of pneumonia pass:
- with the presence of multifunctional pathologies (with prescription of their features and severity);
- with no multifunctional pathologies.
Given the formation of complications of pneumonia can be:
- uncomplicated course;
- complicated direction (with pleurisy, abscess, enterobacterial toxic shock, myocarditis, endocarditis, etc.).
Based on clinical and morphological properties, pneumonia is distinguished:
- parenchymal (croupous or lobular);
- focal (bronchopneumonia, lobular pneumonia);
- interstitial (present in mycoplasma lesions).
Degrees of severity
Classification of pneumonia by severity:
- Mild degree - characterized by mild intoxication (clear understanding, elevated body temperature up to 38 ° C, blood pressure is normal, heart rate is not more than 90 beats per minute), there is no shortness of breath at rest, an insignificant source is noted on x-ray examination inflammation.
- Moderate degree - symptoms of moderately manifested intoxication (clear understanding, hyperhidrosis, weakness, elevated body temperature up to 39 ° C, blood pressure evenly reduced, heart rate - approximately 100 beats per minute.), respiratory rate - up to 30 in minute at rest, X-ray examination shows apparent infiltration.
- Severe severity of pneumonia - characterized by manifested intoxication (fever, temperature rises to 39-40 ° C, blurred consciousness, impotence, delirium, tachycardia - over 100 beats per minute,collapse), shortness of breath - up to 40 per minute at rest, cyanosis, wide infiltration is determined radiographically, the formation of complications of pneumonia.
Criteria
In accordance with the recommendations of doctors, the conclusion "community-acquired pneumonia of moderate severity" is recommended if the patient has manifestations in the lungs on x-ray examination and at least 2 or even more subsequent medical signs:
- fever (>38, 0°C) with an abrupt onset;
- cough with sputum;
- voice changes;
- leukocytosis over 10.
Pneumonia therapy
The main drugs for the treatment of moderate pneumonia are, of course, antibiotics. Their selection, dose and duration of use is determined by the attending physician. In addition, bronchodilators and sputum-thinning drugs, antiallergic and tonic substances are prescribed in combination with plenty of fluids.
With proper treatment of moderate community-acquired pneumonia, dangerous symptoms disappear within 3-4 weeks with absolute resumption of lung transparency. However, the function of the respiratory organs remains reduced for another 1-6 months, and therefore, in this period of time, it is desirable to carry out therapeutic breathing exercises and massage of the chest, physiotherapy exercises, and climatotherapy. If the pneumonic infiltration does not disappear within the specified time, it is carried outseveral examinations to clarify provoking factors (lowered immunity, characteristic features of the pathogen, the presence of another lung disease).
Mode
For an effective cure for pneumonia, you need the right daily routine: all manipulations and studies should be extremely sparing, personal supervision of the patient is important. Bed rest is prescribed, and it is often necessary to change the position of the body. It is necessary to reduce physical activity during the period of pneumonia, especially with severe severity, with a gradual increase in the load after the condition improves. Physical overload after pneumonia is contraindicated for another 6-12 weeks.
Treatment for complications of pneumonia
Along with antibacterial therapy, effective treatment of pneumonia requires adjustment of the treatment of complicating conditions and symptomatic treatment.
Respiratory failure is associated with microcirculation disorders, extensive lesions of the lung or interstitial tissue, pathology of bronchial conduction, the formation of massive exudative pleurisy.
It is necessary to restore bronchial conduction (bronchodilators, mucolytics and expectorants), reduce restrictive changes (for example, prescribe an enema in case of flatulence and high standing of the diaphragm).
In cardiovascular pathologies, cardiotropic substances are used ("Strophanthin-K", "Korglikon", "Digoxin") and agents that restore microcirculation (parenter althe introduction of medium-molecular colloidal solutions, agents that perfect the rheological qualities of blood, and vasodilators).
In case of toxic syndrome, infusion therapy should be carried out along with the corresponding forced diuresis. In severe stages, intravenous administration of glucocorticoids at a dose of 4-5 mg / kg / day is indicated. With an infectious lesion, the implementation of plasmapheresis will be quite effective. Changes in acid-base balance require proper adjustment.
Diet for pneumonia
Food must meet age-related needs for energy, proteins, fats and carbohydrates. But, taking into account the reduction in appetite in the severe course of the disease, the patient must be fed repeatedly, in small doses, and cook his favorite dishes. Already after improving he alth, normalizing body temperature, appetite improves significantly.
Children under 6 months of age should preferably be given breast milk or special fermented milk products. It is necessary to reduce the amount of carbohydrates in the diet, as they increase the fermentation movements in the intestinal tract, and bloating and high standing of the diaphragm complicate breathing, increase shortness of breath. The optimal drinking regimen is very significant, taking into account the daily norm of water. The amount of fluid received must be adjusted in accordance with its loss from the patient's body (fever and shortness of breath).
Prevention of pneumonia
Used for prevention:
- Hardening. Strengthening procedures strengthen the immune system and increase the body's resistance to various infections. Prevention of pneumonia usually includes contrast water treatments and foot soaks. We must not forget that the starting water temperature should not be lower than 35 degrees. Over time, this figure is reduced down to 25 degrees.
- Respiratory exercise. A similar type of prophylaxis is also used in bedridden patients. Respiratory gymnastics is focused on improving lung ventilation. In order to prevent suppuration, it is necessary to inflate balloons or constantly take deep breaths and exhalations.
- Eliminate sources of infection. It has been established that banal tonsillitis or an untreated carious tooth can cause severe pneumonia, since any such diseased organ is a source of pathogenic flora that can end up in the lungs.
- Strengthening immunity. For these purposes, immunomodulators of plant origin are often used: echinacea, chamomile, wild pepper and others. Taken as infusions or teas.
- Massaging. A way to prevent pneumonia is massaging. It is used both in adults and in children, including those who have just been born. At the same time, when massaging, he uses the key technique - patting.
