In the chest cavity there is a special shell - pleura. It is intended for the free movement of the lungs and the maintenance of normal breathing. Between its layers is a wetting liquid.
Pleurisy is an inflammation of this membrane that limits the movement of the lungs. During the described process, fibrous plaque forms on its surface. Pleurisy often occurs as a complication of other diseases.
General information
Pleurisy is an inflammation of the pleural sheets, characterized by too much accumulation of fluid in the cavity of the membrane. Only in some cases, pleurisy can be an independent disease. As noted above, most often it acts as complications of other diseases and disorders in the body.
Among the main symptoms can be noted shortness of breath, shortness of breath, cough, fever. Infectious processes, chest injuries, neoplasms can provoke the occurrence of such a condition. Often pleurisy occurs in patients with pneumonia.
Regardless of the form and stage of the course, pleurisy is a fairly serious pathology that can lead to serious consequences. The treatment is quite successful if the correct diagnosis was timely made and complex therapy started, and the patient fulfills all the doctor’s instructions.
Classification
There are several types of pleurisy diseases, which are divided primarily by the nature of the inflammation. There are fibrinous and effusion pleurisy. The dry appearance is characterized by settling of fibrin on the pleura, which is a plasma protein. In this case, the fluid is present in a minimal amount, which greatly enhances the friction of the pleura sheets. This provokes the occurrence of pain. Fibrous pleurisy refers to the initial stage of development of this pathology, after which the exudative form begins to develop.
Exudative pleurisy is characterized by a significant accumulation of fluid in the cavity of the pulmonary membrane, which leads to excessive pressure on adjacent tissues and organs. This form of pathology is accompanied by an increase in the lesion area and inflammation. In addition, with effusion pleurisy, pleural pockets begin to form, in which pus accumulates after a while. As a result of a decrease in lung volume, respiratory failure gradually forms.
By etiology, pleurisy can be infectious and non-infectious. Infectious forms include the following:
- Bacterial
- Parasitic.
- Fungal.
- Tuberculosis.
Non-infectious species are tumor, traumatic, enzymatic, and also provoked by some diseases. Traumatic species are caused by significant hemorrhages when injuring the sternum, which provokes the accumulation of blood in the pleural cavity. In the absence of suppuration, dense connective tissue begins to form, limiting the functioning of the lungs.
In severe types of injuries, blood in the lung cavity coagulates almost instantly. In some cases, mixed types of disease can occur. According to the nature of the course of pleurisy, they are divided into:
According to the area of distribution, it can be diffuse or delimited. In addition, differences may be in the nature of the effusion. In this case, doctors distinguish such forms of pleurisy:
- Fibrinous.
- Serous purulent.
- Serous.
- Purulent.
- Chillous.
- Hemorrhagic.
- Cholesterol.
The fibrinous form is considered the lightest, which is characterized by the accumulation of a small amount of fibrin and a minimum of fluid. The purulent type of the disease is quite acute and is characterized by the presence of pus between the pleural sheets, which is accompanied by signs of intoxication of the body. Such a condition poses a great threat to human life.
Developmental stages
There are several stages of pleurisy, which are characterized by different symptoms and pathogenesis.
At the 1st stage, increased production of pleural fluid is observed. This pathological process occurs due to the strong expansion of blood vessels. This occurs as a result of activation of the corresponding cells and antibodies by the body's defense system in response to infection. The lymphatic system at this stage is still able to remove the existing excess fluid, so its amount is still normal.
At the 2nd stage, fibrin begins to be deposited on the pleura, which has an adhesive property. This provokes significant friction of the pleura with each other, resulting in the formation of adhesions. As a result of this, small pockets form, and the outflow of fluid from the pleural cavity is impeded. In connection with the constant accumulation of pathological fluid, the process of suppuration begins, and the resulting pus provokes inflammation of adjacent tissues. In this case, the outflow of fluid through the lymphatic system is disrupted.
At the 3rd stage, there is a recovery or transition to the chronic stage. The chronic form is characterized by a decrease in lung mobility, an increase in pleural thickness, as well as a deterioration in the outflow of pathological fluid. In some cases, pleural adhesions form or complete replacement with fibrous fibers occurs.
