The state of the patient in the emphysema of the lungs. Lung emphysema: causes, symptoms, treatment. Causes of emphysema

Emphishema of the lungs is nonspecific pulmonary pathology, accompanied by destructive expansion of alveoli and changes in the alveolar walls themselves. Initially, against the background of such frequently found diseases, such as heavy pneumonia, oncology and tuberculosis of respiratory organs, emphysema was considered as a concomitant disease. In itself, it was rarely found.

However, in recent years, the percentage of emphysema detection as an independent disease is growing steadily. Moreover, the disease often leads to respiratory failure, loss of disability and early disabilities, so the relevance of the problems of diagnosis, treatment and prevention of lung emphysema today is rather acute. Especially often the disease occurs in elderly people.

Table of contents:

To the main reasons leading to the lung emphysema include:

various malformations of the respiratory organs;
thoracic deformation of various etiology;
circulatory disorders due to different diseases;
disturbance of the outflow of lymph;
toxic effect of air components (exhaust gases);
toxic components;
injuries and operations on chest organs;
pathology of respiratory organs (chronic inflammatory pathologies of bronchi and lungs, pneumosclerosis);
congenital pathology of enzyme systems - deficiency of antitripxin, lack of synthesis of elastane, impaired synthesis of surfactant;
pathological processes - getting into light dust asbestos, silicon, manganese, development of light glass.

Note: Against the background of various reasons, the pressure of the air is rising inside the terminal departments of the bronchi and alveoli. If under normal conditions it does not affect the lungs and they are rapidly restored, then in the presence of certain factors provoking the loss of the elasticity of the lung tissue, excessive pressure leads to persistent changes.

In non-eelastic alveoli, air remains. It does not participate in the act of breathing and contributes to even greater emission of pulmonary fabric. On the one hand, it limits the depth of the breath, as in fact, "the lungs already inhaled the air." On the other hand, due to the accumulation of carbon dioxide, lungs include compensatory protection - the breathtone. And this leads to an even greater stretching of the lungs and the aggravation of the severity of the manifestation of the disease. In an effort to interpret Alveol, the body begins to produce more connective tissue. This process unfortunately leads to a narrowing of the lumen of the bronchi and makes it difficult for the inflow and air outflow. At the stage of development of the connective tissue of emphysema, lungs loses touch with external causes, begins to progress independently.

Types and types of emphizm of lungs

According to the modern classification, the following types of disease are distinguished

Diffuse - The lung fabric air portions are distributed throughout the tissue of both lungs. This form was initially considered idiopathic, proceeds with early disabling and the most severe clinical manifestations. This form is most often associated with hereditary causes and deficiency of certain enzyme systems.
Local - With it, normal regions of lung tissue are combined with emphysematoous, and the more fabric is present, the clinical manifestations of the disease are expressed.
Bullosis - There is a presence in the tissues of light bloated areas with dimensions of more than 10 mm. These sites are called Bullah.

To all, specialists allocate the following types of emphizm:

Primary diffuse lung emphysema - It is considered an independent disease with complex etiology. As provoking reasons, both internal factors, such as the lack of enzyme-alpha antitripxin, and external: injuries, diseases, toxic effects of harmful substances contained in the air, smoking.
Recognizing emphysema - Based on the name, the disease is not independent and accompanies a number of lung diseases.

Important! According to the nature of the flow of emphysema, the lungs belongs to continuously occurring progressive diseases. The severity of clinical manifestations and the degree of progression of emphysema depends not only on the form of the disease, but also from therapeutic tactics against the patient.

Light emphysema symptoms

At the primary stages of the development of lung emphysema, its clinical symptoms are masked by manifestations of the underlying disease.

At the stages, when the emphysema clinic begins to prevail, the following symptoms can be highlighted..

, significantly increasing during exercise. In addition, it appears at a high degree of physical activity, in the future - with ordinary activity, in the most remote stages, with the extreme severity of the disease - and alone.
Cianoz Skin Covers - both local (nasolabial triangle, fingertips) and general. Usually, it is expressive with a shortness of breath and depends on physical activity or psycho-emotional state.
Forced position - For patients with emphysema lungs, the most convenient position that facilitates the well-being is a sedentary position with tilted to the torso and support in hand. It fixes the shoulder belt and allows you to include the muscles of the upper shoulder belt in the act of breathing. In advanced cases, with extremely pronounced emphysematous manifestations, patients even sleep in the sitting position. In some patients in the initial stages of the disease, the facilitation of the state is possible if they lie on the stomach and lower the head and shoulders.
Characteristic type of breathing - For the disease, a short "grabby", "fish" inhale and significantly extended, embroodied, which is often conducted with closed teeth with inflating the cheek "Puff exhale".
Bochemy chest - due to the overall increase in the volume of lungs, the kind of chest resembles a man's breast at the height of the maximum breath. In this case, the total volume of movements (excursion) of the chest cell on the breath and exit is significantly reduced.
Expansion of intercostal intervals and pressure regions - These symptoms are similar among themselves by the mechanism of development leading to a common increase in the volume of lungs and increased pressure inside the sternum. Under the constantly growing pressure from the inside, the elastic spaces, which are m / ribbing intervals and the necessary spaces, begin to empty and perform out.

