3. tuberculous pleurisy
4. Symptoms of pleurisy
6. Treatment of pleurisy
pleura - a thin serous membrane that lines the lungs, the inner surface of the chest, mediastinum and diaphragm.She also runs between the lobes of lungs and pleural cavity is formed between her own sheets.Normally the pleura is smooth, its cells produce slippery lubricant, whereby the lungs freely slide on the inner surface during breathing, and pleural sheets do not rub against each other.But when any factors cause pleural lesion, it is subjected to various kinds of inflammation, which is called pleurisy.
to inflammation of the pleura can cause a number of factors.The most common cause of pleurisy - a tuberculosis.Source tuberculous pleurisy is not necessarily located at the very pleura, often penetrate the Koch bacillus from other places of localization.In second place are the complications of pneumonia.In old age, inflammation occurs a
Often the cause of the pathological process are diseases of neighboring organs, such as severe heart disease, connective tissue disease.Injuries to the thorax, rib fractures can cause dry pleurisy.Inflammation usually occurs on the background of other diseases, so treatment for pleurisy almost always requires the use of a set of measures directed against the underlying disease.
Speaking about the varieties of pleurisy, the representatives of medicine implies two variants of the situation.In the first case - a pleural thickening and edema resulting from an inflammatory process.Edema is unevenly deposited in the affected areas of fibrin strands.As a result of the pathological process pleura loses smoothness.This type of pathology is called dry pleurisy.
The second situation is the opposite: the pleura begins to secrete liquid in excess, resulting in inflammatory liquid, or as it is called, exudate accumulates in the pleural cavity.In this case, we are dealing with exudative pleurisy.Sometimes dry pleurisy flows into the pericardial.
Pleurisy also classified in terms of the origin: infectious (pneumococcal, staphylococcal, tuberculous pleurisy and other forms), non-infectious (caused by the problem of lung cancer, rheumatism and other reasons), as well as idiopathic (origin remains unclear).
terms of flow pleurisy inflammation are divided into acute, subacute and chronic.And in terms of localization effusion - to diffuse, encysted or limited.
Almost half of the cases of exudative pleurisy accounted for tubercular form of the disease in Russia.Tuberculous pleurisy - inflammation of the pleura common type, which can be acute, subacute, chronic or recurrent character.Most inflammation occurs on the background of pulmonary tuberculosis, but the source of infection may be intrathoracic lymph nodes and other organs.Development of tuberculous pleurisy contribute to hypothermia, overheating, lack of vitamin C and protein, trauma, excessive exercise.
In recent years, this form of TB is widespread, it accounts for about 14% of the incidence of respiratory tuberculosis origin.In the majority of cases tuberculous pleurisy affects men under the age of 40 years.
Symptoms of pleurisy may vary depending on how the disease process occurs - with or without exudate him.
dry pleurisy accompanied by pain and a dry cough.The pleura is a lot of nerve endings, so the lack of lubricating fluid friction pleura during respiration causes severe pain.Diagnosing dry pleurisy while quite simple - pain gets worse with a deep breath and cough, and if the patient lie on his side, it decreases, as this light is shifted by less than a breath.
Other typical symptoms of this type of pleurisy - pleural friction noise and reduced air in the area of fibrinous pleural overlays.A little fever, there may be chills, night sweats and weakness.In dry pleurisy pain concentrated in the upper quadrant, chest and abdomen.They are accompanied by additional symptoms of pleurisy - flatulence, hiccups, tight abdominals.
pleural effusion, in contrast, occurs without a strong cough, because there is no over-stimulation of the nerve endings.At the same time accumulating fluid compresses the lung, and the patient feels the lack of oxygen, experiencing weakness, he has a shortness of breath, which increases the accumulation of fluid.Home pleural exudation may be accompanied by a dull ache in his side from the affected lung.
External symptoms of this type of pleurisy - weak, average temperature, chills, sweating, loss of appetite.In some cases there is dysphagia, swelling of the face and neck, the voice becomes husky.If pleural effusion occurs against a background of bronchial cancer, possibly hemoptysis.With the accumulation of fluid displaced mediastinum, and respiratory disorders, cardiovascular symptoms join - compensatory tachycardia, low blood pressure.
Without proper treatment of pleurisy symptoms can be further developed - there adhesive process, interlobar pleural cavity gap and overgrown, develops plevroskleroz, respiratory failure and other diseases.
themselves pleurisy symptoms described by patients, rarely give a full clinical picture.Dry pleurisy does not appear on the radiograph, it can be detected by the characteristic sound of breathing, accompanied by pleural friction noise.Pericardial effusion is clearly visible on x-ray, but, on the contrary, is not detected when listening as easy weakened or suppressed in the field of fluid accumulation, and breathing can be heard.When running on pleural effusion pleural adhesions are formed, and the breath begins to be heard.
most reliable results are obtained by a comprehensive examination that includes tapping, chest X-rays, blood tests and, if necessary, additional tests to help identify the associated diseases and prescribe the most effective treatment of pleurisy.
As is almost always preceded by the underlying disease, treatment should include not only symptomatic but also comprehensive measures aimed at addressing the causes.Symptomatic treatment of pleurisy aims only to relieve pain, accelerate resorption of fibrin and prevent the formation of adhesions is moored and the pleural cavity.
In acute tuberculous pleurisy in the complex may include drugs such as isoniazid, streptomycin, ethambutol or rifampicin.The course itself TB treatment takes about a year.
When parapnevomnicheskom pleurisy treatment success depends on the selection of antibiotics on the basis of abnormal sensitivity to them microflora.At the same time appointed immunostimulatory therapy.
pleurisy Treatment of tumor origin requires the use of chemotherapy and disease rheumatic nature - glucocorticosteroid drugs like prednisolone.
To reduce pleural pain used anti-inflammatory and desensitizing agents - Analgin, indomethacin, calcium chloride and other drugs.
This article is available exclusively in the educational purposes and is not research material or professional medical advice.
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