Emphysema of the lungs causes symptoms and treatment. Emphysema of the lungs: what is it, symptoms, treatment, causes, gymnastics. Complications of pulmonary emphysema

Emphysema of the lungs is a disease that occurs with the development of increased airiness of the lung tissue. Emphysema of the lungs is characterized by a long course and very often leads to disability. Women get sick half as often as men. In age groups over 60, pulmonary emphysema is more common than in young people.

Causes of pulmonary emphysema

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

It is impossible not to mention smoking, which is one of the main causes of the development of emphysema. Tobacco smoke promotes the buildup of inflammatory cells in the lung tissue, which in turn release substances that destroy the septa between the lung cells. In smokers, emphysema of the lungs 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 of respiratory failure on the background of long-term smoking, are impressive. She said: "If someone from those who still smokes could live in my body for a couple of minutes, he would never take a cigarette in his mouth."

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

The second group includes factors under the influence of which the pressure in the pulmonary alveoli increases. 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, the second group - secondary.

Symptoms of pulmonary 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 the lung tissue is the acinus.

The acinus consists of alveoli - lung cells, the wall of which is closely adjacent to the blood capillaries. This is where the exchange of oxygen and carbon dioxide takes place. Between adjacent alveoli there is a surfactant - a special fatty film that prevents friction. Normally, the alveoli are elastic, expanding and collapsing in accordance with the phases of respiration. Under the influence of pathological factors in primary emphysema, the elasticity of the alveoli decreases, and in secondary emphysema, the pressure in the alveoli increases and the accumulation of excess air occurs. The wall between adjacent alveoli collapses, a single cavity is formed.

Diagram of the structure of the alveoli in pulmonary emphysema. The upper figure shows the alveoli in emphysema. Below are the normal alveoli.

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

The disease develops imperceptibly for 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 exertion, then it begins to bother and at rest. The appearance of the patient at the time of an attack of shortness of breath is characteristic. The skin of the face turns pink. The patient, as a rule, sits, leaning forward, often holding on to the back of the chair in front of him. Exhalation with emphysema is long, noisy, the patient folds his lips with a tube, trying to make breathing easier. When inhaling, patients do not experience difficulty, exhalation is very difficult. Because of the characteristic appearance during an attack of shortness of breath, patients with pulmonary emphysema are sometimes called "pink puffers."

"Pink puffer" - a typical appearance of the patient with an attack of shortness of breath.

Cough usually occurs some time after the onset of shortness of breath, which distinguishes pulmonary emphysema from bronchitis. The cough is not prolonged, the sputum is scanty, mucous, transparent.

Weight loss is a characteristic feature of pulmonary emphysema. This is due to fatigue of the respiratory muscles, which work at full strength to facilitate exhalation. A pronounced 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, as if frozen on inspiration, the chest. Often it is figuratively called barrel-shaped.

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

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

These external signs indicate prolonged oxygen starvation.

Diagnosis of pulmonary emphysema

In the diagnosis of pulmonary emphysema, the study of respiratory function has an important role. To assess the degree of narrowing of the bronchi, peak flowmetry is used. In a calm state, after a couple of breaths, an exhalation is made into a special recording device - peakfluometer.

The data obtained during peak fluometry allow the differentiation of pulmonary emphysema from bronchial asthma and bronchitis. Spirometry helps to determine the change in the respiratory volume of the lungs and to identify the degree of respiratory failure. The data is recorded at the moment of calm breathing, then the doctor asks to perform several forced inhalation and exhalation. Tests using bronchodilator drugs can also distinguish between different lung diseases and evaluate the effectiveness of treatment.

X-ray examination of the chest organs is of great importance for the diagnosis of pulmonary emphysema. At the same time, dilated cavities are revealed in various parts of the lungs. In addition, an increase in lung volume is determined, indirect evidence of which is the low position 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.

Pulmonary emphysema treatment

All therapeutic measures for emphysema should be aimed at alleviating the manifestations 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 when an infection is attached, a severe form of respiratory failure, as well as when surgical complications occur (pulmonary hemorrhage with a ruptured cavity, pneumothorax).

