A pathological condition called hydrothorax, the treatment of which will be discussed in this article, is a serious ailment that occurs, as a rule, in the form of a complication. It is characterized by accumulation of fluid in the pleural cavity. Of course, this must be treated. How exactly? After considering the causes and symptoms, it will be about this.
Definition and classification
Hydrothorax, the treatment of which will be discussed later, is also called breast dropsy. There are three forms in which this pathology can occur:
- Right-handed. It is rare. Usually accompanied by pain in the stomach and back, heartburn. It may seem to a person that the right part of the sternum protrudes a little, and the lower part of the abdomen seems to be pulled.
- Left-handed. Also a rare form. It manifests itself as symptoms of a panic attack or heart attack. Characterized by tingling pains in the heart region, which radiate under the scapula.
- Bilateral. It is the most common variety. On symptoms, see below.
It should be noted that the degree of progression of the disease is also different. Here the main factor is the amount of accumulated fluid. Hydrothorax can be initial (50-150 ml), small (150-500 ml), medium (500-1500 ml) and neglected (over 1500 ml).
Background
Pleural effusion is usually secondary. The prerequisites for its appearance can be distinguished in such a list:
- Alimentary dystrophy.
- Circulatory failure, accompanied by congestion.
- Myxedema.
- Hypoproteinemia.
- Glomerulonephritis.
- Cirrhosis of the liver.
- Peritoneal dialysis.
- Constrictive pericarditis.
- Hemodialysis.
- Sarcoidosis
- Nephrotic syndrome.
- Pulmonary embolism.
All these processes contribute to the occurrence of violations in the mechanisms that ensure the circulation of fluid in the pleural cavity.
Causes
Before discussing hydrothorax symptoms and treatment, we need to consider them. The main causes of this pathology include:
- Violation of the exchange of electrolytes.
- Increased aldosterone production.
- Lymphatic outflow disorder.
- An increase in the capillary network of the parietal and visceral pleura sheet of hydrostatic pressure.
- Decrease in oncotic pressure in a blood plasma.
- Increased permeability of the vascular wall.
Clinical manifestations
The disease in question is always manifested by the same symptoms. The reason for the occurrence does not play a role. Symptoms are as follows:
- Superficial frequent breathing.
- Shortness of breath during physical exertion.
- Hoarseness and hoarseness of voice.
- Blanching of the skin.
- Dizziness, sometimes loss of consciousness.
- Blue nasolabial triangle.
- Acute anemia
- Nausea and vomiting.
- Deep dry cough.
- Shackling pain of an acute nature, localized in the chest. It radiates to the lumbar region and back.
Also, many patients have a decreased body temperature. Many attribute this to chronic fatigue.
Examination reveals symptoms that are impossible to feel. Among them:
- Changing the shape of the chest. If the lesion is unilateral, asymmetry is observed.
- The "lag" of the affected half that appears at the time of inspiration. The lung seems to be late.
- Chest resistance.
- Tachypnea.
- Smoothness of intercostal spaces.
- Dull percussion sound.
- The absence of respiratory noise and trembling over the focus, subject to pathology.
- Limited mobility of the lower edge of the lung.
Many people who are interested in the causes, symptoms and treatment of hydrothorax are interested in the question - why is there no inflammatory process during fluid accumulation? Everything is simple. Pain syndrome with this disease is absent, and therefore inflammation does not occur.
Diagnostics
The initial examination is percussion, as well as auscultation of the chest. A pulmonologist necessarily examines the patient, taps and listens to his lungs, looks at the response of the body. An anamnesis is also collected.
Diagnostics involves the following activities:
- Roentgenography.
- Ultrasound
- CT
- Puncture of the pleural cavity.
The last procedure from the above allows you to find out if there is a transudate in the lung. It is also possible to determine the nature and properties of the liquid itself.
Principles of Therapy
The treatment of hydrothorax is conservative. It is aimed at treating the underlying disease - the one that caused this pathological condition to appear.
So, for example, with heart failure, treatment of hydrothorax begins with lifestyle adjustments. A person should begin to eat rationally, take a wide range of medications prescribed by a doctor, and also avoid nervous shocks and stress.
Compliance with a strict regime of work and rest. You must sleep at least 8 hours. Eat fractionally, in small portions, at the same time. It is also important to control the amount of fluid in the body and the level of protein in the blood.
If the renal form of the disease is diagnosed, then bed rest is mandatory. You also need to regularly pass urine for protein analysis, and refuse to use salt. Diuretics are prescribed with great care.
In cases where a liver disease provoked bilateral hydrothorax, treatment involves the removal of affected tissue, followed by a transplant of a healthy organ. If it is possible to preserve it, then a hard drug treatment and additional therapy are prescribed, which is necessary in order to avoid infection.
Taking medication
Continuing to talk about the principles of treatment of small hydrothorax, it is necessary to list the drugs indicated for use in this pathology. Usually prescribed such means:
- Antibiotics. They need to be taken after the puncture in order to minimize the risk of inflammation.
- Diuretics. They help get rid of puffiness and remove excess fluid from the body. As a result, blood pressure also normalizes.
- Hormones. They help normalize the endocrine system.
Also prescribed are agents that remove anxiety, improve sleep, stimulate appetite and eliminate pain. It can be hepatoprotectors, sedatives, analgesics.
It is very important that all drugs prescribed to the patient are combined with each other. Otherwise, the development of adverse reactions is possible.
