Emphysema causes, symptoms, treatment. Pulmonary emphysema: what it is, symptoms, treatment, causes, gymnastics. Complications of emphysema

Emphysema is a disease that occurs with the development of increased airiness of the lung tissue. Emphysema is characterized by a long course and very often leads to disability. Women get sick twice as often as men. IN age groups Over 60 years of age, emphysema is more common than in younger people.

Causes of emphysema

All factors under the influence of which pulmonary emphysema can form can be divided into two large groups. The first group includes factors that impair the elasticity and strength of lung tissue. These are, first of all, congenital defects of the body's enzyme system (changes in the properties of surfactant, deficiency of a1-antiripsin). Gaseous toxic substances (cadmium compounds, nitrogen compounds, dust particles) that enter the lungs when breathing also play an important role. Repeated viral infections respiratory tract reduce the protective properties of lung cells and lead to their damage.

One cannot fail to mention smoking, which is one of the main causes of emphysema. Tobacco smoke promotes the accumulation of inflammatory cells in lung tissue, which, in turn, release substances that destroy the walls between lung cells. In smokers, emphysema occurs much more often and is more severe than in non-smokers. The words of Elizabeth Gips, a famous writer and radio presenter who died from respiratory failure against the background of long-term smoking. She said: “If anyone who still smokes could live in my body for a couple of minutes, he would never put a cigarette in his mouth again.”

Elizabeth Gips, writer, radio host, and student of alternative ancient cultures; died of respiratory failure due to long-term smoking

The second group includes factors that increase blood pressure pulmonary alveoli. These are, first of all, previous lung diseases, such as chronic obstructive bronchitis, bronchial asthma.

Emphysema formed under the influence of the first group of factors is called primary, while the second group is called secondary.

Symptoms of emphysema

To understand the mechanism of development of emphysema and its symptoms, it is necessary to discuss the main structural features of the lung tissue. The main structural unit of lung tissue is the acinus.

The acini consists of alveoli - lung cells, the wall of which closely borders the blood capillaries. This is where the exchange of oxygen and carbon dioxide occurs. Between adjacent alveoli there is a surfactant - a special fatty film that prevents friction. Normally, the alveoli are elastic, expand and collapse in accordance with the phases of breathing. Under the influence of pathological factors, with primary emphysema, the elasticity of the alveoli decreases, and with secondary emphysema, the pressure in the alveoli increases and excess air accumulates. The wall between adjacent alveoli is destroyed, forming a single cavity.

Scheme of the structure of the alveoli in pulmonary emphysema. The top picture shows alveoli in emphysema. Below are normal alveoli.

Some authors describe cavities whose size is more than 10 cm. When cavities form, the lung tissue becomes more airy. Due to the reduction in the number of alveoli, the exchange of oxygen and carbon dioxide, respiratory failure occurs. The process of cavity formation is continuous, and ultimately affects all parts of the lungs.

The disease develops unnoticed by the patient. All symptoms appear with significant damage to the lung tissue, so early diagnosis of emphysema is difficult. As a rule, shortness of breath begins to bother the patient after 50-60 years. At first it appears during physical activity, then it begins to bother you at rest. The appearance of the patient at the time of an attack of shortness of breath is characteristic. The skin of the face becomes pink. The patient, as a rule, sits leaning forward, often holding on to the back of the chair in front of him. The exhalation with emphysema is long, noisy, the patient purses his lips into a tube, trying to ease his breathing. When inhaling, patients do not experience difficulty, but exhaling is very difficult. Due to the characteristic appearance During an attack of shortness of breath, patients with emphysema are sometimes called “pink puffers.”

"Pink Puffer" - characteristic appearance patient with an attack of shortness of breath.

Cough, as a rule, occurs some time after the manifestation of shortness of breath, which distinguishes emphysema from bronchitis. The cough is not prolonged, the sputum is scanty, mucous, transparent.

A characteristic sign of pulmonary emphysema is loss of body weight. This is due to fatigue of the respiratory muscles, which work at full strength to facilitate exhalation. A marked decrease in body weight is an unfavorable sign of the development of the disease.

In patients with emphysema, attention is drawn to the expanded, cylindrical shape of the chest, as if frozen while inhaling. It is often figuratively called barrel-shaped.

The apices of the lungs bulge in the supraclavicular areas, and there is expansion and retraction of the intercostal spaces.

Noteworthy is the bluish color of the skin and mucous membranes, as well as characteristic change fingers like drumsticks.

These external signs talk about prolonged oxygen starvation.

Diagnosis of emphysema

In diagnosing pulmonary emphysema, respiratory function testing plays an important role. Peak flowmetry is used to assess the degree of narrowing of the bronchi. In a calm state, after a couple of breaths, you exhale into a special recording device, a peak flow meter.

Data obtained from peak flow measurements make it possible to distinguish emphysema from bronchial asthma and bronchitis. Spirometry helps determine changes in the tidal volume of the lungs and determine the degree of respiratory failure. The data is recorded at the moment of quiet breathing, then the doctor asks you to perform several forced inhalations and exhalations. Tests using bronchodilators can also distinguish various diseases lungs, and also evaluate the effectiveness of treatment.

X-ray examination of the chest organs has great importance for the diagnosis of emphysemax. At the same time, dilated cavities are detected in various parts of the lungs. In addition, an increase in lung volume is determined, indirect evidence of which is the low location of the dome of the diaphragm and its flattening. CT scan also allows you to diagnose cavities in the lungs, as well as their increased airiness.

Treatment of emphysema

All therapeutic measures for emphysema should be aimed at alleviating the symptoms and reducing the progression of respiratory failure, as well as treating the lung disease that led to the development of emphysema. Treatment is usually carried out on an outpatient basis, under the guidance of a pulmonologist or therapist. Hospitalization in a hospital is indicated in case of infection, severe form of respiratory failure, as well as in the event of surgical complications (pulmonary hemorrhage due to cavity rupture, pneumothorax).