Diagnostics

The frequency of occurrence of pathology among all diseases of the respiratory organs is about 4%, at the initial stages, it skillfully masked under many other pulmonary diseases. Timely diagnosis of lung emphysema will help to suspend the development of destructive processes and reduce the risk of developing complications.

What can tell you about the presence of emphysema

Important! If you are subject to chronic lung gland, such as bronchial asthma and chronic forms, if you smoke or work on harmful production - you are in the risk area.

To suspect the development of the emphysema of the lungs, if:

Periods of exacerbation of major diseases.
The exacerbations are heavier and longer.
Earlier, the effective treatment of bronchial diseases and lungs was insufficient.
You started, on the recommendations of the doctor, more intensive therapy.
During periods of remission of chronic diseases of the lungs and especially - exacerbations, you have intensified the severity of shortness of breath.
In exacerbations, physical activity has sharply limited.

Noticing these symptoms, immediately consult a doctor - they can talk about the development of the initial stages of the emphysema of the lungs.

How to do a doctor

The diagnosis of emphysema of the lungs can be exhibited exclusively by a doctor (therapist, pulmonologist) after a comprehensive careful examination of the patient.

When examining a doctor in patients with emphysens are detected, except for the described clinical manifestations, the following symptoms:

box sound at percussion of the chest;
reduction or disappearance of absolute dullness of the heart;
shift of the lower borders of the liver book;
reduced excursion to the lower edge of the lungs;.
vatnaya, muted breathing.

Laboratory and instrumental examination methods help reveal:

increasing the content of red blood cells (erythrocytosis);.
lab inflammation laboratory indicators;
pneumatization (airiness) of light tissue on an x-ray and an increase in the total lung volume.

We use in the diagnosis of emphysema of the lungs and accurate computer methods of examination, helping to establish the most accurate localization of the diseases of the disease. Usually they are used in preparation for surgical intervention.

Patients and functional samples are carried out, allowing to identify the degree of reduction of the functions of the lungs, a decrease in the volume of inhalation and exhalation, a decrease in the working volume of the lungs and other indicators pointing to the emphysee.

The treatment of emphysema of the lungs is quite difficult, since pathogenetically, morphologically and functionally illness is associated with other chronic diseases, which humanity has not learned to fully heal.

The current successful treatment of emphysema implies:

Important! The basic principle of treatment of emphysema at the present stage of the development of medicine (mainly for diffuse lung emphysema) is to determine the progression of the disease and preventing the development of complications.

Complications of lung emphysema

The complications of emphysema, as an independent nosological unit include:

Purulent Fabrics - Mainly characteristic of the bullous form, which is associated with the presence of large cavities, in which ventilation and outflow of the fluid are difficult and bacterial infection occurs very easily. This is due to the fact that most often as the main agent is stable, its own, conditionally pathogenic flora, therefore such pulmonary purulent diseases in emphysema of the lungs are quite difficult to treat antibiotics.
Pneumothorax - most often accompanies with local and bullous form and is associated with the extraction of individual sites of the lungs so much that under certain adverse conditions there is a gap.
Heart failure - In the form of a symptom complex called a "pulmonary heart" is a rather serious complication of lung emphysema, significantly reduce the comfort and life of patients.
Respiratory failure - A complication that occurs is acute, represents a serious threat to health and life. Insufficiency is a decompensation of the function of respiratory organs in response even to minor physical exertion or alone.

Remember! It is impossible to engage in self-treatment in emphysema of the lungs. At the very first symptoms of the disease, contact the doctor.

Sovin Elena Nikolaev, therapist, cardiologist

Emphysema lungs - This is a non-specific chronic disease, a characteristic feature of which is an irreversible expansion of the bronchiol airspace with changes in the alveolo walls. The prevalence of the disease is less than 5% of all patients, among women is 2 times less often. In patients with COPD (chronic obstructive pulmonary disease) the risk of emphysema is significantly higher than that of relatively healthy. The peculiarity of the disease is that this pathology with severe streams strongly affects the ability of the patient. In addition, the resulting broncho-pulmonary syndrome may even lead to disability.

Emphysema of the lungs meets only 5% of patients

Caused factors leading to the development of lung emphysema

Virtually any impact leading to chronic inflammatory phenomena in alveoli stimulates the development of emphysema. The development of this pathology is more likely to have certain factors:

COPD and bronchial;
Inflammatory phenomena in respiratory bronchops and alveoli;
Deterioration of microcirculation in pulmonary fabrics;
Congenital deficiency of the α-1 enzyme antitripsein;
Violations associated with surfactant;
Professional harm (constant increase in air in alveoli and bronchi);
Chronic intoxication (tobacco smoke and other pollutants).

