Treatment of pleurisy with folk remedies is the most popular. Exudative pleurisy: causes, symptoms and treatment methods. Symptoms of the disease and its diagnosis

The arrow in the image indicates exudate.

Exudative pleurisy is usually called an inflammatory process in the lining of the lungs - the pleura, which is accompanied by the formation of pleural effusion. Pleural effusion is the accumulation of excess fluid in the lining of the lungs. In exudative pleurisy, this fluid is called exudate. This type of pleurisy can also be called effusion. He may continue to have dry pleurisy.

In a healthy state, a person has a small amount of serous fluid in the pleural cavity, which prevents excessive friction between the layers of the membrane of the lungs during the act of breathing. However, the amount of fluid in the pleural cavity during effusion pleurisy is many times higher than normal.

Also, exudate differs from normal serous fluid in its composition, which can be different, depending on the primary disease, the complication of which was pleurisy. Treatment should combine effects on both the inflammatory process in the lining of the lungs and the root cause of this process.

When and why does effusion pleurisy occur?

Exudative pleurisy accompanies a number of diseases of infectious and non-infectious origin and has its own symptoms that complement the picture of the underlying disease, the clinical picture of which is often more vivid. The most common underlying diseases are:

The reason for the formation of exudate is a violation of microcirculation - blood circulation in the smallest vessels, which does not allow the inner layer of the lining of the lungs to absorb excess fluid secreted by the outer layer into the pleural cavity. In addition, absorption is also hindered by the substance fibrin that quickly covers the surface of the pleural layers.

How to recognize the disease

Diagnosis and differential diagnosis of the exudative form of the disease is based on clinical picture: the clinic includes not only general, but also symptoms specific to effusion pleurisy, as well as laboratory and instrumental methods chosen by the doctor during the diagnostic search.
Most often, exudative pleurisy does not have such striking symptoms as severe pain in the dry form of the disease, for example. It is characterized by a rise in the patient's body temperature to 37-38 degrees, accompanied by chills, increased sweating, weakness, lethargy and drowsiness of the patient, which are caused by intoxication, that is, the release of toxic products into the blood. On the affected side, the patient usually experiences a feeling of heaviness, which occurs due to compression of the lung tissue by exudate. For example, exudative pleurisy on the left will give symptoms of discomfort and heaviness in the left half of the chest, and on the right – in the right. Later, when the effusion becomes quite large, the patient shows signs of respiratory failure: he can no longer breathe normally, he develops symptoms of shortness of breath and the inability to perform physical activity due to difficulty inhaling. Sometimes a strong reflex dry cough may occur. A dry cough is caused by displacement of the trachea and damage to the pleura itself, which is rich in various nerve endings.

A more detailed examination of the patient will reveal new symptoms of the disease. Upon examination, you can notice that the patient tends to take a semi-sitting position and slightly tilt the body to the painful side, and sometimes lies down on the healthy side. This allows you to increase the respiratory movements of a healthy lung and the flow of oxygen into the body through it, somewhat alleviating the suffering of the patient.

Since the patient’s body does not receive enough oxygen, his skin may take on a grayish or even bluish tint. These symptoms are called cyanosis. The half of the chest in which the exudate is located is usually visually slightly larger than the healthy one. It also lags behind the second half of the chest in terms of the speed of respiratory movements.

If you percussion, that is, start tapping the chest, then over the area where the effusion is located, a dull sound will be heard, unlike the sound over healthy lung tissue.

An important point is that the formation of a large amount of exudate, more than 4 liters, can lead to displacement of the mediastinum - the heart with the surrounding anatomical formations, which will also give characteristic symptoms. For example, a left-sided process will cause the mediastinum to shift to the right if the process is combined with pneumonia, that is, it is infectious. If the inflammatory process in the lining of the lungs during pneumonia is on the right, then the clinic will reveal a shift of the mediastinum to the left.

To the left, with a left-sided lesion, the mediastinum will shift when the effusion is caused by a tumor process and is combined with collapse of the lung tissue on the affected side. In addition, exudative pleurisy on the left can be recognized by the disappearance of the ringing, so-called tympanic sound, if the surface of the abdomen to the left of the navel is percussed immediately below the costal arch. Also, exudative pleurisy on the left will result in weakening, and more often the absence of respiratory noise in the projection of fluid in the pleural cavity on the left. Such signs and symptoms make it possible to diagnose mediastinal displacement with almost complete certainty.

Dry pleurisy will not cause displacement of the mediastinum, since with it the inflammatory process in the pleura is not accompanied by exudation.

Laboratory diagnosis of effusion pleurisy is based mainly on a blood test. An increase in the number of white blood cells - leukocytes, which take part in inflammatory reactions - will be detected in the blood. The erythrocyte sedimentation rate will also be increased. A biochemical blood test will reflect the appearance of inflammatory protein compounds, such as C-reactive protein, for example.

Instrumental diagnosis of the exudative form of pleural inflammation includes a number of techniques. The simplest, but quite informative of them is chest radiography.

X-ray, light area – location of exudate.

Using an x-ray, you can determine the presence of effusion and its approximate level, that is, get an approximate idea of ​​the amount of exudate.

If there is little inflammatory fluid in the pleural cavity, that is, its amount does not exceed 150-200 ml, the so-called laterography method is used to clarify its presence.

The image shows the relative position of the patient with the X-ray machine during laterography.

The latter consists of conducting an X-ray examination with the patient positioned on the affected side. If there is an inflammatory exudate, then a narrow ribbon-like shadow will be visible on the x-ray.

In the lower part of the image there is a darkening (light area) - this is a strip of exudate.

Such diagnostics reduces the frequency of errors that often fill the medical history.

Diagnosis of effusion pleurisy must necessarily include examination of the effusion itself, the evacuation of which is ensured by thoracentesis, that is, puncture of the pleural cavity.

Thoracentesis is a puncture, that is, a puncture, of the pleural cavity with the subsequent removal of the exudate accumulated there.

Correct position of the patient and injection site.

This makes it possible to alleviate the patient’s condition by straightening previously compressed lung tissue, and also makes it possible to examine the inflammatory fluid from the pleural cavity.

Puncture technique.

Fluid should be removed slowly during puncture to avoid sharp fall patient's pressure.

The surgical procedure may be complicated by the following phenomena:

1. Bleeding.
2. Pneumothorax is the entry of air into the pleural cavity, which requires urgent measures to remove it, the first of which is drainage of the pleural cavity.
3. Infection.
4. Damage to nearby organs.
5. A sharp drop in blood pressure in a patient.

When the puncture is performed and fluid is obtained from the pleural cavity, it is necessary to make sure that it is exudate. The fluid may be a so-called transudate - a non-inflammatory effusion that is formed due to changes in physical properties blood in the pulmonary vessels, usually due to heart failure or kidney failure. Transudate is a clear, yellowish liquid that is usually odorless.

Always, if the effusion is recognized as exudate, it should be carried out bacteriological examination to identify the infectious nature of the disease and correctly select antibacterial treatment, in accordance with the causative microorganisms isolated from the effusion.

Differential diagnosis for the exudative form of inflammation of the lining of the lungs should be carried out in two directions. Firstly, the actual confirmation of damage to the lining of the lungs, which is usually possible with a clinic that includes signs of the disease. Secondly, different root causes are characterized by different physical states of the exudate, as well as its composition. The description of all differential diagnostic measures should include a medical history.

Therapeutic measures

Treatment of patients with exudative pleurisy should combine a drug component with a non-drug component, as well as careful nursing care for the patient.

Non-drug treatment boils down to activating the patient and improving the blood supply to the lung tissue. For him, nursing supervision is usually sufficient. Tapping on the chest, movements from side to side, right to left and left to right, in bed are carried out, that is, all kinds of obstruction of the patient’s constant static position.

Drug treatment for effusion pleurisy is quite varied:

It is important to note that in both dry and effusion forms of pleurisy, both nursing and medical supervision of the patient should be carried out with the utmost care. The medical history should record all manipulations performed on the patient. It is especially important that the medical history includes information about thoracentesis, since the latter can have quite serious complications.

Easy and uninterrupted breathing is ensured by this important body like lungs. To make this process painless, the lungs are covered with a double film - pleura.

If pathogenic microorganisms enter the body or a mechanical disturbance occurs, the pleura becomes inflamed. The space between the two films is filled with pus, causing the person to experience painful sensations when inhaling, active movements, sneezing and coughing.