Diet and lifestyle correction for emphysema

It is recommended for patients with emphysema balanced diet with a sufficient content of vitamins and microelements. The diet should always include raw fruits and vegetables, as well as juices and purees from them. With severe respiratory failure, consuming large amounts of carbohydrates can lead to an even greater lack of oxygen. Therefore, in this case, a low-calorie diet with a calorie content of 600 kcal per day is recommended, and then, with positive dynamics, the calorie content of food expands to 800 kcal per day.

Quitting smoking, active and passive, is of great importance. Quitting smoking immediately has the best effect compared to gradual cessation. Currently there is a large arsenal medical supplies(chewing gum, patches), which can help the patient in this difficult matter.

Drug treatment of emphysema

When the inflammatory process worsens, antibacterial drugs are prescribed. For bronchial asthma or bronchitis with attacks of difficulty breathing, drugs that dilate the bronchi (theophyllines, berodual, salbutamol) are recommended. To facilitate the removal of sputum, mucolytics (ambrobene) are indicated.

Oxygen therapy for emphysema

To improve gas exchange at initial stage Oxygen therapy has been successfully used for diseases. This treatment method involves inhaling air with a reduced amount of oxygen for 5 minutes, then the patient breathes air with a normal oxygen content for the same time. The session includes six such cycles. Course of treatment: session 1 time per day for 15-20 days. If it is impossible to use the above technique, inhaling humidified oxygen through a nasal catheter will help alleviate the patient’s condition.

Massage for emphysema

Massage helps remove mucus and dilate the bronchi. Classic, segmental and acupressure massage is used. It is believed that acupressure has the most pronounced bronchodilator effect.

Physical therapy for emphysema

With emphysema, the respiratory muscles are in constant tone, so they get tired quickly. To prevent muscle strain good effect has physical therapy.

The following exercises are used:

Exercises with artificial creation of positive pressure during exhalation. The patient is asked to exhale deeply through a tube, one end of which is in a jar of water. The water barrier creates a lot of pressure when exhaling.
exercises for training diaphragmatic breathing. Starting position: standing, feet shoulder-width apart. The patient needs to do deep breath and as you exhale, stretch your arms in front of you and bend forward. During exhalation, you need to pull in your stomach. Starting position: lying on your back, hands on your stomach. As you exhale, press your hands on the front abdominal wall.
exercises to train the rhythm of breathing.
1. After a deep breath, hold your breath for a short time, then exhale the air in small bursts through pursed lips. At the same time, the cheeks should not puff up.
2. After a deep breath, hold your breath, then exhale with one sharp push through your open mouth. At the end of the exhalation, the lips must be folded into a tube.
3. Take a deep breath, hold your breath. Extend your arms forward, then clench your fingers into a fist. Bring your arms to your shoulders, slowly spread them to the sides, and return them to your shoulders again. Repeat this cycle 2-3 times, then exhale forcefully.
4. Count in your head. Inhale for 12 seconds, hold your breath for 48 seconds, exhale for 24 seconds. Repeat this cycle 2-3 times.

Possible complications of emphysema

Infectious complications. The development of pneumonia and lung abscesses is possible.
Respiratory failure. Associated with impaired exchange of oxygen and carbon dioxide in altered lungs.
Heart failure . With severe emphysema, blood pressure increases pulmonary artery. The right ventricle and right atrium enlarge compensatoryly. Over time, changes affect all parts of the heart. The pumping function of the heart suffers sharply.
Surgical complications. When a cavity ruptures near a large bronchus, a large volume of air may enter this cavity. A pneumothorax is formed. Damage to the wall between the two alveoli can lead to pulmonary hemorrhage.

Prognosis for emphysema

A complete cure for emphysema is impossible. A feature of the disease is its constant progression, even during treatment. If you apply in a timely manner medical care and compliance therapeutic measures The disease can be somewhat slowed down, the quality of life can be improved, and disability can be delayed. When emphysema develops against the background of a congenital defect of the enzyme system, the prognosis is usually unfavorable.

Prevention of emphysema

As preventive measures recommended:
to give up smoking;
observing personal hygiene rules when working with harmful gaseous substances.
timely treatment lung diseases (bronchitis, bronchial asthma), which can lead to the development of emphysema.

General practitioner Sirotkina E.V.

The topic of today's article is emphysema. You will learn what it is, as well as how to treat it with medications and folk remedies. Let's look at all the symptoms and causes. We will also talk about life prognosis, gymnastics, diagnosis and prevention of the disease. Reviews are also possible.

What is pulmonary emphysema?

is a disease that is a violation of lung ventilation and blood circulation. It lasts quite a long time. Very often a person with such a disease becomes disabled.

Signs of emphysema:

chest expansion
shortness of breath
expansion of intercostal spaces

ICD 10 code- J43.9.

Men are more susceptible to this disease. People over 60 years of age are also at risk. The risk of this problem also increases in those who have chronic obstructive diseases of the pulmonary system.

This disease is also dangerous due to complications that can lead to disability and death.

Classification of the disease

The classification of pulmonary emphysema is divided into several large sections.

By origin:

Primary - due to congenital abnormalities in organism. This type is very difficult to treat. It appears even in newborns.
Secondary - more light form diseases. It may occur unnoticed by the patient himself. However, advanced stages can greatly impact a person’s ability to work. Occurs due to chronic lung diseases.

According to the nature of the flow:

Acute - a very rapid change in the lungs as a result of extreme physical exertion or asthma.
Chronic - changes do not appear so quickly.

Due to the occurrence:

Laboratory - appears in newborns due to obstruction of one of the bronchi.
Senile - due to age-related changes in blood vessels and impaired elasticity of the walls of the alveoli.

By prevalence:

Focal - changes in the parenchyma appear around foci of tuberculosis, the site of bronchial blockage, scars.
Diffuse - tissue damage and destruction of the alveoli occurs throughout the lung tissue.