Diet and lifestyle correction for pulmonary emphysema

Patients with pulmonary emphysema are recommended a balanced diet with a sufficient content of vitamins and minerals. The diet should constantly contain raw fruits and vegetables, as well as juices and purees from them. In severe respiratory distress, consuming a lot 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 essential. One-time smoking cessation has the best effect compared to gradual cessation. At the present time, there is a large arsenal of medical products (chewing gums, plasters) that can help a patient in this difficult matter.

Medication for pulmonary emphysema

With an exacerbation of the inflammatory process, antibacterial drugs are prescribed. In case of bronchial asthma or bronchitis with attacks of difficulty in breathing, drugs that dilate the bronchi (theophylline, berodual, salbutamol) are recommended. To facilitate the excretion of sputum, mucolytics (ambrobene) are indicated.

Oxygen therapy for pulmonary emphysema

To improve gas exchange at the initial stage of the disease, oxygen therapy is successfully used. This method of treatment consists in 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. Treatment course: 1 session a day for 15-20 days. If it is impossible to apply the above technique, inhalation of humidified oxygen through a nasal catheter will help to alleviate the patient's condition.

Massage for pulmonary emphysema

The massage promotes the discharge of phlegm and the expansion of the bronchi. Classic, segmental and acupressure massage is used. It is believed that acupressure has the most pronounced bronchodilatory effect.

Physiotherapy exercises for pulmonary emphysema

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

The following exercises apply:

Exercises with artificial creation of positive pressure on the exhale. The patient is asked to carry out a deep, long exhalation through a tube, one end of which is in a jar of water. The water barrier creates a lot of pressure when you exhale.
exercises for training diaphragmatic breathing. Starting position: standing, feet shoulder-width apart. The patient needs to take a deep breath and, while exhaling, stretch out his arms in front of him and lean forward. During exhalation, it is necessary to draw in the stomach. Starting position: lying on your back, hands on your stomach. On exhalation, hands press on the anterior abdominal wall.
exercises for training the rhythm of breathing.
1. After a deep breath, hold your breath for a short time, then exhale the air in small jerks through the lips folded into a tube. In this case, the cheeks should not puff up.
2. After a deep breath we hold our breath, then exhale with one sharp push through our open mouth. At the end of exhalation, the lips must be folded into a tube.
3. Take a deep breath, hold your breath. Stretch your arms forward, then clench your fingers into a fist. Bring your arms to your shoulders, slowly spread apart, and again return to your shoulders. Repeat this cycle 2-3 times, then exhale with force.
4. We count in the mind. Inhale for 12 seconds, hold the breath for 48 seconds, exhale for 24 seconds. Repeat this cycle 2-3 times.

Possible complications of pulmonary emphysema

Infectious complication. Development of pneumonia, lung abscesses is possible.
Respiratory failure. It is associated with a violation of the exchange of oxygen and carbon dioxide in the changed lungs.
Heart failure . In severe emphysema, the pressure in the pulmonary artery rises. The right ventricle and the right atrium are enlarged compensatory. Over time, changes affect all parts of the heart. The pumping function of the heart suffers sharply.
Surgical complications. When a cavity is ruptured next to a large bronchus, a large volume of air can enter this cavity. Formed pneumatorox. Damage to the wall between the two alveoli can lead to pulmonary hemorrhage.

Prognosis for pulmonary emphysema

A complete cure for pulmonary emphysema is impossible. A feature of the disease is its constant progression, even during treatment. With timely access to medical help and adherence to medical measures, the disease can be somewhat slowed down, the quality of life improved, and disability can be delayed. With the development of emphysema against the background of a congenital defect of the enzyme system, the prognosis is usually poor.

Prevention of pulmonary emphysema

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

Physician therapist E.V. Sirotkina

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

Emphysema of the lungs what is it

Is a disease that is a violation of ventilation of the lungs and blood circulation. It takes quite a long time. Very often, a person with such a disease becomes disabled.