The influence of these factors leads to damage to elastic tissue, decrease and / or loss of the ability to fill with air and its decline. The lungs that are filled with air lead to the pathologies of ventilation according to the type of obstruction and sticking the bronchi small caliber in exhalation. There is an absorption of pulmonary fabric, its bloating, as well as the Bull (air cyst), due to the formation of the valve mechanism. Thus, obstructive emphysema of the lungs occurs. The risk of Bull is that their gap is accompanied by phenomena of spontaneous pneumothorax, prone to relapses.

Due to the fact that emphysema is characterized by a serious increase in the lung, it is externally similar to a sponge that has large pores. With a microscopic examination of the lung tissue, the destruction of the Alveol partitions is detected.

Smoking - one of the frequent causes of lung emphysema

Classification

Allocate emphyms:

Primary (congenital) - independent pathological process;
Secondary (acquired) - as a result of other pathologies of the lungs, for example, obstructive or bronchial.

For the prevalence of the pathological process, the forms distinguish:

Diffuse lung emphysema;
Localized.

According to the involvement in changes in the acinus (structural unit of the lungs), emphysema happens:

Plouble or Panacinarian - the acinus is struck completely;
Centrobular or centriocinar - acinus is affected in the central department;
Perylobular or pericipal - acinus is affected in the distal department;
Okolorussaya or irregular, that is, uneven;
Bullese emphysema of the lungs - if bully is detected.

Note! Also separately note the congenital lobar emphyseum and the monklood syndrome - one-sided defeat with an indefinite cause of occurrence.

Light emphysema symptoms

The main signs of the emphysema of the lungs:

Expruit (embarrassing) shortness of breath. Depends on the degree of respiratory failure;
Visually, a significant expansion of the chest with a decrease in its respiratory movements is determined (barrel-shaped chest);
Intercostal gaps are increased;
Included areas smoothed;
Cyanosis. Blue tint of the nasolabial triangle due to the deficiency of oxygen.
"Pink Puffer" is so called the appearance of the patient with this pathology. The skin of a pink face, the patient occupies the forced position of ortopnoe (the body is tilted forward, the legs are omitted, hands with a focus on arrive).

With emphysema of the lungs of human skin becomes pink

Thickening fingers by type "drum sticks".
Loss of body weight.

Complications

Unckengerous emphysema can be carried out to heavy and pathological changes in the cardiovascular system. Capillary violations lead hypertension in a small circulation circle with an increase in the load on the heart, in particular the right departments. In this case, right-hand deficiency with edema, and an increase in liver can develop. It is also possible to occur the emergency condition of spontaneous pneumothorax, which requires mandatory medical care.

Diagnostics

The diagnosis should be engaged. It can put the primary diagnosis based on complaints, inspection and examination. These are the simplest and most basic methods to determine the disease, but they are not exhaustive. Therefore, additional methods are used to form an accurate clinical diagnosis. First of all, it is an x-ray of the lungs. The X-ray apparatus allows you to determine the tissue density and retpering from other changes in the lungs. It is used necessarily spirometry, it allows you to determine the degree of violation in the work of the lungs. Also, the most accurate, but expensive method () can also be used.

Chronic body intoxications lead to lung emphysema

Actual treatment techniques

Specific therapy of the emphysema of the lungs is currently not developed. First of all, it is necessary to completely eliminate those factors that lead to the development of this disease. That is, it is necessary to abandon the usual intoxication. If there is a serious flow of emphysema, it may even be necessary to change the place of work if the patient is subject to toxic exposure, which leads to the development of the disease.

Often this disease does not require the hospitalization of the patient if it is in a satisfactory condition. Treatment is carried out on outpatient conditions with mandatory monitoring of the attendant physician or. The patient is hospitalized in the pulmonary branch of the hospital only if the infectious component has joined or a complication has been developed. Because these conditions require urgent measures to carry out a narrow-profile specialist in the hospital.

When identifying the first symptoms of lung emphysema, it is necessary to urgently turn to the pulmonologist

Treatment of emphysema of the lungs, as well as any other disease, must be comprehensively. To achieve the best result, it should consist of such components:

Diet pattern. The patient's nutrition must be correct and balanced. It is advisable to hold a low-calorie diet with a large content of raw fruits and vegetables. It is required to reduce consumption, since these elements can lead to a lack of oxygen in the patient's body, which will further aggravate its condition.
Medications. Mostly treatment is symptomatic. When aggravating the process, the patient shows therapy with antibacterial agents of a wide range of action. Also, if the patient suffers from a chronic form of the disease, then it should apply the preparations expanding bronchi on an ongoing basis. Such drugs include salbutamol, theophylline that can be both in tablet and in the form of inhalation. If there are problems with the emotion of sputum, patients must use a musolitic agent.
Oxygen therapy. It is used to improve gas exchange in the lungs. The procedure is that the patient is inhaling the air mixture with a reduced amount of oxygen, after which breathes with the normal oxygen content. Such procedures should be carried out by cycles for 15-20 days. This therapy is particularly shown if the emphysema of the lungs in children occurs.