By anatomical features and relation to the acinus:

Bullous (bubbly) - large or small blisters appear where damaged alveoli are located. The blisters themselves can burst and become infected. Also, due to their large volume, neighboring tissues are subject to compression.
Centrilobular - the center of the acinus is damaged. A lot of mucus is released. Inflammation also appears due to the large lumen of the alveoli and bronchi.
Panacinar (hypertrophic, vesicular) is a severe form of emphysema. Inflammation does not appear. However, there is significant respiratory distress.
Interstitial (subcutaneous emphysema) - air bubbles appear due to rupture of the alveoli under the skin. Through the gaps between the tissues and the lymphatic pathways, these bubbles move under the skin of the neck and head.
Peri-scar - occurs near fibrous foci and scars in the lung. The disease occurs with minor symptoms.
Periacinar (distal, perilobular, parasepital) - occurs with tuberculosis. The extreme parts of the acinus near the pleura are affected.

Bullous emphysema

Bullous pulmonary emphysema is serious violation structures of the lung tissue with subsequent destruction of the interalveolar septa. In this case, a huge air cavity appears.

Bullous emphysema

This form of the disease occurs due to purulent and inflammatory processes in the lungs.

With single bullae (blisters), the disease is very difficult to diagnose. It cannot be seen even with a regular x-ray. It is detected only when there are a large number of bullae throughout the lung tissue.

The biggest danger of bullous emphysema is that there is a high risk of blisters bursting. As a rule, it occurs due to a strong cough or during heavy physical exertion.

When the bulla ruptures, air from the lungs enters pleural cavity. Thus, pneumothorax occurs. The accumulated air creates a lot of pressure on the lung.

If there is a large defect in the lung tissue, the lung will not be able to close. As a result, there is a continuous flow of air into the pleural cavity.

At the very critical level air begins to flow into subcutaneous tissue and mediastinum. As a result, respiratory failure and cardiac arrest may occur.

Causes

There are many causes of pulmonary emphysema. However, they can all be divided into two main types.

First type, includes what leads to disruption of the elasticity and strength of lung tissue. The main one from this category will be a violation of the system responsible for the formation of enzymes. In this case, the properties of the surfactant change and a lack of A1-antitrypsin appears in the body.

The presence of gaseous toxic substances in the inhaled air significantly affects the body. Frequent incidence of infectious diseases reduces the ability of the lungs to protect. Therefore, they are more quickly exposed to harmful effects.

Smoking is the main reason why emphysema can develop. Clubs tobacco smoke Inflamed cells accumulate in the lungs, from which substances are released that can destroy the partitions connecting the cells.

People who smoke are more vulnerable to the manifestation of this disease; emphysema in smokers has more complex forms.

Co. second type include factors that can cause an increase in pressure in the alveoli of the lungs. These include previous pulmonary diseases. For example, chronic obstructive bronchitis or bronchial asthma.

Since emphysema has two types, it can be primary or secondary.
All factors lead to the fact that the elastic tissue of the lungs is damaged and loses the ability to fill the lungs with air and release it.

The lungs become overfilled with air, causing the small bronchi to stick together when exhaling. Pulmonary ventilation is also impaired.

With emphysema, the lungs increase in size and take on the appearance of a large-pored sponge. If you examine emphysematous lung tissue using a microscope, you can observe the destruction of the alveolar septa.

Let's talk about the symptoms of emphysema. It is worth saying right away that this disease often has hidden initial forms. Therefore, a person may not even suspect that he is sick.

The presence of symptoms appears already at the stage of severe lung damage.

Usually, the appearance of shortness of breath observed at the age of 50-60 years. This symptom is initially noticed during execution physical work. And later it manifests itself even in a calm state.

During an attack of shortness of breath, the skin of the face becomes pinkish. Most often, the patient takes a sitting position and leans slightly forward. Constantly holding onto something in front of him.

Emphysema makes breathing difficult. When exhaling, various sounds are heard, since this process is very difficult for the patient.

Inhalation occurs without difficulty.

However, it is difficult to exhale. Therefore, it is often observed that the lips are folded into a tube to facilitate the exhalation process.

Since the appearance at moments of shortness of breath is characteristic, such patients are called “pink puffers.”

After the onset of symptoms of shortness of breath, after a certain time it is observed presence of cough which is not too long.

A clear sign that will indicate pulmonary emphysema will be significant weight loss. Indeed, in this case, the muscles become very tired, working exhaustingly to facilitate exhalation. If body weight has decreased, then this is an unfavorable sign of the course of the disease.

Patients also have expanded chest, having the shape of a cylinder. She seemed to freeze while inhaling. Its figurative name is barrel-shaped.

If you pay attention to the area above the collarbones, you will notice expansion here, and the spaces between the ribs seem to sink.

When examining the skin, a bluish tint is noted, and the fingers take on a shape resembling Drumsticks . Such available external changes characteristic in the presence of prolonged oxygen starvation.

Diagnosis of the disease

Respiratory function tests are of great importance in diagnosing pulmonary emphysema. To assess how narrowed the bronchi are, it is used peak flowmetry.

Peak flowmetry in the diagnosis of pulmonary emphysema

The patient should be at rest, inhale twice and exhale into the peak flow meter. He will record the degree of narrowing.

Obtaining this data will make it possible to determine whether a person really suffers from emphysema or whether he has bronchial asthma or bronchitis.

Spirometry determine how much the tidal volume of the lungs changes. This helps in identifying inadequate breathing.

Carrying out additional tests that use bronchodilators, makes it possible to say what kind of disease is present in the lungs. In addition, the effectiveness of treatment can be assessed.

At x-ray, it is possible to identify the presence of dilated cavities that are located in different pulmonary sections. You can also determine increased lung capacity. After all, in this case the dome of the diaphragm moves, and it becomes denser.

Carrying out computed tomography will make it possible to diagnose the presence of cavities in the lungs, which will also be more airy.

Now let's look at the main methods of treating pulmonary emphysema. It is worth saying that everything healing procedures should be aimed at facilitating the respiratory process. In addition, it is necessary to eliminate the disease whose action led to the development of this problem.

Surgical treatment of emphysema

Treatment procedures are mainly carried out on an outpatient basis. But there should be an opportunity to be observed by doctors such as pulmonologist or therapist.