Signs of pulmonary emphysema:

expansion of the chest
shortness of breath
widening of intercostal spaces

ICD code 10- J43.9.

Men are more susceptible to this disease. Also at risk are people over 60 years old. The risk of such a problem also increases in those who have chronic obstructive pulmonary diseases.

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

Disease classification

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

By origin:

Primary - due to congenital abnormalities in the body. This type is very poorly treated. It manifests itself even in newborn children.
Secondary - a milder form of the disease. It can proceed unnoticed by the patient himself. However, advanced stages can hit a person's ability to work hard. Occurs due to chronic lung disease.

By the nature of the flow:

Acute is 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 a violation of the elasticity of the walls of the alveoli.

By prevalence:

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

By anatomical features and attitude to the acinus:

Bullous (vesicular) - large or small blisters appear where the damaged alveoli are located. The blisters themselves can burst and infect. Also, due to their large volume, adjacent tissues are squeezed.
Centrilobular - the acinus center is damaged. Much mucus is secreted. Inflammation is also manifested 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 failure.
Insternal (subcutaneous emphysema) - air bubbles appear due to rupture of the alveoli under the skin. Along the gaps between tissues and lymphatic tracts, these bubbles move under the skin of the neck and head.
Okolorubtsovaya - occurs near fibrous foci and scars in the lung. The disease proceeds with minor symptoms.
Periacinar (distal, perilobular, parasepital) - occurs with tuberculosis. The extreme parts of the acinus near the pleura are affected.

Bullous emphysema of the lungs

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

Bullous emphysema of the lungs

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 is impossible to notice it even with a conventional X-ray. It is found only with a large number of bulls in all lung tissue.

The greatest danger of bullosa pulmonary emphysema is that there is a greater risk of blistering rupture. As a rule, it occurs due to a strong cough or during intense physical exertion.

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

With a large defect in the lung tissue, the lung cannot close. The result is a continuous flow of air into the pleural cavity.

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

Causes of occurrence

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

First type, includes what leads to a violation of the elasticity and strength of the lung tissue. The main of 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 deficiency of A1-antitrypsin appears in the body.

The presence of gaseous toxic substances in the inhaled air significantly affects the body. The frequent incidence of infectious diseases reduces the lungs' ability to defend. Therefore, they are exposed to harmful effects faster.

Smoking is the main reason emphysema can develop. Puffs of tobacco smoke in the lungs accumulate inflamed cells, from which there is a release of substances capable of destroying the partitions that connect the cells.

People who smoke are more vulnerable to the manifestation of such a disease, emphysema in smokers has more complex forms.

NS the second type include factors that can cause an increase in pressure in the alveoli of the lungs. These include postponed 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 produce it.

The lungs overflow with air, so the small bronchi stick together when you exhale. Pulmonary ventilation is also impaired.

With emphysema, the lungs increase in size and take the form of a large-porous sponge. If you look at the emphysematous lung tissue using a microscope, you can observe the destruction of the alveolar septa.

Let's talk about the symptoms of pulmonary emphysema. It should be said right away that this disease often has latent initial forms. Therefore, a person may not even suspect that he is sick.

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

Usually, shortness of breath observed at the age of 50-60 years. Initially, this symptom is noticed while doing physical work. And in the future it manifests itself even in a calm state.

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

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

The inhalation goes smoothly.

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

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

After the onset of symptoms of shortness of breath, after a certain time, there is 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 are very tired, working exhaustingly to relieve exhalation. If the body weight has decreased, then this is an unfavorable sign of the course of the disease.

Patients also have dilated chest in the form 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, then you can see enlargements, and the gaps between the ribs seem to sink.

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

Diagnosis of the disease

Of great importance in the diagnosis of pulmonary emphysema is the study of respiratory function. To assess how narrowed the bronchi is, it is used peak flowmetry.

Peak flowmetry in the diagnosis of pulmonary emphysema

The patient should be at rest, while inhaling twice and exhaling into the peak flow meter. It is he who will fix the degree of narrowing.