Symptoms of pleurisy depending on the type

The initial symptoms of pleurisy are similar to the common cold, so at the first stage the disease is often not recognized. At a later stage, specific symptoms of different types of pleurisy appear:

• Dry pleurisy is manifested by painful sensations in the chest when taking a deep breath, bending the body to the side, or coughing. In the evening, body temperature rises to 38°C. Symptoms such as increased energy, weakness, decreased performance appear;
• With exudative pleurisy, cough, drowsiness and lethargy are accompanied by a feeling of heaviness in the chest. The patient feels as if his chest is being squeezed in a vice. Breathing becomes heavy and shallow, shortness of breath appears. The skin turns pale and becomes bluish around the lips and nose. The rise of the chest during breathing is asymmetrical: the second part of the body rises late;
• Purulent pleurisy is characterized by a high temperature (up to 40 ° C), which is much more difficult to bring down than with other forms of the disease. A person's skin becomes cold, pale and slightly damp. Breathing is difficult, coughing gets worse.

The disease occurs in three stages. In the first phase, changes are practically not manifested by external symptoms, but in the second stage it becomes difficult to breathe, work and perform active actions. At this point, it is very important to consult a doctor to make a diagnosis and prevent further complications.

General principles of treatment of pleurisy

The main treatment for pleurisy is conservative. The help of a surgeon is required only in advanced and severe cases. Therapy is carried out according to the following rules:

1. At the beginning of treatment, the doctor prescribes antibacterial drugs a wide spectrum of action, a means to reduce pain and relieve painful sensations. Medicines that act selectively are prescribed after receiving test results.
2. If tumors are present, glucocorticosteroids and medications are prescribed to slow tumor growth.
3. Auxiliary drugs - diuretic tablets, cough syrups and medications that strengthen blood vessels and support their function.
4. To strengthen the effect obtained, the patient is prescribed warming and other physiotherapeutic procedures.

If internal organs compressed with a large amount of fluid, lymphatic drainage is performed. No more than 1 liter can be pumped out of the body at a time, otherwise internal organs will be displaced. For this reason, lymphatic drainage is often performed several times.

Medications for the treatment of pleurisy

Medications are prescribed to influence the causes of the disease - the penetration of pathogenic microorganisms into the body. The doctor prescribes the following medications:

• Acetylsalicylic acid (Aspirin). It has an analgesic effect, softens inflammation and relieves fever. Contraindicated in heart failure, erosive and ulcerative diseases of the gastrointestinal tract and under the age of 15 years. During pregnancy, the drug can be taken only taking into account the risks and potential benefits for the mother. The daily dose of Aspirin is 8 g. Take up to 6 times a day;
• Analgin. Indicated for relieving acute pain. It is not recommended to take for bronchial and aspirin-induced asthma, blood diseases, kidney and liver failure, and during pregnancy. The product can be given to children from 3 months. Maximum dose– 2 g per day. Take as tablets or solution 2-3 times a day;
• Benzylpenicillin is an antibiotic that interferes with growth and development pathogenic bacteria. Contraindicated in case of sensitivity to penicillins, epilepsy, hay fever and bronchial asthma. 1,000,000-2,000,000 units are administered intramuscularly every 4 hours;
• Indomethacin. Used to reduce fever, relieve pain and inflammation. Contraindicated for peptic ulcers, internal bleeding, congenital heart defects, arterial hypertension, renal and liver failure, blood clotting disorders, age up to 14 years. The permissible dose is 25 mg, 3 times a day;
• Diclofenac sodium. Refers to non-steroidal anti-inflammatory drugs. Relieves pain and reduces fever. Contraindicated under the age of 6 years, with peptic ulcer of the stomach and duodenum, pathology of the liver and kidneys, pregnancy and breastfeeding, hypersensitivity to the components of the drug. Take 100 mg per day;
• Calcium chloride. Anti-inflammatory agent, reduces capillary permeability, prevents allergic reactions, destroys pathogenic microorganisms. It is not recommended to take it if you have atherosclerosis, increased concentration of calcium in the body, hypersensitivity and a tendency to thrombosis;
• Lefosocacin is a broad-spectrum antibacterial drug. It is quickly absorbed into the small intestine and has a healing effect, relieves pain, reduces inflammation and fights pathogens. Contraindicated in people under the age of 18, those with lactose intolerance, epilepsy, and those who are pregnant or breastfeeding. The course and regimen of treatment is determined by the attending physician depending on the degree of the disease and the characteristics of the body;
• Erythromycin is an antibiotic drug that actively treats respiratory diseases, copes with pathogenic microorganisms, relieves pain and has an anti-inflammatory effect. Contraindicated in case of hearing loss, during pregnancy and lactation, while taking terfenadine or astemizole. Maximum daily dose- up to 2 grams. The minimum interval between doses is at least 6 hours.

Before taking these medications, consult your doctor. Remember that the regimen and course of treatment depend on the severity and form of pleurisy. If you take these medications incorrectly, you will cause severe harm and side effects to your body.

Treatment of pleurisy using folk remedies

Folk remedies are an auxiliary method of treating pleurisy. They can be taken to speed up treatment. Below we will look at time-tested medicines prepared according to folk recipes:

1. Take 30 g of camphor and 3 g of eucalyptus and lavender oils. Mix and rub into the area under the shoulder blades 3 times a day. After the procedure, apply a warm compress. Use the oil mixture for 2-3 weeks;
2. Mix 2 tbsp. chopped marigolds, add olive oil (200 ml), transfer to a jar and leave for 2 weeks in a dark place. When the product is ready, use it for rubbing;
3. Take equal parts of coltsfoot leaves, black elderberry flowers and knotweed grass. Chop, place in a saucepan, bring to a boil and cook for 15 minutes. Cool and strain. Take 100 ml. every day throughout treatment;
4. Take equal parts of peppermint, licorice and elecampane roots, marsh cudweed grass, and coltsfoot leaves. Combine and pour a liter of boiling water. Insist. Take 100-150 ml. until complete recovery;
5. Take a medium sized onion. Cut it into several pieces and place on a plate. Lean over the onion and inhale the vapors emitted by the vegetable. Cover your head with a towel and be sure to keep your eyes closed. Repeat the procedure once a day;
6. Take 50 g of badger fat, 300 g of peeled and crushed aloe leaves and 1 glass of natural honey (200 g). Mix all ingredients thoroughly and place in the oven for 10 minutes. Once the mixture is ready, strain it through cheesecloth or a sieve. The raw material is thrown away. The resulting composition should be consumed 2 times a day, half an hour before meals;
7. Chop 300 g of onion, pour in dry white wine (500 ml), add 100 g of honey. Stir, leave for 8 days, then take a tablespoon 4 times a day.

Remember that the effect of medicinal herbs is individual. If hypersensitive or used incorrectly, they can cause allergic reactions and side effects.

X-ray of lungs affected by pleurisy

How to treat pleurisy in pregnant women and children

Pleurisy of the lungs is a disease that should be stopped before it starts. If a pregnant woman is at risk, it is necessary to treat underlying diseases, avoid overexertion and strengthen the immune system. If pleurisy cannot be avoided, therapy should be carried out under the supervision of the attending physician. Treatment is aimed at eliminating the inflammatory process. Local antibiotics, herbal ingredients and other gentle drugs are selected as drugs.

If a child gets pleurisy, treatment is carried out in a hospital. If the condition of a small patient is serious, and respiratory failure develops against the background of pleurisy, then treatment is carried out in the intensive care unit. Strict bed rest, the use of antibiotics and drugs for detoxification (removing pathogenic microorganisms and toxic substances from the body) are prescribed. If necessary, drainage of pus and sanitation of the pleural area are prescribed.

Before prescribing an antibiotic drug, the doctor takes into account general state child, test results and sensitivity to certain drugs. Medicines acceptable for the treatment of children are Methicillin, Ristomycin, Oletetrin, Ristomycin. In severe cases, the doctor may prescribe Tienam, but using it unnecessarily is not recommended.

Antibiotics are administered intravenously or intrapleurally. If pleurisy develops against the background of malignant tumors, chemotherapy is added to treatment. For dry pleurisy, anti-inflammatory drugs are prescribed - Aspirin, Butadione, Brufen.

Possible complications of pleurisy

If you do not start therapy in a timely manner or engage in
If treated independently, pulmonary pleurisy can lead to complications. Consequences of incorrectly rendered medical care severe and in some cases even irreversible. The most dangerous complications include the consequences of purulent pleurisy.

Purulent pleurisy – acute inflammation pleura, which in itself is not a primary disease. As a rule, pleurisy is a complication of other diseases, which are purulent lesions of the respiratory system or lung abscesses.

From this video you will learn about the features and clinical manifestations of pulmonary pleurisy. You will also become familiar with the correct treatment methods, types of inflammation of the pleural film and anti-inflammatory drugs for its treatment.

Types and causes of pleurisy

Depending on the etiology of the disease, two types of pleurisy are distinguished:

• Non-infectious (aseptic) - the inflammatory process provokes diseases of other organs and systems.
• Infectious - arise as a result of invasion of the pleura by infectious pathogens.