Lifelong use of bronchodilators, in the form of inhalations or tablets, is recommended. If there is cardiac and respiratory failure, then oxygen therapy is carried out, after which diuretics are taken. Breathing exercises are also recommended.

If a person is diagnosed with an infection, he is hospitalized in the hospital. He may also be hospitalized if respiratory failure is severe or if any surgical complications arise.

Emphysema can also be treated surgically.

An operation is performed in which the volume of the lungs is reduced. The technique involves eliminating damaged areas of lung tissue, which leads to a decrease in pressure on the remaining part. After this procedure, the patient's condition improves significantly.

Emphysema - treatment with folk remedies

If you have emphysema, you should not miss out on treatment with folk remedies.

Treatment of emphysema with folk remedies

Here are some methods:

Phytotherapy. Some plants have expectorant and bronchodilator properties. For emphysema, they are used to prepare infusions and decoctions, which are later taken orally. Such plants include: licorice, caraway, fennel, thyme, lemon balm, eucalyptus, anise, sage and many others.
Potato. Carrying out hot inhalations over boiled potatoes helps cough up and relaxes the bronchial muscles.
Aromatherapy. The air is saturated with medicinal components essential oils dill, oregano, wormwood, chamomile, thyme, sage and others. For spraying, you can use a diffuser or aroma maker (5 - 8 drops of ether per 15 square meters of room). This helps in improving the patient's condition. You can also apply a few drops of these oils to your feet, palms and chest. In 1 tbsp. l. Add 2-3 drops of vegetable oil or a mixture of several drops.

If a person has emphysema, he should periodically visit a pulmonologist. Folk remedies are used only as a supplement to the main methods of treatment. You should not use only them, as they will not bring the desired effect.

Use of oxygen therapy

To improve gas exchange at the very beginning of the disease, oxygen therapy is prescribed. During this technique, the patient inhales air with a reduced amount of oxygen for 5 minutes.

Oxygen therapy

Treatment is carried out once every day. The course is 15-20 days.

If this method is not possible, then a nasal catheter is inserted into the patient. It is through this that oxygen is supplied to alleviate the patient’s condition.

Breathing exercises for emphysema

A good one also helps a lot breathing exercises with emphysema.

Breathing exercises for emphysema

Here are some exercises:

You should inhale and hold your breath. Next, exhale sharply using the mouth opening. At the very end of exhalation, change the position of the lips to a tube.
Also hold your breath. Next, exhale using small bursts, folding your lips in the form of a tube.
Breathe in and don't exhale. Extending your arms and clenching your fingers into fists, move them to your shoulders, then stretch them to the sides and lower them back to your shoulders. Thus, do this a couple of times, and then exhale strongly.
Inhale for 12 seconds, hold your breath for 48 seconds. and exhale for 24 s. Repeat this three times.

Drug treatment

If there is an exacerbation of the inflammation process, then drugs with an antibacterial effect may be prescribed.

Treatment of bronchial asthma or bronchitis occurs with drugs that dilate the bronchi. To facilitate the removal of mucus, mucolytic drugs should be taken.

Diet for emphysema

The diet for pulmonary emphysema should be balanced. It should contain many vitamin components and microelements. The diet must necessarily consist of vegetable and fruit dishes. In addition, these products should be consumed raw.

Also, the main rule is to avoid nicotine. It's better to quit smoking right away. That is, do not stretch it out for a long cessation. In addition, you should not be in a room where other people smoke.

Application of massage

The use of classical, segmental and acupressure techniques leads to the fact that the sputum leaves faster and the bronchi expand.

In this case, preference is often given to acupressure massage, since it is more effective.

Therapeutic exercises for emphysema

Pulmonary emphysema is accompanied by the muscles always being in tension, which leads to their fatigue. To prevent muscles from becoming overstrained, you should do therapeutic exercises.

Here are some exercises:

For example, exercises that create positive pressure as you exhale. To do this, take a tube. One end of it is placed in water. The second person takes it into his mouth and slowly exhales through it. An obstacle in the form of water puts pressure on the exhaled air.
To train your diaphragm, you need to stand up and take a deep breath. As you exhale, point your arms forward and bend. When exhaling, the stomach should be pulled up.
Another task: lie on the floor, put your hands on your stomach. When exhaling, press on the peritoneum.

Complications of the disease

This disease sometimes leads to various complications. Among them:

Infectious complications. Pneumonia often develops, and lung abscesses occur.
Inadequate breathing. Because there is a disruption in the exchange process between oxygen and carbon dioxide in the lungs.
Heart failure. IN severe course disease, there is an increase in pulmonary pressure. In this regard, there is an increase in the right ventricle and atrium. All parts of the heart gradually change. Therefore, there is a disruption in the blood supply to the heart.
Surgical complications. If the cavity, which is located near a large bronchus, ruptures, then air can enter it. Pneumothorax forms. If the septum between the alveoli is damaged, bleeding will occur.

Emphysema - life prognosis

What is the prognosis for life with emphysema? It is impossible to say exactly how long they live. It all depends on the nature of the disease and its treatment.

However, it should be said right away that it is impossible to completely recover from this disease. The peculiarity of the disease is its constant progression. Even if treatment is being carried out.

If you seek help in time medical institution and follow all the procedures, then the disease is slowed down a little. The condition improves, and disability is postponed.

If emphysema developed due to the fact that there was a defect in the congenital enzyme system, then no one can give a positive prognosis.

Favorable outcome factors:

Detection of the disease at an early stage
The disease passes in a moderate form
The patient strictly follows the diet prescribed by doctors
Complete smoking cessation

Prevention of emphysema

To prevent emphysema, you should do the following:

Stop consuming tobacco products.
Treat in a timely manner pulmonary diseases to prevent the development of the disease.
Leading a healthy lifestyle helps to improve the condition and maintain the body in healthy shape. Exercising, doing breathing exercises, walking in the fresh air, going to the bathhouse - all this helps normal functioning bronchi and lungs.
In order for your lungs to be healthy, you need to be in the forest more often, inhaling the healing aromas of pine needles. Sea air is also beneficial. Such places help open the lungs and saturate the blood with oxygen.
Watch your diet. It must contain fresh fruits. There should also be foods with a high amount of vitamin elements and nutrients.