Methods that facilitate the overall condition of the patient

There are many techniques that help facilitate the patient's condition with emphysens, the main of them is:

Massage. Classic, segmental, point and drainage massages can be carried out. With the help of these massages, the bronchial system is expanding and it helps to light sputum. In addition, therapeutic massage contributes to the excellent relaxation of the entire muscle frame, which leads to an improvement in external breathing.
A complex of medical physical education. Promotes the prevention of overvoltage of the muscular system, because at emphysema, the muscular frame is in constant tone. LFC contains a simple set of exercises that can repeat each. Exercises can be used to form a positive in exhalation, as well as complexes for training a diaphragmal respiration and its rhythm. Such respiratory gymnastics in the emphysema of the lungs should be carried out under the control of a specialist in therapeutic rehabilitation.

In the treatment of lung emphysema, it is necessary to do therapeutic physical education (LFC)

Treatment with folk remedies

It should be remembered that funds for folk treatment are auxiliary and in no case should not be monotherapy. Now the recipes are very common:

Using a richness for inhalations. Pre-plant should be pouring boiling water and insist 15 minutes. Inhalation spend 2 times a day.
Mix in equal proportions The root of licorice, Altea, Sage and Anisa. A tablespoon of this collection should be brewed in a glass of boiling water and insist for an hour. This tincture should be used 3 times a day 3 ml.

Depending on what means and how to treat this disease will directly depend on the prognosis of the patient's life. If the therapy is started on time and is carried out in full, it is possible to significantly improve the quality of the patient's life and save it for a long time from the recurrence of the disease.

In our article, we will answer the question of what emphysema is lungs than it is dangerous whether it is possible to cure this pathology.

Conditions predisposing the symptoms of pathology:

smoking, work in the conditions of dusting or gas surrounding;
prolonged reception of prednisolone;
Sinusites, frequent ARVI, allergic diseases;
diseases of respiratory organs in relatives;
diseases restricting physical activity (heart pathology or musculoskeletal system);
work on glass-capacity production or professional game on wind musical instruments;
frequent, repeating colds;
alcoholism;
male floor and elderly age.

Emphysema appears very quickly.

Prevalence

More than 4% of the total population have lung emphyms. With age, the occurrence of symptoms of pathology is growing, and in the elderly after 60 years it becomes one of the most frequent health problems. Mortality from it is constantly increasing. Emphysema of the lungs is not cancer, but the lifespan after confirming this diagnosis with severe emphysema only half of the patients exceeds 4 years. With light emphysema, this period is experiencing 80% of patients. The forecast of life depends on the degree of violation of the respiratory function, that is, from the severity of restrictive violations.

Emphysema Lungs: Classification

Emphysema code for the ICD-10 - J43.9. To the same subgroup include:

mac-Leod syndrome (J43.0);
panlobular (J 43.1);
centrobular (J 43.2) and
other (J 43.8).

In addition, such types of pathology include other categories of ICD-10:

compensatory (J98.3);
caused by the action of inhaled harmful substances (J68.4);
interstitial (J98.2);
newborn (P25.0);
emphysematous obstructive bronchitis (J44).

In clinical practice, a classification is used based on the reasons, anatomical changes and a radiological picture of pathology.

Depending on the reasons, it may be congenital (primary) and acquired (secondary). A homogeneous (total, diffuse, complete) and heterogeneous (partial, segmental) lesion is isolated by x-ray.

Varieties of emphysematous lesion

Depending on the structural changes, such types of lung emphysema distinguish:

panacinarian (panlobular): the whole acinus suffers;
centriocinar (centrobular): only its central part is affected, that is, branching terminal bronchioles (respiratory bronchiols);
periacinar (perobular): predominantly the alveolar moves are damaged.

Centrobular emphysema affects the upper lobe. A similar process is developing with pneumoconiosis in miners, but in this case the swollen areas alternate with the foci of wrinkling (fibrosis) of the lungs.

Panacinarian emphysema amazes Alveola, destroying partitions between them. It is observed in the lower departments and has a more severe course.

Also, doctors sometimes speak of incorrect emphysema. This condition is accompanied by a different expression increase and destruction of the alveoli in combination with scar changes in the pulmonary fabric. The cause of such a state is, pneumoconiosis, histoplasmosis, eosinophilic granuloma.

At radiological examination, such types of pathology are determined:

diffuse, with the presence of multiple small cavities in light;
bullous, with the formation of hollow foci (bull) with a diameter of more than 1 cm;
combined, with the appearance against the background of diffusely increased air and bubble fabric - Bull.