Infectious inflammations occur against the background of acute pulmonary diseases and pneumonia. The main causative agents of pleurisy are:

• Pneumococcus;
• staphylococcus;
• gram-negative rods.

Tuberculosis pleurisy is provoked by microbacteria tuberculosis. In this case, infection of the cavity with microbacteria occurs from subpleural foci, hilar lymph nodes, or as a result of rupture of caverns (dangerous by the formation of pyopneumothorax). Pleural inflammation of fungal etiology is often caused by blastomycosis, coccidioidosis and other severe fungal diseases.

Aseptic pleurisy deserves special attention. Aseptic inflammation can develop against the background of trauma (traumatic pleurisy), hemorrhage, as a result of pancreatic enzymes entering the pleural cavity (enzymatic pleurisy).

The main causes of aseptic pleurisy:

More than 40% of exudative pleurisy occurs due to the spread of a metastatic tumor into the pleura. Moreover, a tumor of the thyroid gland or stomach, as well as a tumor of the kidney, lung, breast, ovary, lymphoma or bone sarcoma can metastasize. Pleurisy caused by dissemination of secondary or primary malignant tumors along the pleura is diagnosed - carcinomatous pleurisy.

Sympathetic pleurisy occurs as a result of intoxication of the pleura during inflammatory processes or products of necrosis of neighboring organs, sometimes the source is lymphogenous invasion of enzymes from the affected pancreas.

Based on the type of exudate (effusion), pleurisy is distinguished:

• purulent;
• chylous;
• serous;
• putrefactive;
• fibrinous;
• eosinophilic;
• cholesterol;
• hemorrhagic;
• serous-fibrinous.

Pathogenesis

The localization and extent of spread of pleurisy is significantly influenced by:

• general and local reactivity of the body;
• the route of penetration of microorganisms into the pleural cavity and the type of infection (with infectious pleurisy);
• condition of the pleural cavity and the presence of concomitant pathologies.

In clinical practice, pleurisy caused by pneumonia is divided into metapneumonic and parapneumonic. Such a separate classification is not entirely correct because Metapneumonic pleurisy is actually not an independent disease that occurs after pneumonia. Pathological inflammation develops due to undetected secondary infection and suppuration during pneumonia itself.

The danger of pleurisy

Productive-regenerative and exudative processes during pleurisy lead to adhesion and subsequent fusion of the pleural layers, as well as other functional disorders.

Pleurisy is caused by:

• sharp pain when inhaling - develops as a result of friction of pleural layers affected by inflammation;
• compression of the lung and displacement of the mediastinum (the space between the right and left pleural cavities) - this occurs due to the accumulation of liquid exudate;
• violations of ventilation and hypoxemia - occur due to compression in the lung tissue;
• displacement of the heart muscle and circulatory disorders - due to increased pressure in the sternum, compression of the vena cava and deterioration of venous blood flow;
• purulent-resorptive intoxications - develop with purulent pleurisy.

Symptoms of pleurisy

Symptoms of dry pleurisy

Due to the fact that pleurisy is a secondary inflammation against the background of other pathologies, the symptoms of the disease may be subtle.

Dry pleurisy is diagnosed with:

• chills;
• weakness;
• sleep disturbance;
• noise on auscultation;
• shallow breathing;
• severe pain when coughing;
• stabbing pain behind the sternum;
• uneven rise of the chest when breathing.

Characteristic signs of dry pleurisy of the diaphragm:

• hiccups;
• flatulence;
• pain in the hyporibs;
• abdominal hypertonicity;
• heaviness in the chest.

The symptoms of fibrinous pleurisy are identical to the underlying disease that provoked the inflammation.

Symptoms of exudative pleurisy

With pleural exudation the following are observed:

• cyanosis;
• weakness;
• dyspnea;
• sweating;
• dry cough,
• heaviness in the side;
• loss of appetite;
• dull pain in the hypochondrium;
• noise when inhaling and exhaling;
• febrile body temperature;
• smoothing of intercostal spaces;
• asymmetrical rise of the chest when breathing.

Paramediastinal (encysted) pleurisy is characterized by:

• dysphagia;
• hoarseness of voice;
• swelling of the face and neck.

The pathogenesis of serous pleurisy, which developed as a result of a bronchogenic form of cancer, is characterized by hemoptysis. If pleurisy is caused by lupus erythematosus, collateral development of pericarditis, renal and articular anomalies is possible. For metastatic pleurisy, the danger is asymptomatic accumulation of exudate, as well as disruption of the of cardio-vascular system(tachycardia, decreased blood pressure) and mediastinal shift.

With exudative pleurisy, symptoms can be isolated or increasing and common with other problems in the body. Palpation of the patient's chest allows one to diagnose characteristic crepitus during breathing.

If you notice similar symptoms, consult a doctor immediately. It is easier to prevent a disease than to deal with the consequences.

Diagnosis of pleurisy

When taking a history of the disease, the pulmonologist examines the chest and performs auscultation. Exudative pleurisy is characterized by protrusion of the intercostal spaces, asymmetry of the sternum, bronchophony and weak breathing. The upper limit of the effusion is determined by percussion using ultrasound or radiography.

To make a diagnosis of pleurisy and prescribe therapy, additional studies are carried out:

• pleural puncture;
• chest x-ray;
• biopsy and thoracoscopy of the pleura;
• bacteriological and cytological studies of exudate.

With pleurisy, the following abnormalities are present in a detailed blood test:

• excess ESR;
• increase in seromucoids;
• neutrophilic leukocytosis;
• excess fibrin and sialic acids.

In the case of dry pleurisy of the diaphragm, which accompanies basal pneumonia and inflammation in the subphrenic space, diagnostic difficulties may occur. This pathology is not characterized by pleural friction noise, and the pain radiates to the neck and anterior abdominal wall. There may be pain when swallowing and painful hiccups, as with tracheitis.

An obvious symptom of pleurisy is painful palpation during examination:

• crura of the sternocleidomastoid muscle of the neck;
• first intercostal space;
• along the diaphragm line (Mussy signs);
• in the area of ​​the spinous endings of the upper cervical vertebrae.

If exudative pleurisy develops after fibrinous pleurisy, pain in the chest is replaced by a feeling of heaviness and fullness. In this case, they diagnose: general weakness, shortness of breath, reflex cough. Due to the accumulation of exudate, patients experience a feeling of lack of oxygen, swelling of the neck veins and cyanosis. Swelling of the skin in the lower parts of the chest, increased heart rate and Wintrich's sign are also possible.

In clinical pulmonology, it is believed that if the volume of accumulated pleural exudate is more than 300-500 ml, it can be diagnosed by percussion. Enclosed pleurisy is characterized by atypical boundaries of the effusion.

One of the most informative diagnostic methods is pleural puncture, which helps confirm the accumulation of liquid exudate and its nature. As a rule, the study is carried out in the area of ​​the seventh-eighth intercostal space (along the axillary line at the back). If the resulting puncture reveals the development of pyogenic microflora (when the exudate is cloudy and with sediment), this is a sign of pleural empyema.

In the case of serous-hemorrhagic and serous effusions, bacterial cultures are not informative. Thoracoscopy is important in diagnosing the nature of pleurisy. This study involves visual inspection of tissues, morphological analysis and biopsy.

A full diagnosis can be performed at any modern pulmonology center.

Treatment of pleurisy

The main therapy for pleurisy is aimed at eliminating the etiology and relieving acute painful symptoms of the disease. To treat pleurisy, the source of which is pneumonia, the pulmonologist prescribes a course of antibiotics and a diet. Tuberculosis pleurisy requires careful diagnosis of the body systems, a complex of specific therapy (isoniazid, rifampicin, streptomycin) and monitoring by a phthisiatrician.

For the treatment of rheumatic pleurisy the following is prescribed:

• analgesics;
• immunomodulators;
• a course of physiotherapy;
• diuretics;
• glucocorticosteroids,
• cardiovascular drugs;
• non-steroidal anti-inflammatory drugs.

Exudative pleurisy with a large volume of effusion poses a danger to life. To remove exudate, thoracentesis (pleural puncture) or drainage is performed. In order not to provoke cardiovascular complications by sharply straightening the lung and displacing it in the pleural cavity, no more than 1.5 liters of effusion can be removed at a time. After removal acute symptoms For exudative pleurisy, for better restoration of lung function, the following are recommended: manual and vibration massage, electrophoresis, breathing exercises.

Therapy for purulent pleurisy includes:

• disinfection of the pleural cavity with antiseptics;
• intrapleural injections of antibiotics;
• taking enzymes and hydrocortisone.