Conclusion

And with this we finish talking about pulmonary emphysema. Now you know what it is and how to treat it. We looked at the main symptoms and causes. We also touched a little on the life prognosis of this disease. In the future, there may be reviews on this disease below.

Emphysema occurs when the alveoli of the lung tissue stretch beyond acceptable limits and lose the ability to contract back. This disrupts the normal flow of oxygen into the blood and the removal of carbon dioxide from the body, which leads to heart failure.

In accordance with modern classification diffuse and bullous pulmonary emphysema are distinguished. The first form assumes complete defeat fabrics. Bullous emphysema is diagnosed when swollen (widened) areas are adjacent to normal lung tissue.

Causes of emphysema

The disease often manifests itself as a consequence chronic bronchitis or bronchial asthma. The bullous form can also occur under the influence of hereditary factors and certain lung diseases, in particular tuberculosis. In addition, the development of the disease is influenced by factors such as smoking and excessive air pollution, which is especially typical for large cities.

Emphysema - symptoms

Severe shortness of breath up to suffocation, widening of the intercostal spaces, barrel-shaped chest, weakened breathing, decreased mobility of the diaphragm, increased transparency of the pulmonary fields with x-ray examination- these are the symptoms of pulmonary emphysema. Treatment of the disease depends on the severity of the symptoms and clinical picture.

The primary stage of development of pulmonary emphysema is characterized by: severe shortness of breath, rapid fatigue during any physical activity, the effect of the so-called “puffing”, disturbance of the blood gas composition and collapse of the small bronchi.

As the condition of the lung tissue deteriorates, the transparency of the lung fields increases, the diaphragm shifts and other changes interfere with normal gas exchange.

Emphysema - treatment and prognosis

In the treatment of pulmonary emphysema, the main measures are aimed at eliminating respiratory failure and treating the disease under the influence of which a person developed the disease. Treatment with folk remedies shows enough effective results However, we under no circumstances recommend abandoning traditional medicinal methods.

Basic principles of treatment of emphysema:

quitting smoking is one of the most important stages on the road to recovery. Let us note that a sharp, immediate reduction in the number of cigarettes smoked has a much greater effect than a gradual cessation of tobacco;
appointment antibacterial drugs– main medicines are anticholinergics (Berodual, Atrovent), beta-2 sympathomimetics (Berotec, Salbutamol) and theophyllines (Euphylline, Teopec). The choice of drug and the intensity of therapy depend on the severity of the symptoms that emphysema manifests itself. Treatment with antibacterial complexes is combined with the use of expectorants;
breathing exercises to improve gas exchange. As a rule, patients are prescribed ambient air with a reduced oxygen content for 5 minutes. The patient breathes normal air for the next 5 minutes. The cyclic pattern is repeated 6-7 times during 1 session. The full course of treatment lasts about 3 weeks;
Pulmonary emphysema, the symptoms of which are associated with severe respiratory failure, is treated with low-flow oxygen therapy. It can also be used at home, using compressed gas cylinders or special concentrators as oxygen sources;
V last years Doctors actively use aeroion therapy, which shows good results in eliminating respiratory failure. The course of treatment lasts 15-20 days;
Special breathing exercises and training programs aimed at enabling a person to control his breathing are also effective;
For better sputum removal, positional drainage is used - the patient takes a certain position in which the cough reflex and viscous sputum cause the least inconvenience. In this case, you can combine drainage treatment of emphysema with the use of expectorant herbs and infusions, for example, thermopsis, wild rosemary, plantain or coltsfoot.

Is there a permanent cure for emphysema? Forecasts are individual in each specific case and depend on how fully patients follow all the recommendations of the attending physician, and whether they are willing to make certain sacrifices for the sake of their health. Also, timely detection and adequate treatment of the disease that led to emphysema has a huge impact on the treatment process.

Emphysema - treatment with folk remedies

Home remedies:

drink green potato tops juice with a daily increase in dose until the volume of juice reaches half a glass;
inhalation of jacket potato vapors;
applying pieces of pre-boiled potatoes to the chest.

Herbal infusions:

Add three tablespoons of buckwheat flowers to 500 ml of boiling water. Infuse the mixture in a thermos for two hours. Take half a glass 3-4 times a day;
Take one part each of juniper fruit and dandelion root, add two parts of birch leaf to them and pour boiling water over the resulting mixture. The broth is infused for three hours, after which it is filtered and poured into a suitable container. The infusion should be consumed 2-3 times a day. Standard dosage – 1/3 cup;
a teaspoon of potatoes is poured into a glass of boiling water, left for one hour and filtered. Take half a glass of infusion 40 minutes before meals for one month.

Video from YouTube on the topic of the article:

According to WHO, up to 4% of the population, mainly older men, suffer from emphysema (emphysao - “to swell”), a pathological increase in lung volume. There are acute and chronic forms of pathology, as well as vicarious (focal, local) and diffuse emphysema. The disease occurs with disturbances in pulmonary ventilation and blood circulation in the respiratory organs. Let's take a closer look at why emphysema occurs, what it is and how to treat it.

What is pulmonary emphysema?

Pulmonary emphysema (from the Greek emphysema - bloating) is a pathological change in the lung tissue, characterized by increased airiness due to expansion of the alveoli and destruction of the alveolar walls.

Pulmonary emphysema is a pathological condition that often develops in a wide variety of bronchopulmonary processes and is of extremely great importance in pulmonology. The risk of developing the disease in some categories is higher than in other people:

Congenital forms of pulmonary emphysema associated with whey protein deficiency are more often detected in residents of Northern Europe.
Men get sick more often. Emphysema is detected at autopsy in 60% of men and 30% of women.
People who smoke have a 15 times higher risk of developing emphysema. Passive smoking also dangerous.

Without treatment, changes in the lungs due to emphysema can lead to loss of ability to work and disability.