To physiological forms that do not cause violations of gas exchange include:

senile, accompanied by an expansion of alveoli without damage bronchiole;
vicarial (replaceable) emphysema arising after removing part of the lung for the normalization of gas exchange.

Development mechanism

In most cases, emphysema of the lungs complicates COPD, and the main reason for this disease is smoking. The effect of resins and nicotine leads to constant inflammation of the bronchi. At the same time, enzymes are distinguished from destroyed cells and leukocytes - proteases. They gradually "corrupt" muscle and connecting cells of small bronchioles. Therefore, emphysema is an integral part of a heavy COPD.

Emphiste-affected

Long damage, the yield of proteases and the destruction of the elastic carcass of the pulmonary fabric is such a mechanism for the development of pathology under the action of dust, harmful gases.

If a smoking patient or a patient with bronchial asthma has a congenital deficiency of alpha-1-antitripsein, its lungs are even more sensitive to its own proteases, so the pathology has such a person earlier.

The decay of the elastic carcass of the acinus is the cause of the formation of cavities in the pulmonary fabric. So emphysematous bulls are formed. In addition, during the exhalation, small bronchiols emerging from such cavities are falling down, and the air cannot completely remove from the lungs. Finally, the number of functioning cells of lung tissue decreases. All this leads to the development of symptoms of permanent oxygen starvation and an increase in blood carbon dioxide in the blood.

The lack of oxygen in the blood becomes the cause of the spasm of the pulmonary arteries and the discharge of the part of the blood through the shunts into the venous system, which increases hypoxia.

The severity of pathology is directly related to the severity caused by it.

In a separate form, one-sided emphysema is distinguished, or Mac-Leod syndrome. It develops in young people. It is believed that the cause becomes frequent bronchitis under the age of 8 years. As a result, one easiest exposed emphysema and swells, a shifting mediastinum and squeezing healthy light. With the development of symptoms of respiratory failure, an operation is carried out - removal of a part or all the affected organ.

Complaints and symptoms in lung emphysema

The complexity of timely recognition and treatment of such an irreversible state is that pathology does not cause any complaints and symptoms for a long time. Only over time develops respiratory failure, which subsequently becomes the cause of disabilities and mortality.

Emphysema of the lungs usually accompanies COPD, and its symptoms are associated with this disease. The main complaints of the patient - it is also a cough with a moocroty. Less frequent sound when breathing, heaviness in the chest, weight loss. Dyspnea appears closer to 60 years, intensified with colds. Wet a little, she is bright.

Appearance of the patient with emphysema: photo

The most characteristic objective symptoms that the doctor defines when inspection:

usually thin body;
the position of the chest in the position of inhale;
breast shape, reminiscent of barrels (the distance between the sternum and the spine is approaching the distance between the armpits) - an emphysematous chest;
reduction of noticeable movements when inhaling and exhalation;
expansion of the gaps between the ribs, and sometimes their escape;
empty of regions over the clavicle;
box sound with percussion of the lungs;
the omission of the lower ribs, their low-speed breaths;
weave breathing.

Skin sinusiness for patients is uncharacteristic, with the strengthening of shortness of breath, their skin pose. They often exhale through the half-open mouth, and during the breath tightly closed the lips.

Primary lung emphysema, having an innate cause and associated with a deficit of alpha-1-antitripsein, has some features of clinical flow and symptoms:

it begins at 30 - 40 years with increasing shortness of breath without cough;
often combined with liver cirrhosis at a young age;
weight reduced;
very low load tolerance;
and the corresponding heart pathology appears only at the late stage of the disease;
it is characterized by an increase in the total capacity of the lungs according to FVD;
the form of the disease is a panacinarian.

Emphisma Lungs: Diagnostics

Laboratory methods with symptoms of this pathology have an auxiliary value. In the blood, the content of erythrocytes and hematocrit increases, which reflects the adaptation of the body to the lack of oxygen.

If the concomitant COPD has a medium or severe flow, the patient is pulse oximetry. In case the level of saturation of blood oxygen during this study will be less than 92%, the study of its gas composition is shown.

Bullese emphysema on a computed tomogram

In the event that the symptoms of the disease arose in a person under 45 years old, or there were family cases, it is necessary to determine the blood in the blood of alpha-1-antitripsein.

Instrumental diagnostics of lung emphysema:

Removes the decline in the designer and the rate of exhalation, there are signs of a mixed obstructive and restrictive respiratory disorder and irreversible bronchial obstruction.
on which emphysematous lungs are determined - transparent, increased airiness, more darkened than normal;
computer tomography is the most accurate diagnostic method.

Treatment

Medical treatment is prescribed by the main disease, first of all COPD. However, none of the modern drugs can prevent the development of emphysema and is used only to improve the condition of the patient. To cure emphyms of the lungs is impossible.

It is used in the form (mainly rypratropy - atrovant - or tiotropia bromide, including using) and. In addition, long-term courses are prescribed, slowing the progression of COPD. Theophylline preparations in treatment are usually refused, since their small doses do not facilitate shortness of breath, but too large easily lead to side symptoms.