In the treatment of recurrent exudative pleurisy, chemotherapy or talc is administered into the pleural cavity to glue the layers of the pleura. For the therapeutic correction of dry pleurisy, in addition to symptomatic drug treatment, they do tight chest compression, conduct a course of electrophoresis and warming compresses. Active drugs help to cope well with cough: ethylmorphine hydrochloride, codeine and dionine.

Patients diagnosed with “dry pleurisy” are prescribed:

• anti-inflammatory drugs;
• breathing exercises;
• immunomodulators.

Chronic pleurisy, complicated by other pathologies, requires surgical treatment with decortication of the lung - pleurectomy.

Surgical correction (palliative pleurectomy) is also carried out in oncology clinics when an oncological tumor develops on the lung or pleura.

Treatment of pleurisy at home

In order not to aggravate the inflammation and prevent the development of irreversible pathologies, treatment of pleurisy at home should be carried out under the supervision of a doctor, after a thorough diagnosis and prescription of a course of medications.

The initial goal of therapy is to remove the cause of pleurisy (infection, deformation, genetic abnormality). Next, symptoms are relieved and conditions are provided for complete recovery of the body. Patients are prescribed antibacterial and immunostimulating therapy, good nutrition, drinking regimen and rest.

For the treatment of pulmonary pleurisy at home, infusions of herbs are recommended as expectorants and anti-inflammatory drugs: linden blossom, licorice root, coltsfoot leaves, plantain grass, fennel fruit, white willow bark, knotweed.

Complications of pleurisy

The effectiveness of treatment of pleurisy and post-therapeutic complications mainly depend on the etiology, location and stage of the disease. A prolonged inflammatory process in the pleura is dangerous:

• development of the adhesive process;
• formation of volumetric moorings;
• thickening of the pleural layers;
• limiting the functionality of the diaphragm dome;
• fusion of pleural cavities and interlobar fissures;
• development of respiratory failure and pleurosclerosis.

Recovery after illness and prevention of pleurisy

With a small amount of exudate, fluid resorption, restoration of lung functionality and tissue regeneration occur quite quickly (3-4 weeks). Infectious pleurisy, the treatment of which involves the evacuation of effusion, is dangerous for relapses. Oncological pleurisy is characterized by a progressive course and multiple pathologies. It is quite difficult for the body to recover after purulent pleurisy. For patients who have had pleurisy, systematic physiotherapy, sanatorium treatment and clinical observation for 2 years are recommended.

• Prevention of purulent pleurisy consists of recognizing and removing air, blood, and exudate from the pleural cavity. Postoperative empyema can be prevented by sealing the lung tissue, operating asepsis, and treating the bronchial stump.
• The best prevention of pleurisy is to strengthen the body’s immune forces, prevent tuberculosis, acute pneumonia, rheumatism and other diseases that cause pleurisy. To prevent the development of functional respiratory pathologies, you should stop smoking and inhaling irritating carcinogens.

This article is posted for educational purposes only and does not constitute scientific material or professional medical advice.

https://illness.docdoc.ru/plevrit

Pleurisy

Pleurisy– various etiologically inflammatory lesions of the serous membrane surrounding the lungs. Pleurisy is accompanied by chest pain, shortness of breath, cough, weakness, fever, and auscultatory phenomena (pleural friction noise, decreased breathing). Diagnosis of pleurisy is carried out using radiography (scopy) of the chest, ultrasound of the pleural cavity, pleural puncture, and diagnostic thoracoscopy. Treatment may include conservative therapy (antibiotics, NSAIDs, exercise therapy, physiotherapy), a series of therapeutic punctures or drainage of the pleural cavity, surgical tactics (pleurodesis, pleurectomy).

Pleurisy is inflammation of the visceral (pulmonary) and parietal (parietal) layers of the pleura. Pleurisy can be accompanied by the accumulation of effusion in the pleural cavity (exudative pleurisy) or occur with the formation of fibrinous deposits on the surface of the inflamed pleural layers (fibrinous or dry pleurisy). The diagnosis of “pleurisy” is made in 5-10% of all patients undergoing treatment in therapeutic hospitals. Pleurisy can aggravate the course of various diseases in pulmonology, phthisiology, cardiology, and oncology. Statistically, pleurisy is diagnosed more often in middle-aged and elderly men.

Often, pleurisy is not an independent pathology, but accompanies a number of diseases of the lungs and other organs. Based on the causes of occurrence, pleurisy is divided into infectious and non-infectious (aseptic).

Causes of pleurisy infectious etiology serve:

Pleurisy of non-infectious etiology causes:

• malignant tumors of the pleura (pleural mesothelioma), metastases to the pleura in lung cancer, breast cancer, lymphoma, ovarian tumors, etc. (in 25% of patients with pleurisy);
• diffuse lesions connective tissue(systemic lupus erythematosus, rheumatoid arthritis, scleroderma, rheumatism, systemic vasculitis, etc.

• PE, pulmonary infarction, myocardial infarction;
• other reasons ( hemorrhagic diathesis, leukemia, pancreatitis, etc.).

The mechanism of development of pleurisy of various etiologies has its own specifics. Pathogens of infectious pleurisy directly affect the pleural cavity, penetrating into it in various ways. Contact, lymphogenous or hematogenous routes of penetration are possible from subpleurally located sources of infection (abscess, pneumonia, bronchiectasis, festering cyst, tuberculosis). Direct entry of microorganisms into the pleural cavity occurs when the integrity of the chest is violated (in case of wounds, injuries, surgical interventions).

Pleurisy can develop as a result of increased permeability of lymphatic and blood vessels for systemic vasculitis, tumor processes, acute pancreatitis; violations of lymph outflow; reducing general and local reactivity of the body.

A small amount of exudate can be reabsorbed by the pleura, leaving a fibrin layer on its surface. This is how dry (fibrinous) pleurisy forms. If the formation and accumulation of effusion in the pleural cavity exceeds the speed and possibility of its outflow, then exudative pleurisy develops.

The acute phase of pleurisy is characterized by inflammatory edema and cellular infiltration of the pleura, accumulation of exudate in the pleural cavity. When the liquid part of the exudate is absorbed, moorings can form on the surface of the pleura - fibrinous pleural deposits, leading to partial or complete pleurosclerosis (obliteration of the pleural cavity).

The classification of pleurisy proposed in 1984 by St. Petersburg State Medical University professor N.V. is most often used in clinical practice. Putov.

By etiology:

• infectious (by infectious agent - pneumococcal, staphylococcal, tuberculous and other pleurisy)
• non-infectious (indicating a disease leading to the development of pleurisy - lung cancer, rheumatism, etc.)
• idiopathic (of unclear etiology)

According to the presence and nature of the exudate:

• exudative (pleurisy with serous, serous-fibrinous, purulent, putrefactive, hemorrhagic, cholesterol, eosinophilic, chylous, mixed effusion)
• fibrinous (dry)

According to the course of inflammation:

• spicy
• subacute
• chronic

According to the location of the effusion:

• diffuse
• encysted or limited (parietal, apical, diaphragmatic, costodiaphragmatic, interlobar, paramediastinal).

As a rule, being a secondary process, complication or syndrome of other diseases, the symptoms of pleurisy can prevail, masking the underlying pathology. The clinical picture of dry pleurisy is characterized by stabbing pain in the chest, aggravated by coughing, breathing and movement. The patient is forced to take a position, lying on the painful side, to limit the mobility of the chest. Breathing is shallow, gentle, the affected half of the chest noticeably lags behind during respiratory movements. A characteristic symptom dry pleurisy is a pleural friction noise heard during auscultation, weakened breathing in the area of ​​fibrinous pleural overlays. Body temperature sometimes rises to subfebrile levels, and pleurisy may be accompanied by chills, night sweats, and weakness.

Diaphragmatic dry pleurisy has a specific clinical picture: pain in the hypochondrium, chest and abdominal cavity, flatulence, hiccups, abdominal muscle tension.

The development of fibrinous pleurisy depends on the underlying disease. In a number of patients, manifestations of dry pleurisy disappear after 2-3 weeks, however, relapses are possible. In tuberculosis, the course of pleurisy is long, often accompanied by exudation of exudate into the pleural cavity.

Exudative pleurisy

The onset of pleural exudation is accompanied by a dull pain in the affected side, a reflexively occurring painful dry cough, a lag in the corresponding half of the chest in breathing, and a pleural friction noise. As the exudate accumulates, the pain is replaced by a feeling of heaviness in the side, increasing shortness of breath, moderate cyanosis, and smoothing of the intercostal spaces. Exudative pleurisy is characterized by general symptoms: weakness, febrile body temperature (with pleural empyema - with chills), loss of appetite, sweating. With encysted paramediastinal pleurisy, dysphagia, hoarseness, swelling of the face and neck are observed. With serous pleurisy caused by a bronchogenic form of cancer, hemoptysis is often observed. Pleurisy caused by systemic lupus erythematosus is often combined with pericarditis, kidney and joint damage. Metastatic pleurisy is characterized by a slow accumulation of exudate and is asymptomatic.