Causes leading to the development of emphysema

The likelihood of developing emphysema increases if the following factors are present:

congenital deficiency of α-1 antitrypsin, leading to destruction of alveolar lung tissue by proteolytic enzymes;
inhalation of tobacco smoke, toxic substances and pollutants;
microcirculation disorders in lung tissues;
bronchial asthma and chronic obstructive pulmonary diseases;
inflammatory processes in the respiratory bronchi and alveoli;
features professional activity related to constant increase air pressure in the bronchi and alveolar tissue.

Under the influence of these factors, damage to the elastic tissue of the lungs occurs, reduction and loss of its ability to fill and collapse.

Emphysema can be considered as an occupationally caused pathology. It is often diagnosed in individuals who inhale various aerosols. In the role etiological factor may be a pneumonectomy (removal of one lung) or trauma. In children, the reason may lie in frequent inflammatory diseases lung tissue (pneumonia).

The mechanism of lung damage in emphysema:

Stretching of bronchioles and alveoli - their size doubles.
Smooth muscles are stretched, and the walls of blood vessels become thinner. The capillaries become empty and the nutrition in the acinus is disrupted.
Elastic fibers degenerate. In this case, the walls between the alveoli are destroyed and cavities are formed.
The area in which gas exchange occurs between air and blood decreases. The body experiences oxygen deficiency.
The enlarged areas compress healthy lung tissue, further impairing the ventilation function of the lungs. Shortness of breath and other symptoms of emphysema appear.
To compensate and improve the respiratory function of the lungs, the respiratory muscles are actively involved.
The load on the pulmonary circulation increases - the vessels of the lungs become overfilled with blood. This causes disturbances in the functioning of the right side of the heart.

Types of disease

Highlight the following types emphysema:

Alveolar - caused by an increase in the volume of the alveoli;
Interstitial - develops as a result of the penetration of air particles into the interlobular connective tissue - interstitium;
Idiopathic or primary emphysema occurs without previous respiratory diseases;
Obstructive or secondary emphysema is a complication of chronic obstructive bronchitis.

According to the nature of the flow:

Spicy. It can be caused by significant exercise stress, attack of bronchial asthma, entry of a foreign object into the bronchial network. There is swelling of the lung and overstretching of the alveoli. The condition of acute emphysema is reversible, but requires emergency treatment.
Chronic emphysema. Changes in the lungs occur gradually; at an early stage, a complete cure can be achieved. Without treatment it leads to disability.

According to anatomical features, they are distinguished:

Panacinar (vesicular, hypertrophic) form. Diagnosed in patients with severe emphysema. There is no inflammation, there is respiratory failure.
Centrilobular form. Due to the expansion of the lumen of the bronchi and alveoli, an inflammatory process develops, and mucus is released in large quantities.
Periacinar (parasepital, distal, perilobular) form. Develops with tuberculosis. It may result in a complication - rupture of the affected area of the lung (pneumothorax).
Peri-scar form. It is characterized by minor symptoms and appears near fibrotic foci and scars in the lungs.
Interstitial (subcutaneous) form. Due to the rupture of the alveoli, air bubbles form under the skin.
Bullous (bubble) form. Bullae (bubbles) with a diameter of 0.5-20 cm are formed near the pleura or throughout the parenchyma. They arise at the site of damaged alveoli. They can rupture, become infected, and put pressure on surrounding tissues. Bullous emphysema usually develops as a result of loss of tissue elasticity. Treatment of emphysema begins with eliminating the causes that provoke the disease.

Symptoms of emphysema

The symptoms of emphysema are numerous. Most of them are not specific and can be observed in other pathologies respiratory system. Subjective signs of emphysema include:

nonproductive cough;
expiratory shortness of breath;
the appearance of dry wheezing;
feeling of lack of air;
weight loss
a person experiences a strong and sudden pain syndrome in one of the halves of the chest or behind the sternum;
Tachycardia is observed when the rhythm of the heart muscle is disrupted due to lack of air.

Patients with pulmonary emphysema mainly complain of shortness of breath and cough. Shortness of breath, gradually increasing, reflects the degree of respiratory failure. At first it occurs only during physical exertion, then it appears while walking, especially in cold, damp weather, and sharply intensifies after coughing attacks - the patient cannot “catch his breath.” Shortness of breath with emphysema is inconsistent, changeable (“it doesn’t happen from day to day”) - stronger today, weaker tomorrow.

Noteworthy is the bluish color of the skin and mucous membranes, as well as the characteristic change in the fingers like drumsticks.

In people with chronic long-term emphysema of the lung External signs of the disease develop:

short neck;
anteroposteriorly expanded (barrel-shaped) chest;
the supraclavicular fossae protrude;
on inhalation, the intercostal spaces are retracted due to tension in the respiratory muscles;
the abdomen is somewhat saggy as a result of the prolapse of the diaphragm.

Complications

A lack of oxygen in the blood and an unproductive increase in lung volume affect the entire body, but above all, the heart and nervous system.

The increased load on the heart is also a compensation reaction - the body’s desire to pump more blood due to tissue hypoxia.
Arrhythmias, acquired heart defects, and coronary artery disease may occur—a symptom complex known collectively as “cardiopulmonary failure.”
In the extreme stages of the disease, lack of oxygen causes damage to nerve cells in the brain, which is manifested by decreased intelligence, sleep disturbances, and mental pathologies.

Diagnosis of the disease

At the first symptoms or suspicion of emphysema patient's lung examined by a pulmonologist or therapist. It is difficult to determine the presence of emphysema in the early stages. Often, patients consult a doctor when the process is already advanced.

Diagnostics includes:

blood test to diagnose emphysema
detailed patient interview;
inspection skin and chest;
percussion and auscultation of the lungs;
determination of the boundaries of the heart;
spirometry;
plain radiography;
CT or MRI;
assessment of blood gas composition.