What causes the disease
Among the main causes of pleurisy of the lungs are the following:
- Infections
- Neoplasms.
- Injury to the sternum.
- Allergic reactions.
- The effect of toxins on the body.
- Tuberculosis.
There are certain provoking factors that contribute to the development of pathology:
- The presence of respiratory diseases.
- Alcohol abuse and smoking.
- Decreased immune system function.
- Reflux of the stomach.
Basically, a disease develops when penetrating into the pleural region of pathogens. Infection occurs by airborne droplets, through the lymphatic system, and blood.
Key features
Symptoms of pleurisy largely depend on the form of the pathology. The dry type of the disease manifests itself in the form of acute, stitching pain in the sternum, which is aggravated by sneezing, coughing, moving, and breathing too actively. To reduce pain, the patient lays on the area of pain to limit chest mobility.
With the apical type of disease, which is characteristic for the course of tuberculosis, you can hear the sounds of friction of the pleura. Muscles become tense and painful. Among the main symptoms of pleurisy, one can distinguish the following:
- Temperature rise.
- Intense night sweats.
- Weakness.
- Chills.
With tuberculosis, pleurisy lasts a very long time and is often accompanied by the release of fluid into the pleural cavity. With the diaphragmatic location of the disease, signs of pleurisy of the lungs are quite specific and appear as painful sensations under the ribs, in the abdominal cavity and in the sternum. The abdominals are somewhat tense, flatulence and hiccups occur.
With an exudative type of the course of the disease, dull pain in the affected area is observed, as well as a painful cough. In addition, a characteristic noise is heard, a feeling of heaviness in the side, shortness of breath, cyanosis of the skin. Common symptoms of pleurisy are also observed:
- Loss of appetite.
- Increased sweating.
- Temperature rise.
- Severe weakness.
Pleural empyema occurs with chills, and with the serous type of the disease, blood secretion is observed. If the disease was triggered by lupus erythematosus, then joint symptoms of inflammation of the joints and kidneys, pericarditis join the common signs. In the case of metastases, the pathological fluid accumulates quite slowly, so the pathology is almost asymptomatic.
Chylous pleurisy is characterized by the fact that the fluid between the pleural lobes is more like milk. It develops mainly due to the formation of a malignant tumor of the lymph nodes. Their integrity is violated, the lymph penetrates the pleural cavity. Among the main symptoms of pleurisy can be identified constant fever, pain under the ribs, rapid breathing, coughing, which is initially dry, and then passes with the release of sputum.
Diagnostics
The diagnosis of pleurisy is established on the basis of a comprehensive examination. Diagnosis involves the following actions of physicians:
- Interrogation of the patient.
- Carrying out an external inspection.
- Listening to the lungs and heart.
- Analysis of urine and blood.
- X-ray examination.
- Sputum analysis.
- The study of pleural fluid.
After conducting a comprehensive diagnosis, the doctor selects the method of treatment.
Therapies
If pleurisy is detected, the clinical recommendations must be followed very strictly to prevent the development of complications. The methods of therapy largely depend on the initial cause that provoked the occurrence of the pathological process. Initially, the course of treatment should be aimed at stopping the primary disease and improving well-being. Among the main methods of treating pleurisy, it is necessary to highlight the following:
- Drug therapy.
- Folk techniques.
- Surgical intervention.
- Compliance with the diet.
After the resorption of the accumulated exudate, the patient is prescribed physiotherapeutic methods of treatment, respiratory gymnastics and physiotherapy exercises. Of great importance is exercise therapy for pleurisy, as special exercises will help facilitate coughing.
The use of drug therapy
Treatment of pleurisy must be comprehensive. Medications are of primary importance, but before using them, you should definitely consult your doctor. Since the disease in most cases occurs due to the penetration of pathogens into the pleura, drugs are prescribed to eliminate the infection.
Antibiotics for pleurisy are prescribed, because most often pathogenic bacteria are found in the patient’s biomaterials taken for research. First, doctors prescribe broad-spectrum antibacterial drugs, and after conducting a study and determining the infection, a specific drug is prescribed.
The dosage and course of therapy depends on the diagnosis and the complexity of the pathology. The most common antibiotics for pleurisy are Ampicillin, Clindamycin, Imipenem, Ceftriaxone.