Obtaining these data will allow you to determine whether a person really suffers from emphysema of the lung or he has bronchial asthma or bronchitis.

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

Conducting additional tests that apply bronchodilator drugs, makes it possible to say what disease is in the lungs. In addition, the effectiveness of the treatment can be assessed.

At x-ray, it is possible to reveal the presence of dilated cavities that are located in different pulmonary departments. Increased lung volume can also be detected. Indeed, in this case, the dome of the diaphragm shifts, 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 all medical 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 pulmonary 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 intake of bronchodilators, in the form of inhalation or tablets, is recommended. If there is heart and respiratory failure, then oxygen therapy is performed, after which diuretics are taken. Respiratory gymnastics are also recommended.

If a person is found to have an infection, then he is admitted to the hospital. He may also be hospitalized if respiratory failure is severe or if there are any surgical complications.

Emphysema can also be treated surgically.

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

Emphysema of the lungs - treatment with folk remedies

With emphysema of the lungs, treatment with folk remedies should not be missed.

Treatment of emphysema of the lungs with folk remedies

Here are some methods:

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

If a person is sick with emphysema, then he should periodically visit a pulmonologist. Folk remedies are used only as an adjunct to the main methods of treatment. You should not use only them, since this will not bring the desired effect.

Oxygen therapy use

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

Oxygen therapy

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

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

Respiratory gymnastics for pulmonary emphysema

Good breathing exercises with emphysema of the lungs also help a lot.

Respiratory gymnastics for pulmonary emphysema

Here are some exercises:

You should inhale and hold your breath. Then exhale sharply using the mouth opening. At the very end of exhalation, the position of the lips is changed to a tube.
Also hold your breath. Then, with the help of small jerks, exhale, fold your lips in the form of a tube.
Breathe in and do not breathe out. Stretching out your arms and clenching your fingers into fists, transfer them to your shoulders, then stretch them to the sides and again lower them onto your shoulders. Thus, do it a couple of times, then exhale strongly.
Breathe in for 12 seconds, hold your breath for 48 seconds. and exhale for 24 seconds. Repeat this three times.

Drug treatment

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

Treatment of bronchial asthma or bronchitis occurs with agents that dilate the bronchi. Mucolytic drugs should be taken to facilitate the removal of mucus.

Diet for pulmonary emphysema

The diet for pulmonary emphysema should be balanced. It should contain a lot of vitamin components and microelements. The diet must necessarily consist of vegetable and fruit dishes. In addition, these foods should be eaten raw.

Also, the main rule is the rejection of nicotine. It is better to quit smoking right away. That is, do not stretch for a prolonged cessation. In addition, you must not be in a room where other people smoke.

Massage application

The use of the technique of classical, segmental and acupressure massage leads to the fact that the phlegm leaves faster and the bronchi expand.

At the same time, acupressure is more often given preference, since it has greater effectiveness.

Therapeutic gymnastics for pulmonary emphysema

Emphysema of the lungs is accompanied by the presence of muscles always in tension, which leads to their fatigue. To prevent overstraining the muscles, you should engage in therapeutic exercises.

Here are some exercises:

For example, exercises that create positive pressure as you exhale. For this, a tube is taken. One end of it is placed in water. The second person takes it into his mouth and exhales slowly through it. The water obstruction exerts pressure on the exhaled air.
To do a diaphragm workout, you need to get up, take a deep breath. Exhaling, direct your arms forward and tilt. When exhaling, the abdomen should be tucked 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:

Complications of an infectious type... Pneumonia often develops, and lung abscesses occur.
Insufficient breathing. Since there is a violation of the metabolic process between oxygen and carbon dioxide in the lungs.
Heart failure... In the severe course of the disease, there is an increase in pulmonary pressure. In this regard, there is an increase in the right ventricle and atrium. All cardiac departments gradually change. Therefore, there is a violation of the supply of blood to the heart.
Surgical complications... If the cavity, which is located near a large bronchus, ruptures, then air can penetrate into it. The formation of pneumothorax occurs. If the septum between the alveoli is damaged, bleeding will occur.