A large amount of exudate leads to a displacement of the mediastinum in the opposite direction, disorders of the external respiration and the cardiovascular system (a significant decrease in the depth of breathing, increased frequency, development of compensatory tachycardia, decreased blood pressure).

The outcome of pleurisy largely depends on its etiology. In cases of persistent pleurisy, the development of adhesions in the pleural cavity, fusion of interlobar fissures and pleural cavities, the formation of massive moorings, thickening of the pleural layers, the development of pleurosclerosis and respiratory failure, and limited mobility of the dome of the diaphragm cannot be ruled out in the future.

Along with the clinical manifestations of exudative pleurisy, when examining the patient, asymmetry of the chest, bulging of the intercostal spaces on the corresponding half of the chest, and lag of the affected side when breathing are revealed. The percussion sound over the exudate is dull, bronchophony and vocal tremor are weakened, breathing is weak or cannot be heard. The upper limit of the effusion is determined by percussion, chest x-ray or ultrasound of the pleural cavity.

When performing a pleural puncture, a fluid is obtained, the nature and volume of which depends on the cause of pleurisy. Cytological and bacteriological examination of pleural exudate makes it possible to clarify the etiology of pleurisy. Pleural effusion is characterized by a relative density above 1018-1020, variety cellular elements, positive Rivolt reaction.

In the blood, an increase in ESR, neutrophilic leukocytosis, an increase in the values ​​of seromucoids, sialic acids, and fibrin are detected. To clarify the cause of pleurisy, thoracoscopy with pleural biopsy is performed.

Therapeutic measures for pleurisy are aimed at eliminating the etiological factor and alleviating symptoms. For pleurisy caused by pneumonia, antibiotic therapy is prescribed. Rheumatic pleurisy is treated with nonsteroidal anti-inflammatory drugs and glucocorticosteroids. For tuberculous pleurisy, treatment is carried out by a phthisiatrician and consists of specific therapy with rifampicin, isoniazid and streptomycin for several months.

For symptomatic purposes, the prescription of analgesics, diuretics, and cardiovascular drugs is indicated; after resorption of the effusion, physiotherapy and physical therapy are indicated.

In case of exudative pleurisy with a large amount of effusion, they resort to its evacuation by performing pleural puncture (thoracentesis) or drainage. It is recommended to evacuate no more than 1-1.5 liters of exudate at a time in order to avoid cardiovascular complications (due to a sharp straightening of the lung and reverse displacement of the mediastinum). For purulent pleurisy, the pleural cavity is washed with antiseptic solutions. According to indications, antibiotics, enzymes, hydrocortisone, etc. are administered intrapleurally.

In the treatment of dry pleurisy, in addition to etiological treatment, patients are advised to rest. To relieve pain, mustard plasters, cupping, warm compresses and tight bandaging of the chest are prescribed. To suppress cough, codeine and ethylmorphine hydrochloride are prescribed. Anti-inflammatory drugs are effective in the treatment of dry pleurisy: acetylsalicylic acid, ibuprofen, etc. After normalization of well-being and blood counts, a patient with dry pleurisy is prescribed breathing exercises to prevent adhesions in the pleural cavity.

In order to treat recurrent exudative pleurisy, pleurodesis is performed (injection of talc or chemotherapy into the pleural cavity to glue the layers of the pleura). To treat chronic purulent pleurisy, they resort to surgical intervention– pleurectomy with lung decoration. If pleurisy develops as a result of inoperable damage to the pleura or lung by a malignant tumor, palliative pleurectomy is performed according to indications.

A small amount of exudate can resolve on its own. The cessation of exudation after elimination of the underlying disease occurs within 2-4 weeks. After evacuation of the fluid (in the case of infectious pleurisy, including tuberculous etiology), a persistent course with repeated accumulation of effusion in the pleural cavity is possible. Pleurisy caused by oncological causes has a progressive course and an unfavorable outcome. Purulent pleurisy has an unfavorable course.

Patients who have suffered pleurisy are under clinical observation for 2-3 years. It is recommended to exclude occupational hazards, fortify and high-calorie nutrition, and exclude colds and hypothermia.

In the prevention of pleurisy, the leading role belongs to the prevention and treatment of the main diseases leading to their development: acute pneumonia, tuberculosis, rheumatism, as well as increasing the body's resistance to various infections.

https://www.krasotaimedicina.ru/diseases/zabolevanija_pulmonology/pleurisy

Symptoms of pleurisy

The main symptom of pleurisy is pain in the side, which intensifies when inhaling. and cough. The pain may subside when lying on the affected side. There is a limitation in the respiratory mobility of the proper half of the chest. With percussion sounds, weakened breathing may be heard as a result of the patient sparing the affected side, and pleural friction noise. Body temperature may rise slightly, chills with the appearance of night sweats, and possible weakness are possible.

It is very difficult to diagnose diaphragmatic dry pleurisy. The following symptoms are characteristic of it:

1. Pain in the chest and chest (hypochondrium), as well as in the area of ​​the lower ribs;
2. Hiccups;
3. Stomach ache;
4. Flatulence;
5. Abdominal muscle tension;
6. Pain when swallowing.

To recognize diaphragmatic pleurisy, an X-ray examination will help, which will help identify the presence of indirect symptoms of a functional disorder of the diaphragm, for example: its high standing and limited mobility on the affected side.

Causes of pleurisy

The cause of pleurisy of an infectious nature is directly related to the penetration of pathogens:

• Specific infections: Mycobacterium tuberculosis, Treponema pallidum;
• Nonspecific infections: pneumococcus, staphylococcus, Escherichia coli.

Pathogens penetrate the pleura by contact, through the blood and inhaled air when the pleural cavity is damaged. Common reason the development of pleurisy is a systemic disease in connective tissues (systemic lupus erythematosus, rheumatism). The pathogenesis of most pleurisy is allergic in nature. Pleurisy can last from a couple of days to several months.

The causes of pleurisy can be various chest injuries, as well as penetrating wounds and possible rib fractures.

In a similar situation, this disease is often combined with tuberculosis, pneumothorax and lung tumor.

Treatment of pleurisy

Treatment of pleurisy is complex and involves an active impact on the underlying diseases and early suppression of pleurisy. In case of effusion pleurisy, the patient must be treated in a hospital setting. A course of effective treatment is prescribed by a medical specialist.

Treatment of patients with pleurisy at the ENT-Asthma clinic is comprehensive and includes eliminating the causes that caused the development of the disease. If the pleural effusion is not inflammatory in nature, then treatment is aimed at restoring cardiovascular activity.

Treatment of pleurisy at the ENT-Asthma clinic consists of the following components:

1. Antibacterial therapy is prescribed for infectious and allergic pleurisy, chemotherapy is carried out for pleurisy of tumor etiology;
2. Sanitation of the pleural cavity allows for evacuation of exudate; if necessary, rinsing with antiseptic solutions is performed;
3. The positive effect in the treatment of pleurisy is secured by the use of desensitizing and anti-inflammatory drugs;
4. The use of means that are aimed at mobilizing the body’s protective and immunobiological reactions, that is, increasing immunity.

In addition to the prescribed treatment for pleurisy, herbal medicine can be used, which has a special formulation and is selected by an experienced specialist at the ENT-Asthma clinic. After a full cycle of treatment for pleurisy in our clinic, breathing is stabilized, lost immunity is restored, and the general condition of the patient’s body improves.

https://www.lor-astma.ru/plevrit.htm

Characteristics of the disease and types of pleurisy

Pleurisy is an inflammation of the pleura, the serous membrane that envelops the lungs. The pleura looks like translucent sheets of connective tissue. One of them is adjacent to the lungs, the other lines the chest cavity from the inside. Fluid circulates in the space between them, which ensures the sliding of the two layers of the pleura during inhalation and exhalation. Its amount normally does not exceed 10 ml. With pleurisy of the lungs, fluid accumulates in excess. This phenomenon is called pleural effusion. This form of pleurisy is called effusion, or exudative. It occurs most often. Pleurisy can also be dry - in this case, fibrin protein is deposited on the surface of the pleura, and the membrane thickens. However, as a rule, dry (fibrinous) pleurisy is only the first stage of the disease, which precedes further formation of exudate. In addition, when the pleural cavity is infected, the exudate can be purulent.

As already mentioned, medicine does not classify pleurisy as an independent disease, calling it a complication of other pathological processes. Pleurisy may indicate lung disease or other diseases that do not cause damage to the lung tissue. Based on the nature of the development of this pathological condition and the cytological analysis of the pleural fluid, along with other studies, the doctor is able to determine the presence of the underlying disease and take adequate measures, but pleurisy itself requires treatment. Moreover, in the active phase it is able to come to the fore in the clinical picture. That is why in practice pleurisy is often called a separate disease of the respiratory system.