X-ray examination of the chest organs is of great importance for the diagnosis of pulmonary emphysema. At the same time, dilated cavities are detected in various parts of the lungs. In addition, an increase in lung volume is determined, indirect evidence of which is the low location of the dome of the diaphragm and its flattening. Computed tomography also allows you to diagnose cavities in the lungs, as well as their increased airiness.

How to treat emphysema

There are no specific treatment programs for pulmonary emphysema, and those carried out do not differ significantly from those recommended in the group of patients with chronic obstructive respiratory diseases.

In the treatment program for patients with pulmonary emphysema, the first place should be given to general events, increasing the quality of life of patients.

Treatment of pulmonary emphysema has the following objectives:

elimination of the main symptoms of the disease;
improvement of heart function;
improving bronchial patency;
ensuring normal blood oxygen saturation.

For relax acute conditions use drug therapy:

Eufillin to relieve an attack of shortness of breath. The drug is administered intravenously and relieves shortness of breath within a few minutes.
Prednisolone as a strong anti-inflammatory agent.
For mild or moderate respiratory failure, oxygen inhalation is used. However, here it is necessary to carefully select the oxygen concentration, because this can be both beneficial and harmful.

For all patients with emphysema, physical programs are indicated, especially chest massage, breathing exercises and teaching the patient kinesitherapy.

Is hospitalization necessary to treat emphysema? In most cases, patients with emphysema are treated at home. It is enough to take medications according to the schedule, adhere to a diet and follow the doctor’s recommendations.

Indications for hospitalization:

sharp increase in symptoms (shortness of breath at rest, severe weakness)
the appearance of new signs of illness (cyanosis, hemoptysis)
ineffectiveness of the prescribed treatment (symptoms do not decrease, peak flow measurements worsen)
severe concomitant diseases
newly developed arrhythmias; difficulties in establishing a diagnosis.

Emphysema has a favorable prognosis if the following conditions are met:

Prevention of pulmonary infections;
Refusal bad habits(smoking);
Providing balanced nutrition;
Living in a clean air environment;
Sensitivity to medications from the group of bronchodilators.

Breathing exercises

When treating emphysema, it is recommended to regularly conduct various breathing exercises in order to improve the exchange of oxygen in the lung cavity. The patient should do this for 10-15 minutes. inhale the air deeply, then try to hold it as long as possible while exhaling with gradual exhalation. This procedure It is recommended to carry out daily, at least 3 - 4 r. per day, in small sessions.

Massage for emphysema

Massage helps remove mucus and dilate the bronchi. Classic, segmental and acupressure massage is used. It is believed that acupressure has the most pronounced bronchodilator effect. The purpose of massage:

prevent further development of the process;
normalize respiratory function;
reduce (eliminate) tissue hypoxia, cough;
improve local ventilation, metabolism and sleep of the patient.

Exercise therapy

With emphysema, the respiratory muscles are in constant tone, so they get tired quickly. To prevent muscle overstrain, physical therapy has a good effect.

Oxygen inhalations

A long procedure (up to 18 hours in a row) of breathing through an oxygen mask. In severe cases, oxygen-helium mixtures are used.

Surgical treatment of emphysema

Surgical treatment for emphysema is not often required. It is necessary when the lesions are significant and drug treatment does not reduce the symptoms of the disease. Indications for surgery:

Multiple bullae (more than a third of the chest area);
Severe shortness of breath;
Complications of the disease: oncological process, bloody sputum, infection.
Frequent hospitalizations;
Transition of the disease to a severe form.

Severe exhaustion may be a contraindication to surgery. old age, chest deformation, asthma, pneumonia, in severe form.

Nutrition

Compliance with rational food intake in the treatment of emphysema plays a fairly important role. It is recommended to eat as many fresh fruits and vegetables as possible, which contain a large number of vitamins and microelements beneficial to the body. Patients need to adhere to the consumption of low-calorie foods so as not to provoke a significant burden on the functioning of the respiratory system.

The daily calorie intake should not exceed more than 800 - 1000 kcal.

WITH daily diet Fried and fatty foods that negatively affect the functioning of internal organs and systems should be excluded. It is recommended to increase the volume of fluid consumed to 1-1.5 liters. in a day.

In any case, you cannot treat the disease yourself. If you suspect that you or your relative have emphysema, you should immediately contact a specialist for timely diagnosis and initiation of treatment.

Life prognosis with emphysema

A complete cure for emphysema is impossible. A feature of the disease is its constant progression, even during treatment. With timely seeking medical help and compliance with treatment measures, the disease can be somewhat slowed down, the quality of life can be improved, and disability can also be delayed. When emphysema develops against the background of a congenital defect of the enzyme system, the prognosis is usually unfavorable.

Even if the patient is given the most unfavorable prognosis due to the severity of the disease, he will still be able to live at least 12 months from the date of diagnosis.

The length of time a patient survives after diagnosis of the disease is largely influenced by the following factors:

General condition of the patient's body.
The emergence and development of such systemic ailments, such as bronchial asthma, chronic bronchitis, tuberculosis.
How the patient lives plays a big role. Does he lead an active lifestyle or does he have little mobility? He follows the system rational nutrition or eats food haphazardly.
The age of the patient plays an important role: young people live longer after diagnosis than older people with the same severity of the disease.
If the disease has genetic roots, then the prognosis of life expectancy with emphysema is determined by heredity.

Despite the fact that pulmonary emphysema occurs irreversible processes, the quality of life of patients can be improved by constantly using inhaled drugs.

Prevention

Anti-tobacco programs aimed at preventing children and adolescents from smoking, as well as stopping smoking in people of any age, are of great preventive importance.
It is also necessary to treat lung diseases in time so that they do not become chronic.
It is important to monitor patients with chronic respiratory diseases with a pulmonologist, administer vaccines to the population, etc.

Emphysema– damage to the alveolar vesicles of the lungs, associated with their overextension and loss of plasticity. Due to the inability of the alveoli to contract, the interalveolar septa rupture and air cavities form in the lungs.
This disease has a chronic course and is characterized by expansion of the alveolar cavities. The processes occurring in the affected tissues can be briefly described as a combination of anemia, hyperextension and atrophy. The alveoli expand, the walls become thinner and rupture. In the bullous form, cavities are formed in the lungs, which in severe cases reach 5-6 centimeters in diameter. The cavities are most often located along the edge of the lung. The surface of the lung is significantly reduced, air enters the blood in smaller quantities. The patient develops hypoxia.