Emphysema of the lungs - life prognosis

What is the prognosis of life with pulmonary 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 constant progression. Even if treatment is being carried out.

If you turn to a medical institution for help in time and follow all procedures, then the disease is slightly inhibited. The condition improves, and the disability is postponed.

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

Factors of a favorable outcome:

Detection of the disease at the initial stage
The disease is mild
The patient strictly follows the diet prescribed by the doctors
Quitting smoking completely

Prevention of pulmonary emphysema

In order to prevent pulmonary emphysema, the following should be done:

Stop consuming tobacco products.
Timely treatment of pulmonary diseases in order to prevent the development of the disease.
Leading a healthy lifestyle helps to improve condition and keep the body healthy. Playing sports, doing breathing exercises, walking in the fresh air, visiting a bath - all this contributes to the normal functioning of the bronchi and lungs.
In order for the lungs to be healthy, you need to be in the forest more often, inhale the healing aromas of pine needles. The sea air is also useful. Such places contribute to the opening of the lungs and saturate the blood with oxygen.
Watch your diet. Fresh fruits must be present in it. There should also be foods with a high amount of vitamins and nutrients.

Conclusion

And this is where we finish talking about emphysema of the lungs. Now you know what it is and how to treat it. We looked at the main symptoms and causes. Also, the prognosis of the life of this disease was slightly affected. In the future, there may be reviews on this disease below.

Pulmonary emphysema occurs when the alveoli of the lung tissue are stretched beyond acceptable limits and lose the ability to reverse contraction. In this case, a violation of the normal flow of oxygen into the blood and the removal of carbon dioxide from the body occurs, which leads to heart failure.

In accordance with the modern classification, diffuse and bullous emphysema of the lungs are distinguished. The first form involves complete tissue damage. Bullous pulmonary emphysema is diagnosed when swollen (enlarged) areas are adjacent to normal lung tissue.

Causes of pulmonary emphysema

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

Emphysema of the lungs - symptoms

Severe shortness of breath up to suffocation, widening of the intercostal spaces, a barrel-shaped chest, weakened breathing, a decrease in the mobility of the diaphragm, an increase in the transparency of the pulmonary fields during X-ray examination - these are the symptoms that manifest themselves in pulmonary emphysema. Treatment of the disease depends on the severity of the symptoms and the clinical picture.

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

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

Emphysema of the lungs - 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 has a disease. Treatment with folk remedies shows quite effective results, however, we in no way recommend abandoning traditional drug methods.

Basic principles of pulmonary emphysema treatment:

quitting smoking is one of the most important steps in your recovery. Note that a sharp, one-step reduction in the number of cigarettes smoked has a much greater effect than a gradual quitting of tobacco;
the appointment of antibacterial drugs - the main drugs are anticholinergics (berodual, atrovent), beta-2 sympathomimetics (berotek, salbutamol) and theophyllines (aminophylline, teopec). The choice of the drug and the intensity of therapy depend on the severity of those symptoms that manifest themselves in pulmonary emphysema. Treatment with antibacterial complexes is combined with the intake of expectorants;
breathing exercises to improve gas exchange. Typically, patients are prescribed atmospheric air with a reduced oxygen content for 5 minutes. The patient breathes regular air for the next 5 minutes. The cyclic scheme is repeated 6-7 times during 1 session. The full course of treatment lasts about 3 weeks;
pulmonary emphysema, 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;
in recent years, doctors have been actively using aeroionotherapy, which shows good results in eliminating respiratory failure. The course of treatment lasts 15-20 days;
effective and special breathing exercises, training programs aimed at ensuring that a person can control his breathing;
positional drainage is used for better sputum drainage - the patient assumes a certain position in which the cough reflex and viscous sputum deliver the least inconvenience. In this case, it is possible to combine the drainage treatment of emphysema of the lungs with the use of expectorant herbs and infusions, for example, thermopsis, wild rosemary, plantain or coltsfoot.