So, depending on the state of the pleural fluid, the following are distinguished:

• purulent pleurisy;
• serous pleurisy;
• serous-purulent pleurisy.

The purulent form is the most dangerous, since it is accompanied by intoxication of the entire body and, in the absence of proper treatment, threatens the life of the patient.

Pleurisy can also be:

• acute or chronic;
• severe or moderate;
• affect both parts of the chest or appear on only one side;
• development is often provoked by infection, in which case it is called infectious.

There is a wide list of non-infectious causes of pulmonary pleurisy:

• connective tissue diseases;
• vasculitis;
• pulmonary embolism;
• chest injuries;
• allergy;
• oncology.

In the latter case, we can talk not only about lung cancer itself, but also about tumors of the stomach, breast, ovaries, pancreas, melanoma, etc. When metastases penetrate into the lymph nodes of the chest, the outflow of lymph occurs more slowly, and the pleura becomes more permeable.

Fluid leaks into the pleural cavity. It is possible to close the lumen of a large bronchus, which lowers the pressure in the pleural cavity, and therefore provokes the accumulation of exudate.

In non-small cell lung cancer (NSCLC), pleurisy is diagnosed in more than half of the cases. In adenocarcinoma, the frequency of metastatic pleurisy reaches 47%. For squamous cell lung cancer - 10%. Bronchiolo-alveolar cancer leads to pleural effusion at an early stage, and in this case, pleurisy may be the only signal of the presence of a malignant tumor.

Depending on the form, the clinical manifestations of pleurisy differ. However, as a rule, it is not difficult to determine pulmonary pleurisy. Much harder to find the real reason, which caused inflammation of the pleura and the appearance of pleural effusion.

Symptoms of pleurisy

The main symptoms of pulmonary pleurisy are pain in the chest, especially when inhaling, a cough that does not bring relief, shortness of breath, and a feeling of tightness in the chest. Depending on the nature of the pleural inflammation and location, these signs may be obvious or almost absent. With dry pleurisy, the patient feels pain in the side, which intensifies when coughing, breathing becomes difficult, weakness, sweating, and chills are possible. The temperature remains normal or increases slightly - no more than 37° C.

With exudative pleurisy, weakness and poor health are more pronounced. Fluid accumulates in the pleural cavity, compresses the lungs, and prevents them from expanding. The patient cannot breathe fully. Irritation of nerve receptors in the inner layers of the pleura (there are practically none in the lungs themselves) causes a symptomatic cough. In the future, shortness of breath and heaviness in the chest only intensify. The skin becomes pale. A large accumulation of fluid prevents the outflow of blood from the neck veins, they begin to bulge, which eventually becomes noticeable. The part of the chest affected by pleurisy is limited in movement.

With purulent pleurisy, noticeable temperature fluctuations are added to all the above symptoms: up to 39–40° in the evening and 36.6–37° in the morning. This indicates the need to urgently consult a doctor, since the purulent form is fraught with serious consequences.

Diagnosis of pleurisy takes place in several stages:

1. Examination and interview of the patient. The doctor finds out the clinical manifestations, how long ago it occurred and the patient’s level of well-being.
2. Clinical examination. Various methods are used: auscultation (listening with a stethoscope), percussion (tapping with special instruments for the presence of fluid), palpation (palpation to identify painful areas).
3. X-ray and CT scan. X-ray allows you to visualize pleurisy, assess the volume of fluid, and in some cases, identify metastases in the pleura and lymph nodes. Computed tomography helps to determine the extent of prevalence more accurately.
4. Blood analysis. During the inflammatory process in the body, the ESR, the number of leukocytes or lymphocytes increases. This study is necessary to diagnose infectious pleurisy.
5. Pleural puncture. This is the collection of fluid from the pleural cavity for laboratory research. The procedure is carried out in cases where there is no threat to the patient’s life. If too much fluid has accumulated, thoracentesis (thoracentesis) is immediately performed - removal of exudate through a puncture using a long needle and electric suction, or a port system is installed, which is the preferred solution. The patient's condition improves, and some of the fluid is sent for analysis.

If after all the stages the exact picture remains unclear, the doctor may prescribe a video thoracoscopy. A thoracoscope is inserted into the chest - this is an instrument with a video camera that allows you to examine the affected areas from the inside. If we are talking about oncology, it is necessary to collect a fragment of the tumor for further research. After these manipulations, it is possible to make an accurate diagnosis and begin treatment.

Treatment of the condition

Treatment of pulmonary pleurisy should be comprehensive, aimed at eliminating the disease that caused it. Therapy for pleurisy itself is usually symptomatic, designed to accelerate the resorption of fibrin, prevent the formation of adhesions in the pleural cavity and fluid “bags,” and alleviate the patient’s condition. The first step is to remove pleural edema. At high temperatures, the patient is prescribed antipyretics, and for pain, analgesic NSAIDs. All these actions make it possible to stabilize the patient’s condition, normalize respiratory function and effectively treat the underlying disease.

Treatment of pleurisy in mild form Possibly at home, in difficult cases - exclusively in a hospital. It may include different methods and techniques.

1. Thoracentesis . This is a procedure in which accumulated fluid is removed from the pleural cavity. Prescribed for all cases of effusion pleurisy in the absence of contraindications. Thoracentesis is performed with caution in the presence of pathology of the blood coagulation system, high blood pressure in the pulmonary artery, severe obstructive pulmonary disease, or the presence of only one functional lung.

   Used for the procedure local anesthesia. A needle is inserted into the pleural cavity on the side of the scapula under ultrasound guidance and exudate is collected. The compression of the lung tissue decreases, making it easier for the patient to breathe.

2. Often the procedure needs to be repeated, for this purpose modern and completely safe intrapleural port systems , providing constant access to the pleural cavity both for evacuation of exudate and for administering medications, including chemotherapy.
   We are talking about a system consisting of a catheter, which is inserted into the pleural cavity, and a titanium chamber with a silicone membrane. Installation requires only two small incisions, which are later sutured. The port is installed in soft fabrics chest wall, under the skin. In the future, it does not cause any inconvenience to the patient. The manipulation takes no more than an hour. The patient can go home the very next day after the port is installed. When you need to evacuate the exudate again, it is enough to pierce the skin and the silicone membrane under it. It's fast, safe and painless. In the event of a sudden need and lack of access to medical care, with a certain skill and knowledge of the rules of the procedure, even relatives are able to independently empty the patient’s pleural cavity of fluid through a port.
3. Another type of intervention is pleurodesis . This is an operation to artificially create adhesions between the layers of the pleura and destroy the pleural cavity so that there is nowhere for fluid to accumulate. The procedure is usually prescribed for cancer patients when chemotherapy is ineffective. The pleural cavity is filled with a special substance that prevents the production of exudate and has an antitumor effect - in the case of oncology. These may be immunomodulators (for example, interleukins), glucocorticosteroids, antimicrobials, radioisotopes and alkylating cytostatics (derivatives of oxazaphosphorine and bis-β-chlorethylamine, nitrosourea or ethylenediamine, platinum preparations, alkylsulfonates, triazines or tetrazines), which depends solely on the specific clinical case.
4. If the above methods do not work, it is shown removal of the pleura and installation of a shunt . After shunting, fluid from the pleural cavity passes into the abdominal cavity. However, these methods are considered radical and can cause serious complications, so they are resorted to last.
5. Drug treatment . In cases where pleurisy is of an infectious nature or complicated by an infection, antibacterial drugs are used, the choice of which depends entirely on the type of pathogen and its sensitivity to a specific antibiotic. Medicines, depending on the nature of the pathogenic flora, may include:

• natural, synthetic, semi-synthetic and combined penicillins (benzylpenicillin, phenoxymethylpenicillin, methicillin, oxacillin, nafcillin, ticarcillin, carbpenicillin, Sultasin, Oxamp, Amoxiclav, mezlocillin, azlocillin, mecillam);
• cephalosporins (“Mefoxin”, “Ceftriaxone”, “Keyten”, “Latamoccef”, “Cefpirome”, “Cefepime”, “Zeftera”, “Ceftolozane”);
• fluoroquinolones (“Microflox”, lomefloxacin, norfloxacin, levofloxacin, sparfloxacin, moxifloxacin, gemifloxacin, gatifloxacin, sitafloxacin, trovafloxacin);
• carbapenems (“Tienam”, doripenem, meropenem);
• glycopeptides (“Vancomycin”, “Vero-Bleomycin”, “Targotsid”, “Vibativ”, ramoplanin, decaplanin);
• macrolides (“Sumamed”, “Yutacid”, “Rovamycin”, “Rulid”);
• ansamycins (“Rifampicin”);
• aminoglycosides (amikacin, netilmicin, sisomycin, isepamycin), but they are incompatible with penicillins and cephalosporins during simultaneous therapy;
• lincosamides (lincomycin, clindamycin);
• tetracyclines (doxycycline, Minolexin);
• amphenicols (“Levomycetin”);
• other synthetic antibacterial agents (hydroxymethylquinoxaline dioxide, fosfomycin, dioxidine).