The course of the disease is accompanied by painful sensations. To eliminate the pain, the use of anti-inflammatory drugs (Ibuprofen, Meloxicam, Diclofenac, Nimesil.) And glucocorticoids is indicated. The main remedy prescribed for patients is Prednisolone.
In pleurisy, bacteria poison the human body with toxic substances. They provoke rotting processes in the body. To remove toxins and dead bacteria, detoxification therapy is used, which includes:
- Intravenous glucose infusion.
- Detoxification drugs "Albumin" or "Atoxil".
- Diuretics ("Furosemide").
Drinking plenty of water is not prescribed, as an excessive amount of fluid leads to an increase in effusion. If there is a temperature during pleurisy, the use of antipyretic drugs is required.
The development of the disease is associated with a weakening of the immune system, since it is she who is responsible for opposing pathogens. To strengthen immunity, immunomodulators "Timogen", "Imudon" are prescribed. Additionally, you can take vitamin complexes.
Cough with pleurisy is treated with special antitussive drugs, as well as expectorant drugs. The medicine is selected by the doctor purely individually, depending on the nature of the cough.
When taking antibacterial drugs, intestinal microflora are disturbed. Probiotics are prescribed to restore it. There are many of them, but most often doctors prescribe Acipol, Linex, Bifiform.
Methods of traditional medicine
A good effect is provided by traditional medicine. You can take chopped horseradish root mixed with lemon juice. Onion inhalations are widely used to combat diseases of the respiratory system. It is necessary to make pulp from a medium-sized onion and transfer it to a large container. Then close your eyes, tilt your head to the pulp and inhale the fumes through the mouth.
For faster removal of accumulated fluid from the body, you need to grind the ginseng root, transfer it to compression paper with small holes, then wrap gauze and apply as a compress to the stomach area. Then wrap it all up with a warm cloth.
To facilitate expectoration and restoration of the alveoli, the patient is shown pulmonary collection, as well as a decoction prepared on the basis of licorice root, ledum, plantain leaves. Fresh beetroot juice is a good remedy. It is also recommended to regularly eat boiled beets.
A decoction of chamomile and horsetail will help reduce puffiness and remove excess fluid from the body. Folk remedies will not be able to cure diseases on their own, but will be a good addition to drug therapy.
Surgical intervention
With pleurisy of the lungs, an operation is performed in case of a severe course of the disease. Often, pleural puncture is prescribed. Its essence is the introduction of a thick needle into the pleural cavity under local anesthesia, through which a certain part of the fluid is taken.
As a result of such a manipulation, excessive pressure in the lungs can be eliminated, which normalizes the respiratory mobility and well-being of the patient. A similar procedure is indicated for the ineffectiveness of drug therapy, as well as as a complex therapy. In case of severe pathology, competent nursing care for pleurisy is required. It includes taking the necessary tests by health workers, performing procedures, providing the patient with a half-bed regimen and diet (table No. 15), as well as applying a bandage to the chest and dry heat on the side of the lungs that is affected (performed with normalization of temperature readings).
Dietary Compliance
With the occurrence of pleurisy, clinical recommendations include strict adherence to diet. It is prescribed, depending on the disease that provoked the pathology in the pleura.
Nutrition must consist of products enriched with vitamins and minerals. This will strengthen the immune system and the whole body. In addition, heavy food intake should be avoided. It is also important to adjust the drinking regimen.
Possible complications
The consequences of pleurisy can be quite dangerous. If shortness of breath appears after a course of therapy, this may indicate that adhesions have formed between the pleura sheets, restricting lung mobility during breathing.
Preventive measures
In order to prevent the occurrence of pleurisy, it is necessary to carry out preventive measures, which include:
- Timely seeking help from a doctor.
- Compliance with the requirements of rehabilitation after surgery.
- Prevention of hypothermia.
- Compliance with hygiene rules.
- Normalization of the day.
- Frequent airing of the room.
- Refusal from alcohol and smoking.
It is important to timely and comprehensively treat all existing respiratory diseases. These preventative measures will help prevent pleurisy and normalize overall well-being.
After discharge from the hospital, the patient needs to perform breathing exercises prescribed by the doctor to restore the full functioning of the lungs. Showing minor physical activity, yoga and walks in the fresh air.