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

Emphysema of the lungs - treatment with folk remedies

Home remedies:

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

Herbal infusions:

add three tablespoons of buckwheat flowers to 500 ml of boiling water. Leave the mixture in a thermos for two hours. Take half a glass 3-4 times a day;
take one part of the fruit of the juniper and the root of the dandelion, add two parts of a birch leaf to them and pour the resulting mixture with boiling water. 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. The standard dosage is 1/3 cup;
a teaspoon of potatoes is poured with a glass of boiling water, infused for one hour and filtered. Take half a glass of infusion 40 minutes before meals for one month.

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

What is pulmonary emphysema?

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

Emphysema of the lungs is a pathological condition that often develops in a variety of bronchopulmonary processes and is extremely important in pulmonology. Some categories of people are at higher risk of developing the disease than others:

Congenital forms of pulmonary emphysema associated with whey protein deficiency are more common in northern Europeans.
Men get sick more often. Emphysema is found at autopsy in 60% of men and 30% of women.
People who smoke are 15 times more likely to develop emphysema. Secondhand smoke is also dangerous.

Left untreated, changes in the lungs of emphysema can lead to disability and disability.

Causes leading to the development of emphysema

The likelihood of developing pulmonary emphysema increases with the following factors:

congenital deficiency of α-1 antitrypsin, leading to the destruction of the alveolar tissue of the lungs 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 of professional activity associated with a constant increase in air pressure in the bronchi and alveolar tissue.

Under the influence of these factors, damage to the elastic tissue of the lungs occurs, a decrease and loss of its capacity for air filling and collapse.

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

The mechanism of lung damage in emphysema:

Stretching of the bronchioles and alveoli - their size doubles.
Smooth muscles are stretched, and the walls of blood vessels become thinner. Capillaries become empty and nutrition in the acinus is disturbed.
Elastic fibers degenerate. In this case, the walls between the alveoli are destroyed and cavities are formed.
The area in which gas exchange between air and blood takes place decreases. The body is deficient in oxygen.
The enlarged areas compress healthy lung tissue, which further disrupts 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 connected.
The load on the pulmonary circulation increases - the vessels of the lungs overflow with blood. This causes disturbances in the work of the right heart.

Disease types

The following types of emphysema are distinguished:

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 prior respiratory disease;
Obstructive or secondary emphysema is a complication of chronic obstructive bronchitis.

By the nature of the flow:

Sharp. It can be caused by significant physical exertion, an attack of bronchial asthma, the ingress of a foreign object into the bronchial network. There is a swelling of the lung and hyperextension of the alveoli. The condition of acute emphysema is reversible, but requires urgent treatment.
Chronic emphysema... Changes in the lungs occur gradually; at an early stage, a complete cure can be achieved. Leads to disability if left untreated.

By anatomical features, there are:

Panacinar (vesicular, hypertrophic) form. It is 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 secreted in large quantities.
Periacinar (parasepital, distal, perilobular) form. Develops with tuberculosis. It can result in a complication - rupture of the affected area of the lung (pneumothorax).
Okolubtsovaya form. It is characterized by minor symptoms, manifests itself near fibrous foci and scars in the lungs.
Insternal (subcutaneous) form. Due to the rupture of the alveoli, air bubbles form under the skin.
Bullous (vesicular) form. Bulls (bubbles) with a diameter of 0.5-20 cm are formed near the pleura or throughout the parenchyma. They appear at the site of damaged alveoli. They can rupture, become infected, and squeeze the surrounding tissues. Bullous emphysema usually develops as a result of loss of tissue elasticity. Treatment for emphysema begins with eliminating the underlying causes of the disease.

Symptoms of pulmonary emphysema

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

unproductive cough;
expiratory dyspnea;
the appearance of dry wheezing;
feeling short of breath;
weight loss
a person has 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 disturbed with a 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 with physical exertion, then 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 of the lungs is unstable, changeable ("day after day") - stronger today, weaker tomorrow.

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

People with chronic long-term emphysema of the lung develop external signs of the disease:

short neck;
widened anteroposterior size (barrel-shaped) chest;
the supraclavicular fossa protrude;
on inhalation, the intercostal spaces are drawn in due to the tension of the respiratory muscles;
the abdomen is somewhat saggy as a result of the omission of the diaphragm.

Complications

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 response - the body's desire to pump more blood due to tissue hypoxia.
Perhaps the occurrence of arrhythmias, acquired heart defects, ischemic disease - a symptom complex known under the general name "cardiopulmonary insufficiency".
In the extreme stages of the disease, a lack of oxygen causes damage to nerve cells in the brain, which is manifested by a decrease in intelligence, sleep disturbances, and mental pathologies.

Diagnosis of the disease

At the first symptoms or suspicion of emphysema of the lung, the patient is examined by a pulmonologist or therapist. Determining the presence of emphysema in the early stages is difficult. Often, patients go to the doctor when the process is already running.

Diagnostics includes:

blood test to diagnose pulmonary emphysema
detailed patient survey;
examination of the skin and chest;
percussion and auscultation of the lungs;
definition of the boundaries of the heart;
spirometry;
survey radiography;
CT or MRI;
assessment of the gas composition of the blood.

How to treat pulmonary emphysema

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

In the treatment program of patients with emphysema, the first place should be given to general measures that improve the quality of life of patients.

Treatment of pulmonary emphysema pursues the following tasks:

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

To alleviate acute conditions, drug therapy is used:

Eufillin for relieving an attack of shortness of breath. The drug is administered intravenously and relieves shortness of breath within a few minutes.
Prednisolone as a potent anti-inflammatory agent.
With 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.

In all patients with emphysema, physical programs are shown, especially chest massage, breathing exercises and patient training in kinesitherapy.

Do I need hospitalization for the treatment of emphysema? In most cases, people with emphysema are treated at home. It is enough to take medications according to the scheme, adhere to a diet and follow the doctor's recommendations.

Indications for hospitalization:

a sharp increase in symptoms (shortness of breath at rest, severe weakness)
the appearance of new signs of the disease (cyanosis, hemoptysis)
ineffectiveness of the prescribed treatment (symptoms do not decrease, peak flowmetry indicators worsen)
severe concomitant diseases
newly developed arrhythmias; difficulty in making a diagnosis.

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

Prevention of lung infections;
Quitting bad habits (smoking);
Providing a balanced diet;
Living in a clean air environment;
Sensitivity to medicines from the group of bronchodilator drugs.

Breathing exercises

In the treatment of emphysema, it is recommended to regularly carry out various breathing exercises in order to improve the exchange of oxygen in the lung cavity. The patient follows for 10 - 15 minutes. inhale the air deeply, then try to hold it as long as possible on exhalation with a gradual exhalation. This procedure is recommended to be carried out daily, at least 3-4 rubles. a day, in small sessions.

Massage for pulmonary emphysema

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

Exercise therapy

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

Oxygen inhalation

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

Surgical treatment of pulmonary 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;
The transition of the disease to a severe form.

Contraindication to the operation may be severe exhaustion, old age, chest deformity, asthma, pneumonia, in severe form.

Nutrition

Compliance with the rational use of food in the treatment of emphysema plays a rather important role. It is recommended to eat as much fresh fruits and vegetables as possible, which contain a large amount of vitamins and minerals useful for the body. Patients need to adhere to the use of low-calorie food, so as not to provoke a significant load on the functioning of the respiratory system.

The daily daily calorie content should not exceed 800 - 1000 kcal.

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

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

Life prognosis for pulmonary emphysema

Even if the patient has the worst 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 following factors greatly influence the patient's life span after the diagnosis of the disease:

The general condition of the patient's body.
The emergence and development of such systemic ailments as bronchial asthma, chronic bronchitis, tuberculosis.
How the patient lives plays an important role. He leads an active way of existence or he has little mobility. He observes the system of rational nutrition or eats food haphazardly.
An important role is given to the patient's age: 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 pulmonary emphysema is determined by heredity.

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

Prevention

Anti-tobacco programs aimed at preventing smoking in children and adolescents, as well as at smoking cessation for people of all ages, are of great prophylactic importance.
You also need to treat lung diseases on time so that they do not become chronic.
Observation by a pulmonologist of patients with chronic respiratory diseases, vaccines among the population, etc. is important.

Emphysema of the lungs- damage to the alveolar vesicles of the lungs, associated with their overstretching and loss of plasticity. Due to the inability to contract the alveoli, the interalveolar septa rupture and cavities with air are formed in the lungs.
This disease has a chronic course and is characterized by the expansion of the alveolar cavities. The processes occurring in the affected tissues can be described briefly as a combination of anemia, hyperextension and atrophy. The alveoli expand, the walls become thinner and torn. In the bullous form, cavities are formed in the lungs, in severe cases of the disease reaching 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 among men, emphysema is 3 times more common than among women. The disease affects in most cases the elderly (over 60 years old).

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

The scheme of the development of emphysema in a smoker

Causes of occurrence

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

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

Doctors combine diseases against which emphysema develops into one group called .

How emphysema occurs

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

Views

By 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 of pulmonary emphysema;
vicarious emphysema is an increase in the volume of one lung to compensate for respiratory function when the second is damaged. With such a disease, gas exchange in the lung does not decrease, but increases.

Pulmonary emphysema symptoms

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

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

In the chronic form, the clinical picture is determined by the following signs:

Dyspnea with little physical activity;
the rib cage becomes barrel-shaped;
bulging clavicular region;
the expiratory phase is lengthened even more and is carried out in two stages;

After prompt and adequate treatment, the symptoms of the acute form decrease. In a chronic course, pathological changes in lung tissue are irreversible.

Diagnostics

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

The following studies are assigned:

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

Necessarily:

X-ray examination: the size of the pulmonary lumen, the nature of the bronchial pattern is established;
blood test- often reveals an increase in the specific number of erythrocytes (compensatory phenomenon).

Differential diagnosis

For an accurate diagnosis, it is necessary to exclude:

vicarious emphysema.

Treatment

The patient needs complete rest and bed rest. Quitting smoking is mandatory, the greatest result will be given by a complete one-time refusal to smoke, and not a gradual decrease in the amount smoked.

For the prevention of bronchitis, which can become fatal if the lungs are affected, patients are advised to have an environment with clean air and a mild climate. The air in the room where the patient is located is humidified.

In acute course, the following are prescribed:

Inhalation, oxygen chamber;
special breathing exercises, alleviating the patient's condition. Gymnastics trains the muscles involved in the breathing process, which contributes to a more active saturation of blood with oxygen. If an attack of the disease is caused by bronchitis or asthma, it is important first of all to cure the ailment provoking the appearance of emphysema.
drugs are prescribed suppressing inflammatory processes- these are antimicrobial drugs (atrovent, salbutamol, etc.). These medicines are prescribed in combination with expectorants.

With a bullous form, apply:

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

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Chronic pulmonary emphysema does not respond to conservative treatment, but modern medicine offers a surgical lung transplant. To facilitate the well-being of a chronic patient, moderate breathing exercises (diaphragmatic breathing, inflation of balloons and other techniques) are suitable.

Alternative treatment for emphysema

There are folk remedies that 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;
a teaspoon of wild rosemary- 500 ml of boiling water is brewed. Do inhalation over hot infusion;
3 tablespoons buckwheat flowers brew 500 ml of hot water. Take half a glass three times a day;
Squeeze out juice from green tops of potatoes and take once a day, starting with a tablespoon, gradually increase the single dose to 100 ml.

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

Prevention

The first and main preventive measure against pulmonary emphysema is smoking cessation. A healthy lifestyle, moderate hardening, adherence to the daily regimen 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 the indicators of cardiac activity and the working volume of the lungs. The prognosis is very poor with the onset of cardiac symptoms and a decrease in lung volumes.

If you have the slightest complaint about shortness of breath, especially with a complicated pulmonary history, you need to 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.