To treat inflammation of the pleura, anti-inflammatory and desensitizing drugs are also prescribed (electrophoresis of a 5% solution of novocaine, analgin, diphenhydramine, 10% solution of calcium chloride, 0.2% solution of platyphylline hydrotartrate, indomethacin, etc.), regulators of water-electrolyte balance ( saline and glucose solution), diuretics (“Furosemide”), lidase electrophoresis (64 units every 3 days, 10–15 procedures per course of treatment). They may prescribe drugs for dilation of the bronchi and cardiac glycosides that enhance myocardial contraction (Eufillin, Korglykon). Pleurisy of the lungs in oncology responds well to chemotherapy - after it, swelling and symptoms usually go away. Medications administered systemically - by injection or intrapleurally through the membrane valve of the port system.

According to statistics, chemotherapy courses in combination with other treatment methods help eliminate pleurisy in approximately 60% of patients sensitive to chemotherapy.

During the course of treatment, the patient must be constantly under medical supervision and receive supportive therapy. After completing the course, it is necessary to conduct an examination, and after a few weeks it is necessary to schedule it again.

Disease prognosis

Advanced forms of pulmonary pleurisy may have severe complications: the occurrence of pleural adhesions, bronchopleural fistulas, circulatory disorders due to compression of blood vessels.

During the development of pleurisy, under fluid pressure, arteries, veins and even the heart can shift in the opposite direction, which leads to an increase in intrathoracic pressure and disruption of blood flow to the heart. In this regard, preventing pulmonary heart failure is the central task of all therapeutic measures for pleurisy. If displacement is detected, the patient is indicated for emergency thoracentesis.

A dangerous complication is empyema - the formation of a “pocket” of pus, which can ultimately lead to scarring of the cavity and the final sealing of the lung. A breakthrough of purulent exudate into the lung tissue can be fatal. Finally, pleurisy can cause amyloidosis of parenchymal organs or kidney damage.

Special attention is paid to pleurisy when diagnosing it in cancer patients. Effusion in the pleural cavity aggravates the course lung cancer, increases weakness, gives additional shortness of breath, provokes pain. When the vessels are compressed, tissue ventilation is disrupted. Given immune disorders, this creates a favorable environment for the spread of bacteria and viruses.

The consequences of the disease and the chances of recovery depend on the underlying diagnosis. In cancer patients, fluid in the pleural cavity usually accumulates in the later stages of cancer. This makes treatment difficult and the prognosis is often poor. In other cases, if the fluid from the pleural cavity is removed in time and adequate treatment is prescribed, there is no threat to the patient’s life. However, patients need regular monitoring in order to promptly diagnose a relapse when it occurs.

https://www.pravda.ru/navigator/lechenie-plevrita-legkikh.html

Symptoms of the disease and its diagnosis

The main symptom of pleurisy is pain in the side. It intensifies during inhalation when the patient coughs. If you lie on the affected side, the pain subsides. The inflamed side of the chest is characterized by low mobility, and noises are heard when listening. There may be a slight increase in body temperature, chills often appear, and the patient sweats profusely at night.

As for dry pleurisy, its symptoms are somewhat different:

• pain in the hypochondrium;
• the occurrence of hiccups;
• abdominal pain;
• strong gas formation;
• painful sensations when swallowing;
• tension in the abdominal muscles.

Diaphragmatic pleurisy can be diagnosed using an x-ray. It can show deviations in the location of the diaphragm and its mobility.

Treatment methods for pulmonary pleurisy in adults

Treatment of pleurisy is a course of measures aimed at alleviating symptoms and eliminating the cause of the disease. Pleurisy caused by pneumonia is treated with antibiotics. As for rheumatic pleurisy, the main medications used to treat it are nonsteroidal drugs that relieve inflammation and glucocorticosteroids. Tuberculous pleurisy is treated with the help of a phthisiatrician. Rifampicin, isoniazid, and streptomycin are used as therapy. The duration of treatment is several months. To eliminate symptomatic manifestations, the following are prescribed:

• painkillers;
• diuretics;
• cardiovascular drugs.

Treatment of exudative pleurisy occurs by sampling the effusion. This procedure is called a pleural puncture or drainage. If relapses occur, a pleurodesis procedure is necessary - the pleural area is filled with talc or chemotherapy, which glues the pleural layers together.

Treatment of acute purulent pleurisy consists of washing the pleural cavity with antiseptic solutions. Antibiotics are injected into the pleural cavity. Quite often, injections of drugs such as hydrocortisone and enzymes are given in combination. Treatment of chronic purulent pleurisy requires the intervention of surgeons. They perform the procedure of pleurectomy and lung decortication.

Treatment of dry pleurisy requires a state of rest. In order to relieve pain, the patient's chest is tightly bandaged, warming it with lotions. Drug therapy is also carried out, prescribing:

• codeine;
• dionine;
• acetyl;
• ibuprofen.

If the state of health has returned to normal, the patient is recommended to undergo breathing exercises, which improves the process of fusion of the pleura.

Traditional methods for treating pleurisy. Preventive measures

Drug treatment of pleurisy can be supplemented with traditional medicine. To alleviate the disease, use:

• onion juice and honey;
• infuse and take horsetail;
• drink a decoction of anise seeds, supplemented with licorice root, marshmallow, sage leaves and young pine shoots;
• infuse mint, elecampane, licorice root, marsh dried grass, coltsfoot;
• Calamus root is often brewed;
• drink freshly squeezed beet juice.

Patients who have undergone treatment for pleurisy are observed in the dispensary for up to 3 years.

To prevent relapses, it is necessary to monitor nutrition, temperature, and exclude colds.

Preventive measures for the occurrence of pleurisy of various etymologies include timely treatment of diseases that lead to their development, as well as adherence to a healthy lifestyle. It is necessary to monitor your health, take vitamins and other complexes that keep the human body in good shape.

The main thing to remember is that treating pleurisy at home is unacceptable! Such negligence can cost a person his life.

http://now-foods.ru/plevrit-legkih-simptomy-i-lechenie.html

Some diseases cause very serious complications, one of which is pleurisy. It comes in several types. The most common is the one in which fluid begins to accumulate in the tissues; it is also called effusion. The danger of this disease is that its symptoms can be disguised as the underlying pathology. Let's figure out what treatment is required for a patient diagnosed with exudative pleurisy.

It is extremely rare that pleurisy is a primary pathology. It is usually preceded by one of the following reasons:

• the occurrence of pathological processes in the lungs caused by the proliferation of bacteria or infection with a virus;
• inflammatory processes in the pancreas;
• connective tissue lesions;
• rheumatism;
• oncology that has affected organs located nearby;
• tuberculosis;
• chest injuries (for example, after a rib fracture).

This disease is diagnosed separately from other pathologies, as it is characterized by its own characteristics. Not every person who has a chest injury or a disease that affects the lungs develops exudative pleurisy. Most often, this pathology affects those who have experienced severe stress or general hypothermia. Most patients with this pathology have problems with immunity, vitamin deficiency or endocrine disorders.

Patients also often have a history of chronic alcoholism, allergies, and frequent bronchial diseases.

The “trigger” for the effusion form of pleurisy can be irradiation with radioactive substances and chemical poisoning, which was received at an early stage of the development of primary diseases or simultaneously with traumatic effects on the chest.

Symptoms and features of the course of effusion pleurisy

First of all, pleurisy is characterized by the appearance of symptoms of intoxication: weakness, sweating, malaise, temperature fluctuations from low-grade to extremely high. This disease is also accompanied by severe pain, which makes it difficult for the patient to take a sleeping position. If only one lobe of the lung is affected, it will be easier to sleep on the opposite side. While walking, a person with this pathology will instinctively support the affected side.

Over time, symptoms may weaken or disappear altogether, which is not a sign of recovery. Typically, symptoms become less severe due to fluid accumulation in the pleura. At this stage, soreness in the trapezius and pectoral muscles and shortness of breath may appear. Asymmetry in the chest becomes noticeable when moving.

In the absence of treatment, the nasolabial triangle begins to turn blue, the neck veins swell, the spaces between the ribs bulge, and there is a cough without sputum discharge. The upper body may also turn blue. During listening, the therapist will discover a “silent” lung located above the source of inflammation. In difficult cases, during the examination the doctor may hear the sound of pleural friction.