In contact with

At-risk groups

Medical statistics say that emphysema is 3 times more common among men than among women. The disease mostly affects older people (over 60 years of age).

Prevalence is high among people in occupations associated with inhalation harmful substances: coal dust, small particles of asbestos, toxic fumes from some paints. Smoking significantly complicates the picture and can be an independent cause of the disease.

Scheme of development of emphysema in a smoker

Causes

Emphysema can be either congenital (associated with genetic mutations) or acquired. The main prerequisites are:

Congenital anomalies of lung development;
long-term smoking;
significant air pollution;
removal of one of the lung lobes.

Doctors combine the diseases that cause emphysema into one group called .

How does emphysema occur?

Under the influence of disease or harmful factors, the alveolar structure changes and excess air is retained during exhalation. The volume of inhaled air decreases and oxygen enters the blood in small quantities. Volume increases connective tissue, which does not have the necessary elasticity, which makes it even more difficult for the lungs to contract correctly. The patient makes more frequent breathing movements, trying to get rid of the feeling of suffocation. The lungs are increased in volume compared to healthy ones, put pressure on the chest from the inside and form a barrel-shaped chest over time.

Kinds

Interaction with other diseases:

Primary emphysema (idiopathic) – manifests itself as an independent disease;
secondary(obstructive) – resulting from complications of pulmonary diseases.

Depending on the type of lesion:

Diffuse;
bullous(focal) form pulmonary emphysema;
vicar Emphysema is an increase in the volume of one lung to compensate for respiratory function when the second is damaged. With this disease, gas exchange in the lung does not decrease, but increases.

Symptoms of pulmonary emphysema

The chronic form develops after the patient has suffered acute emphysema, often during the course of the disease obstructive bronchitis. The acute course of the disease is characterized by:

Strong dyspnea with wheezing at rest;
panting when breathing;
sharp squeezing chest pain;
fast fatiguability even with little physical activity;
sudden movements of the chest when inhaling(inhalation – short, exhalation – extended);
tachycardia(compensatory increase in cardiac activity);
cyanosis(blue discoloration of mucous membranes, eyelids, nail holes).

At chronic form clinical picture determined by the following characteristics:

Dyspnea with little physical activity;
the chest takes on a barrel shape;
bulging of the clavicular region;
the exhalation phase is further lengthened and is carried out in two stages;

After surgery and adequate treatment symptoms acute form are decreasing. In case of chronic course pathological changes lung tissue are irreversible.

Diagnostics

The diagnosis is made after collecting the necessary medical history and accompanying clinical signs.

The following studies are prescribed:

Inspection, percussion, listening to the chest;
tomography pulmonary region;
x-ray chest;
pulmonary volume measurement;
general blood analysis;
blood gas analysis.

Necessarily:

X-ray examination: the size of the pulmonary lumen and the nature of the bronchial pattern are determined;
blood analysis– often reveals an increase in the specific number of red blood cells (compensatory phenomenon).

Differential diagnosis

To make an accurate diagnosis it is necessary to exclude:

vicarious emphysema.

Treatment

The patient needs complete rest and bed rest. Smoking cessation is mandatory; the greatest results will come from a complete, immediate cessation of cigarettes, rather than a gradual reduction in the amount smoked.

To prevent bronchitis, which can be fatal if the lungs are affected, patients are recommended to be in an environment with clean air and a mild climate. The air in the room where the patient is located is humidified.

At acute course are appointed:

Inhalations, oxygen chamber;
special breathing exercises, alleviating the patient's condition. Gymnastics trains the muscles involved in the breathing process, which contributes to more active saturation of the blood with oxygen. If an attack of illness is caused by bronchitis or asthma, it is important to first cure the disease that provokes the appearance of emphysema.
drugs are prescribed, stopping inflammatory processes- This antimicrobials(Atrovent, salbutamol, etc.). These medications are prescribed in combination with expectorants.

For bullous form use:

Surgical intervention (bulla removal). The operation is performed by opening the chest or using an endoscope through an incision. This operation is performed if the patient is at risk of pneumothorax.

Has the doctor diagnosed your baby with bronchitis? Read!

Does your child's runny nose persist for a long time? It's a dull pain in the sinuses and elevated temperature indicates sinusitis - about ways to prevent and treat this disease!

Chronic form of pulmonary emphysema not amenable to conservative treatment, however modern medicine offers surgical lung transplantation. To ease the well-being of a chronic patient, moderate breathing exercises are suitable ( diaphragmatic breathing, inflating balloons and other techniques).

Alternative treatment for emphysema

Exist folk remedies, which help in the fight against pulmonary emphysema. This is the use of herbs in the form of inhalations and infusions.

Potato color– pour a glass of boiling water and leave for 2-3 hours. Drink half a glass of infusion three times a day before meals;
teaspoon wild rosemary– brew 500 ml of boiling water. Do inhalations over a hot infusion;
3 tablespoons buckwheat flowers brew 500 ml hot water. Take half a glass three times a day;
Squeeze juice from green potato tops and take once a day, starting with a tablespoon, gradually increase a single dose to 100 ml.

Remember that the methods traditional medicine will be effective only in combination with timely medical care.

Prevention

First and main preventative measure against pulmonary emphysema - quit smoking. Healthy image life, moderate hardening, adherence to a daily routine will strengthen the body’s defenses.

Forecast

To determine the severity of the disease, you need to pay attention not only to the general condition of the patient, which may improve after recovery from bronchitis, but also to indicators of cardiac activity and working volume of the lungs. The prognosis is very poor when cardiac symptoms appear and pulmonary volumes decrease.

If you have the slightest complaint of difficulty breathing, especially with a complicated pulmonary history, you should see a doctor right away. The disease is easier to stop in the early stages of development, and its development can lead to disability and death.