In severe cases, when the oxygen voltage in the blood drops to 60 mm Hg. Art. (According to the analysis of the gas composition of blood), the patient is prescribed for substitution treatment for long oxygen therapy. Showing the use of domestic apparatus. Treatment at home with oxygenators significantly improves well-being and prolongs the life of the patient.

Treatment with folk remedies in emphysema of the lungs is inefficient.

Oxygen therapy at home

Operation in emphysema of the lungs is carried out in the ineffectiveness of drugs, rapidly developing pathology, as well as in its complications - pneumothorax or bleeding into the cavity of the pleura. The choice of treatment method depends on the type of pathology - diffuse or bullous, and on its cause and severity of symptoms.

Diffuse form

To improve the condition of patients with diffuse form, 2 methods of treatment are used:

surgical decrease (reduction) of the volume of pulmonary fabric;
transplantation (transplantation) of the lungs.

In modern thoracic hospitals, reduction is made including with the help of endoscopic technology, that is, without major cuts. However, for such an operation, compliance with many conditions, including smoking refusal, as well as objective symptoms of reversible bronchial obstruction (after samples with salbutol, the growth of FEV1 must be more than 20%). If the walls of the bronchi do not frame under the action of the bronchoditics, that is, the sample with salbutomol is negative, the operation according to the reduction of the pulmonary volume is contraindicated.

The operation is also contraindicated in the deficiency of alpha-1-antitripsein, symptoms of malignant or systemic diseases transferred operations on the lungs, many diseases of the cardiovascular system.

With ordinary technique, the operations are removed from both sides, the remaining fabric is strips and operates better.

When endoscopy is used with which you can:

install in the lumen of the bronchi valve, overlapping distal departments, which causes an appeal (collapse) parts of the lung;
introduce several stretched metal spirals into bronons, which, after the reduction, tighten the tissue section;
enter the special foam or water vapor into the necessary segments, which lead to a decrease in the volume of the desired segment.

Transplantation must be performed by patients with diffuse form, which turned out to be ineffective both drug and surgical treatment.

Bullous form

Surgical removal of the bubble (Bully) is performed if this formation is the reason for the appearance of symptoms of significant respiratory failure (OTV1 less than 50% of the due value). Endoscopic intervention is preferable.

Respiratory gymnastics in lung emphysema

The complex of exercises for treatment is performed within 15 minutes at least 4 times a day. It should be performed at an average pace, without delaying breathing and not fit. Such a sequence of exercises is offered:

in the sitting position, pronounced on the exhalation of sounds "M", "B", "s" and other consonants for 2 minutes;
sitting on a chair, connect the brushes under the chin, elbows to dilute, turn to the side to the side, in exhalation - straight;
sitting, exhaled as long as possible, counting seconds;
stand up, on the breath lift hands up, throw off your head; On the exhale, lower the head, lift the leg, bent in the knee and press it to the body;
in the standing position on the exhale pull the vowels;
lie on the back, during the exhalation to sit down, lean forward, bring hands back;
3 accounts breathe, pulling the belly, to one - exhale, protruding it;
walking with rhythmic breath: on inhale - 2 steps, in exhalation - 4.

Forecast

Basic complications (consequences) of pathology - respiratory failure and spontaneous pneumothorax.

Spontaneous pneumothorax occurs when the wall is damaged by the surface of the superficially located Bulla (bubble). Due to this, air from bronchiol enters the pleural cavity. Symptoms - sudden sharp chest pain, accompanied by dry coughing and shortness of breath.

Terms of favorable forecast with proper treatment:

age up to 60 years;
to give up smoking;
OFV1 more than 50%;
there is no deficiency of alpha-1-antitripsein.

Emphysema of the lungs - severe disease. In the USA, it serves the 3rd frequency of death. Considering that in Russia, signs of pathology can be found in 60% of men and 30% of women, it is important to give patients as much information on this state, its causes, symptoms and treatment.

Prevention

Since the main cause of pathology is COPD, the prevention of this state is the refusal of smoking. It is necessary not to just declare it, but to offer patients with special programs for the treatment of nicotine addiction.

Also, emphysema is found under the action of professional harm, therefore compliance with safety, the protection of respiratory organs in production is very important.

To slow down the progression of the disease, it is necessary to take a timely and properly on COPD and warn its exacerbations.

Emphysema Lungs: Video

Such a disease of the lungs, as an emphysema, is accompanied by a cough with a mocroid, shortness of breath, pneumothoraxes and symptoms of respiratory failure.

Pathology is characterized by a high risk of developing complications from lungs and hearts, disability and a significant percentage of fatal outcomes.

Emphysema of the lungs - what is it and how to treat the disease?

Lung emphysema is a disease in which the lungs are expanding, and their walls undergo destruction, as a result, the pulmonary tissue varies pathologically. Together with asthmatic bronchitis and pathology refers to chronic obstructive lung diseases ().