Complications and prognosis

At timely treatment pleurisy does not cause complications. Its symptoms disappear 1-3 weeks after the start of therapy. If the patient does not start therapy in a timely manner, complications may develop:

• disruptions in the functioning of the heart and blood vessels;
• formation of adhesions on the pleura;
• reduction in lung volume and respiratory failure;
• accumulation of calcium in the pleura;
• changes in the composition of the effusion, it becomes purulent;
• pneumosclerosis;
• irreversible dilation of the bronchi.

If the integrity of the pleura is compromised, the development of pneumothorax is possible. In the most advanced cases, the disease can be fatal.

Treatment with traditional remedies

There are several ways to treat pleurisy with increased production of exudate. One of them is puncture. It is done for diagnostics and pumping out fluid. For treatment, the puncture can be performed only once, because otherwise adhesions will form. It is possible to remove up to 1.5 liters of liquid per session. A larger amount of effusion cannot be removed, since the mediastinum of the organs will be disrupted.

Treatment is carried out only in a hospital. It is most often conservative, as doctors strive to preserve respiratory functions to the fullest extent possible. Patients are prescribed drug treatment with drugs from the following groups:

• antibiotics (if the primary disease was caused by bacteria);
• codeine-containing (for sputum discharge);
• antihistamines (Cetrin, Erius, Diazolin and others);
• antipyretics (Ibuprofen or Medsicam);
• painkillers (Nise, Tramadol, Cefekon or Nimesil);
• diuretics (Diacarb, Veroshpiron or Indapamide).

In difficult cases, glucocorticosteroids are prescribed. Injections, ointments and tablets can be used to relieve inflammation.

The patient’s lifestyle plays an important role in treatment. He needs to stick to a diet, include more fresh fruits and vegetables in the menu, and avoid stress. Additionally, it is necessary to engage in physical therapy, setting gentle loads for yourself.

If there are no contraindications, the doctor may prescribe additional procedures: paraffin baths, mud wraps, electrophoresis, ultraviolet irradiation of the chest, diathermy, massage, inductothermy. As a rule, auxiliary therapy is prescribed to eliminate residual effects after the healing process begins.

Traditional medicine methods

There are several herbal remedies that may be helpful for pleurisy. They are prepared the same way, but have different composition. To prepare a healthy decoction, you need to pour a tablespoon of dry plant material with a glass of boiling water, simmer the mixture over low heat for 2-3 minutes. Then you need to let the broth stand for about 10 minutes and strain. These folk remedies are always taken 15 minutes after breakfast. Examples of herbal infusions for such decoctions:

• 40 grams each of motherwort, broom, viburnum bark, valerian root, centaury;
• 40 grams each of willow bark, linden inflorescences, meadowsweet flowers, black currant leaves, elderberries and tea rose fruits;
• 40 grams of birch leaves, willow bark and black elderberry flowers, 100 grams of tea rose fruits and 30 grams of licorice root;
• 40 grams of hop cones, 60 grams each of valerian root, lemon balm leaves, willow bark, elderberries;
• 30 grams of dried raspberries, saponaria root and mullein flowers, 70 grams of black elderberry flowers and 40 grams of St. John's wort.

In addition to decoctions, other means can be used:

1. Curd compress, which is placed on the back for three hours three times a day. Since exudative pleurisy requires bed rest, it will not be difficult to withstand such a long time. Traditional medicine specialists recommend eating 100 grams of boiled lung a quarter of an hour before applying the compress.
2. A useful mixture for removing fluid from the lungs is obtained from 300 grams of finely chopped onions, half a liter of white grape wine, 100 grams of light-colored honey (floral or linden). The disadvantage of this medicinal mixture is that it must be infused for 8 days. This medicine should be taken before each meal (four times a day) in a tablespoon.
3. Onions can also be used for inhalation. To do this, you need to chop a couple of onions as finely as possible (alternatively, pass them through a meat grinder). Cover your head with a towel and breathe in the vapors of this plant through your mouth.
4. Mix 250 grams of badger fat (bought at a pharmacy is suitable) with 300 grams of aloe leaf pulp and a glass of honey. Heat the mixture in the oven for a quarter of an hour. Strain and take the product three times a day, one tablespoon at a time.
5. Another remedy is rubbing. For them you will need to purchase essential oils and mix them. The basis for preparing the mixture is 20 grams of turpentine and 30 grams of camphor oil, into which you need to pour 5 grams of mountain pine and eucalyptus oils. To enhance the outflow of lymph, the resulting medicine must be rubbed into the skin of the chest every morning and evening.
6. Mustard wraps will also contribute to a speedy recovery. For them, you will need to grind 100 grams of black mustard seeds in a mortar and dilute them with warm water to a paste. The composition is applied in a thin layer to the fabric. The compress is placed only on the part of the chest where the focus of pleurisy is located. You only need to keep the mustard on your chest for 10 minutes, after which the skin should be thoroughly rinsed and dried. Be sure to wear dry clothes.

Lung pathologies are common nowadays. These diseases, according to statistics, attack every third inhabitant of the planet. One of the frequently diagnosed diseases is pulmonary pleurisy. This disease is characterized by the development of an inflammatory process in the serous membrane covering the lung cavity.

Pleurisy in rare cases occurs as an independent disease; often the disease is a complication of lung diseases and other inflammatory processes in the body. Pleurisy – very dangerous illness requiring immediate treatment. Ignoring manifestations, as well as lack of therapy, is fraught with the development of complications. Treatment of pleurisy with folk remedies will be an excellent addition to traditional therapy prescribed by a doctor.

Not a single person is immune from the occurrence of the disease - neither an adult nor a child. The reasons for the development of pleurisy in older people, children and adults are very different, but medicine divides them into two large groups. The disease can be infectious or non-infectious.

As for non-infectious pleurisy, its occurrence can be triggered by:

• pathologies of connective tissue of the lungs;
• pulmonary infarction (death of a section of an organ);
• metastases;
• renal failure;
• blood clotting disorder;
• frequent hypothermia;
• overwork;
• chest injuries;
• intolerance medications;
• complications after surgery.

There are dry pleurisy, exudative and empyema (accumulation of purulent contents in the pleural cavity). The most dangerous and unpleasant is exudative pleurisy, accompanied by the leakage of inflammatory fluid into the pleural cavity under the strong influence of toxic substances, microbes and enzymes.

Symptoms of the disease

The disease is accompanied by severe symptoms. Each of the forms has its own manifestations. Dry pleurisy is characterized by:

• painful sensations in the affected half of the chest when turning, sneezing or bending over;
• an increase in temperature to 38 degrees;
• heavy sweating at night;
• malaise and fatigue.

As for exudative pleurisy, it is characterized by:

• severe shortness of breath;
• cyanosis of the dermis;
• cough;
• headaches;
• pain when swallowing.

As for empyema, this type of illness is accompanied by: an increase in temperature to 39 degrees, chills, blueness skin, severe shortness of breath and muscle pain.

Folk remedies will help in treating the disease

Along with the methods traditional medicine have proven themselves in treatment pathological process compositions from medicinal plants. However, every person faced with pleurisy should understand that the main method of treatment is the use of medications prescribed by the attending physician. Only a qualified specialist can choose the tactics, regimen and course of treatment, as well as medications. You should not self-medicate or refuse to take medications in favor of folk remedies.

Medicines made from natural ingredients are certainly effective. But the result can only be achieved if plant compositions are used as an auxiliary method of therapy. Moreover, it is important to strictly follow the proportions and dosages specified in the recipes. Before using a particular drug, consult with your doctor regarding its appropriateness.

Traditional medicine has many remedies for external and internal use that help cure pathology. The most popular and effective medications include the following.

1. Onions in the fight against illness. Take one onion, peel it, rinse and chop it. Squeeze the juice and mix it in equal proportions with natural honey. Take a tablespoon of the drug twice a day - after lunch and evening meals.

2. Application of healing collection. Mix anise seeds in equal proportions with crushed licorice and marshmallow rhizomes, sage herb and pine buds. Pour the raw materials into a glass liter bottle, then fill with freshly boiled water. Place the tightly closed container in a warm place for two hours. Filter and consume a tablespoon of the drug five times a day. The duration of the therapeutic course is one and a half weeks.

3. Treatment of pleurisy with a mucolytic preparation. Mix licorice rhizome with coltsfoot, mint, linden flowers and elecampane rhizome in equal proportions. Steam 20 grams of raw materials in two hundred milliliters of boiled water. Leave the mixture to sit for a couple of hours. After filtering the product, divide the entire volume into three equal portions and consume throughout the day - after each meal.

4. Horsetail will help get rid of the disease. