The human lungs are covered with a thin serous membrane - pleura, which protects them from various injuries. The space between the leaves of this membrane is called the term “pleural cavity”. This area, like all respiratory organs, is involved in the body’s breathing process. Any violation of the normal activity of the lungs is accompanied by the occurrence of certain changes in the pleural cavity. One of the most common pathologies of the respiratory system at the moment is pleurisy - inflammation of the pleura. There may be several reasons for the development of this disease. Most often, it develops as a complication of the common cold, pneumonia, inflammation of the pancreas, pulmonary tuberculosis. The causes of pleurisy, which have a non-infectious origin, include: myocardial infarction, helminthic invasion, myxedema, cirrhosis, leukemia, glomerulonephritis, lung cancer.
Pleural inflammation can occur spontaneously with damage to the chest as a result of a strong blow, injury, fracture of the ribs. Specialists distinguish dry and exudative pleurisy. In the first case, the pleural cavity remains dry throughout the period of the disease. In the case of exudative or wet pleurisy, a certain amount of fluid may accumulate in the cavity of the inflamed pleura.
The main signs of pleurisy are considered:
- The occurrence of pain in the chest. This pain is usually aggravated by a deep breath, it can give into the arm or shoulder.
- Temperature rise.
- Strong dry cough.
- Dyspnea.
- Slight blanching of the skin (cyanosis).
In a person who does not have problems with the work of the respiratory system, the pleural cavity contains a small amount of serous fluid necessary for the normal functioning of the lungs, the excess of which is removed through the lymphatic and blood capillaries. The development of inflammation contributes to the imbalance between the production of serous fluid and its removal from the pleura. In the first hours of pleurisy, there is an expansion of capillaries that drain fluid from the pleural cavity, an increase in their impermeability and swelling. Gradually, a complete blockage of the capillaries occurs, while the pleura becomes edematous, exudate stagnates in it (a protein-rich liquid that is released, as a rule, at the site of localization of inflammation). As the inflammation of the lining of the lungs develops, the exudate accumulated in its cavity can gradually dissolve or transform into fibrous tissue. In the presence of purulent exudate, mandatory surgical care is required, the patient's pleural cavity in this case is subject to mandatory drainage.
Treatment of any form of pleurisy begins with establishing the exact cause of the disease. Diagnosis consists in:
- Chest x-ray.
- Ultrasound examination of the respiratory system.
- Electrocardiograms (to exclude myocardial infarction).
- General blood test (with pleurisy, an increase in ESR, leukocytosis is observed).
One of the main steps in establishing a diagnosis is puncture of the pleural cavity, which implies a puncture of the chest with a trocar for diagnostic purposes. Puncture allows you to take a pleural fluid for its detailed laboratory research. If a malignant tumor is suspected, thoracoscopy is performed - a study of the lung area using a special device that is inserted directly into the chest through its puncture.
The method of treating pleurisy depends entirely on the cause of the disease. In the case of a combination of tuberculosis and pleurisy, antibiotic therapy is prescribed, with rheumatic inflammation of the pleura, hormonal treatment with glucocorticoids is indicated. In the presence of purulent pleurisy, the pleural cavity is often drained (cleansing from pus and administering antibiotics directly to the pleural region) under conditions of the thoracic department of the clinic. After the course of treatment, the patient is shown rest in a sanatorium or in a sea resort.