From the Greek language "Emphysema" translates as "bloating." Among the male population, the disease is diagnosed twice as often, in the elderly the risk of its development increases.

Emphysema is progressive and is chronic disease. Due to prolonged inflammation and narrowing of the breathlessness of the respiratory tract, the lung tissue becomes less elastic, and after exhalation in the lungs there are more air than usual.

The connecting tissue begins to grow (pneumosclerosis with lung emphysema), replacing air seats, and these changes are irreversible.

Emphysema is localized and diffuse. In the first case, not all lungs are damaged, but only some of their sections. This type is often due to congenital disorders.

What is dangerous to the cluster of fluid in the pleural cavity, the causes and signs of the hydrotorax and how to treat:

With a diffuse type, all the pulmonary fabric is amazed, which can perform complication of obstructive or allergic bronchitis.

Also allocate such forms of emphysema:

Vesicular is the most common, in which changes are irreversible, in most cases it is a complication of other pulmonary diseases;
Vicarina - an increase in the volume of one section with the simultaneous compression of others, the alveoli is not affected;
Senile - age increase in tissue stiffness without their destruction, deformation of lung plots;
McA Laud syndrome is a unilateral damage to vessels and tissue of light unclear etiology;
Interstitial - accumulation of air under the pleura, between slices and in other areas due to bridging bronchi or alveoli;
The acute swelling of the pulmonary fabric is developing after removing one of the lungs or due to an attack of asthma.

Causes of emphysema The lungs are:

Disturbed microcirculation in pulmonary fabric;
and other obstructive chronic lung pathology;
Inflammatory process in alveoli or bronchi;
Smoking, including passive, is considered as one of the main factors of emphysema;
Constant to enter into light toxic compounds, for example, in employment in industrial production;
The hereditary insufficiency of the α-1 antitrypsin, which leads to the fact that proteolytic enzymes begin to destroy alveolar tissues.

Under the influence of these factors, the elastic lung fabric is damaged, its ability to the normal filling process of air and its removal is violated.

Small branches of the bronchi sticks out, the pulmonary fabric becomes swollen and worn out, air cysts are formed, or bulls. Their gap leads to. In emphysema, the lungs are enlarged and resemble a sponge with large pores.

Signs of emphysema of light diffuse type:

shortness of breath even with small exercise;
sharp weight loss;
barrel shape of the chest;
slouch;
intervals between the edges are expanded;
digging of the screwdriver;
missing breathing relaxed and places when listening to the phononendoscope.

What is the lung bronchoscopy, indications for the procedure and preparation for it:

With a diffuse emphysema, X-ray shows the increased transparency of the light zone and low-locked the diaphragm. The heart begins to take a more vertical position and increases breathing insufficiency.

The symptoms in the emphysema of the localized type are developing due to the fact that the affected parts of the lungs are powered by healthy areas, the resulting disorders in respiration are developing up to the attacks of choking.

The risk of breaking the air subleumal cavities is high, in which the air penetrates the cavity of the pleura.

Methods for treating emphysema of the lungs are aimed at eliminating respiratory failure and causes the lesions of lung tissue, for example, any disease.

The first condition of successful therapy is a complete unloading of smoking. This is helped by not only special drugs with nicotine content, but also the patient's motivation and psychological assistance.

In emphysema, which developed due to other pathology, use means for the treatment of primary disease. These are medicines from a group of antibiotics and expectorant preparations (mercolics), selected by the doctor individually.

To facilitate respiration, exercises are shown, allowing more lungs in air exchange.

Segmental, point or classic massage is carried out for better wet wet. Preparations of Salbutamol, Berodal or Theophylline are prescribed to expand the Bronchi Bronchi.

The alternate supply in light air with low and the usual oxygen content is used if the respiratory failure is low. The rate of such treatment of emphysema is designed for 2-3 weeks.

With a pronounced disease, the respiratory process is carried out inhalation with small doses of pure oxygen or ionized air, and in extreme cases - ventilation of the lungs.

Bullous emphysema most often requires operational intervention, the purpose of which is the removal of air cyst (Bull). The operation is carried out by a classic or minimally invasive (using an endoscope), and its timely conduct warns the development of pneumothorax.

Emphysema Lungs - Forecast of life and mortality

Without proper and timely treatment, pathology has steadily progresses, heart and respiratory failure develops. This leads to the disability of the patient and its disability. In this case, with emphysema of the lungs, the forecast of the life is unfavorable, and the lethal exodus may occur earlier than in 3-4 years.

But if the therapy is carried out, inhalations are regularly used, despite the irreversibility of lung damage, the quality of life can be increased.

A theoretically relatively favorable outlook is the life expectancy of 4-5 years, but under good conditions a person can live with emphysens 10-20 years and longer.