Diet
It is difficult to say with one hundred percent certainty what nutrition principles a patient suffering from hydrothorax will have to adhere to. It all depends on which pathology provoked this condition. But, as a rule, they prescribe diet No. 10 or No. 10A.
Partial nutrition, salt exclusion from the diet, as well as limited consumption of water and other liquids are assumed.
The ban includes all harmful, fatty and spicy dishes, broths, butter and puff pastry, bread and pastries, goose, duck, pork, cooking fats, animal entrails, canned food, sausages, fish, dairy products, sweets, legumes, sour berries and fruits.
However, a nutritionist will give all recommendations to the patient, taking into account the underlying disease and the stage of development of hydrothorax.
When the cause is oncology
This case deserves special attention. Treatment of hydrothorax with oncology is no less important than with any other pathologies.
It should be noted that the tumor itself can occur in any internal system of the body. But, as a rule, this pathology occurs if the cancer affects the mammary glands, ovaries or lungs.
Less commonly, hydrothorax occurs due to the formation of a tumor in the digestive tract. Also, pleural mesothelioma and melanoma are attributed to infrequent manifestations of breast dropsy.
In such cases, therapy is thought through very carefully, the oncologist takes into account absolutely all the characteristics of the patient’s body, possible risks, benefits, as well as the compatibility of the drugs.
Pumping fluid
Conservative treatment of bilateral hydrothorax is powerless if a person is diagnosed with a total form of this pathology. In such cases, the only way out is the operation of pumping out the liquid, which is carried out according to a technique identical to that by which the puncture is performed.
No special training is required. A man should sit down, bend forward, lower his hands on the table set in front of him. The doctor determines the place that will be punctured, taking into account previously conducted studies - tapping, ultrasound and radiography.
Pump out the liquid after introducing the patient into a state of local anesthesia. Pain is blocked by administering a 0.5% solution of novocaine.
Introducing the needle, the doctor focuses on the upper edge of the rib. With a puncture, blood vessels or nerves cannot be touched. It is also important to keep depth. Otherwise, the needle may enter too deep, which could result in lung damage. After administration, it is replaced by a puncture unit.
For one such procedure, you can remove about 1 liter of transudate. No more - this is fraught with dangerous consequences. Even a fatal outcome is possible.
Alternative treatment of hydrothorax
And this topic is worth considering. However, before discussing popular recipes, it is important to make a reservation that the use of alternative medicine methods must be approved by the attending physician. Because often the patient's initiative in such matters is fraught with consequences for his own health.
But here are what folk remedies hydrothorax treatment is most often carried out:
- Parsley broth in milk. The recipe is simple. It is necessary to pour parsley (0.5 kg) with milk (1 liter) and send to simmer on a slow fire. You do not need to boil - you need to wait until the liquid becomes 2 times less. Then the flask should be cooled, filtered and taken for 1-2 tbsp. l in a day.
- Decoction of turnip peel. Another remedy widely used in alternative treatment of hydrothorax. Pour 1 cup of the peel into a saucepan and pour water (3 L). Then close the container and send it to the oven (or oven) for two hours. Then drink the resulting medicine one glass a day.
- Onion juice. To make it, you need to finely chop two peeled heads and sprinkle with a small amount of sugar (3-4 tablespoons is enough). Leave the resulting mass overnight, and squeeze in the morning. Drink juice on an empty stomach for 2 tbsp. l per day.
Of course, this is only a small list of what is used in the treatment of folk remedies for hydrothorax of the lung. There are dozens of other recipes. But the simplest, perhaps, is the infusion of horsetail. You just need to fill in 50 grams of grass with a glass of boiling water and insist for 1-2 hours. Then strain and drink 2-3 times a day for 3 tbsp. l
How to remove fluid?
If a person has healthy kidneys, then he is allowed to use viburnum berries for medicinal purposes. They are eaten, after falling asleep with sugar, make decoctions, compotes, fruit drinks. It is useful to use a spoon or two of fasting viburnum, about 15 minutes before eating. This berry is not only a powerful diuretic - it also replenishes the body's need for minerals and vitamins.
Thyme, mint and chamomile tea may also help. For 1 cup of boiling water, take 0.5 teaspoon of all the listed herbs, and then take a drink before bedtime.
Cranberry juice also contributes to the reduction of puffiness. It is easy to prepare - you need to fill in a glass of sugar with 400-500 grams of frozen cranberries (hardly anyone can find fresh), wait until the juice appears, and then pour 2 liters of water. Send the container to the stove and let it warm for 20 minutes (do not boil). You can drink one glass a day.
If there are no contraindications, you can still drink a decoction of raspberries and rose hips. It also effectively removes excess fluid from the body. To prepare a single serving, 40 grams of raspberries and rose hips are enough. They must be filled with water (500 ml), boiled and cooled. The resulting volume to drink during the day.
Complications
If hydrothorax is not treated, acute respiratory failure will occur. Why? Because the lung tissue has been stably squeezed by fluid over time. The transudate is accumulating, the pleural sheets lose the ability to absorb it - hence the breathing problems.
If the infection also joined the pathology, hydrothorax is complicated by pleural empyema. This is the name of a diffuse purulent lesion. And this, in turn, is fraught with the appearance of bronchopleural fistula, secondary bronchiectasis, multiple organ failure, septicopyemia, etc. It is important to know that mortality in empyema is 5-22%.