Complications

If pathology is rapidly progressing or treatment is not carried out, such complications of the lung emphysema are developing:

failure of ventilation of light obstructive type;
cardiac arreed lack of failure and as a result, ascites, feet edema, hepatomegaly.

The most dangerous consequence is a spontaneous pneumothorax, in which it is necessary to carry out the drainage of the pleural cavity and the aspiration of the air.

Emphysema of the lungs, the symptoms of which are quite easy to recognize, may arise for many reasons. But only a doctor will be able to prescribe its treatment correctly.

Because of the poor ecological situation on the planet from respiratory failure, many people suffer. Emphysema of the lungs is the condition of the body in which the tissue in the lungs is stretched and cannot be reduced. As a result, the withdrawal of carbon dioxide from the blood and the intake of oxygen into it is significantly violated. Fabrics in the lungs feel oxygen fasting and begin to die. The disease can hurt the lungs completely or only individual sections.

In order to understand the nature of the development of the disease, it is necessary to determine which form wears illness. Emphysema is primary and secondary. In the first case, it develops as a separate disease, and in the second, as a complication after the suffered disease of the lungs. As a rule, the reasons for secondary emphysema is chronic bronchitis or bronchial asthma. A significant role in the development of the disease is played by the suffered diseases of the lungs (tuberculosis), as well as smoking, work in highly ridden premises and hereditary leaning.

Emphishema of the lungs is a serous disease, and if it does not start treatment in time, then a person may have not only respiratory, but also heart failure. Disease During the long period can be inconspicuous, but then manifest itself in the launched form, in this case, without surgery, it is unlikely to do without surgery. The risk of emphysemic disease rises in people after 55 years, especially often the disease turns into men. Perhaps such gender susceptibility is due to greater smoking among men, rather than among women.

Symptomatic disease

On the existence of such a disease as an emphysema, many people do not know at all until they themselves will face it, but the symptoms and the consequences of it are rather unpleasant. The symptoms of lung emphysema are always pronounced, and they are hard to confuse with the manifestation of any other disease.

Most patients argue that signs of emphysema of the lungs they began to learn from the compulsory position of the body - on the stomach that they had to take to get relief from choking. The man that sick emphysema is forced to sleep while sitting, as the horizontal position brings discomfort and cause severe compresses in the chest.

The main signs of emphysema look like this:

saddy (if the disease is hereditary in nature, then the outbreak can manifest themselves even at a young age without any reasons);
cyanosis (syntipating limbs and language);
loose breathing;
weight loss;
fast fatigue and reduced performance;
an increase in sternum in volume;
expansion of intercostal intervals;
switching of the test area.

The most important feature of emphysema is shortness of breath, as a rule, it is manifested after a small physical activity and at first it has a non-permanent character.

With the development of the disease, it will be more frequent, and at the slightest voltage of the patient will feel the attacks of suffocation. People who are sick of emphysemia often carry out sharp, grab the breaths and privileges. Sometimes, even with closed lips, they can feel exhale. Watching the sternum of the patient, it can be noted that with the development of the disease, it becomes less and less participating in the respiratory process. In most cases, respiratory motion carry out additional muscles of the neck and chest.

At the location of such a disease as lung emphysema, symptoms may differ slightly. For example, if the disease has grown the pulmonary artery, the patient constantly feels sudden chest pain, high sweating, reduced blood pressure, cough and hemoptysis. In the case when emphysema is localized in the carotid artery, a person is accompanied by headaches and dizziness, the coordination of movements is disturbed, the closet of consciousness and a speech defect can develop. If the mezentheral artery is involved in the disease, then the patient has a burning pain in his stomach, bloody, and liquid and bloody feces appear.

The redemption of the renal artery leads to pain in the kidneys, red urine and oligouyrosis (reduced amount of urine). The most terrible symptoms will be signs of damage to the arteries of the limbs. As a result, a person will not be able to produce any physical actions affected by the limb, signs of gangrenes are possible, dark spots or bubbles with liquid will appear on the limbs.

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Diagnosis and treatment of disease

If you suspect with emphysee, you need to turn to a pulmonologist to see, which can be diagnosed after making an office, to diagnose and appoint treatment course.

The diagnosis of lung emphysema implies a set of procedures that accurately determine the stage of illness.

In addition to inspection (listening and climbing sternum), the doctor may assign the following studies:

x-rays of light;
CT lungs;
computer tomography of the lungs;
functional diagnostics;
general blood test, urine and feces;
analysis of blood gas composition and polycythemia.

The treatment of lung emphysema is oxygen therapy, that is, inhalation by air with an elevated level of oxygen, and, of course, respiratory gymnastics.

Often the patient doctor prescribes antibacterial drugs:

Atrovant;
Berodal;
Theoke;
Eufillin;
Salbutamol;
Berotek.

The intensity of drug therapy directly depends on the symptoms, often antibacterial drugs can be combined with expectorant means and methods of traditional medicine. In the launched cases, doctors are forced to resort to surgical intervention.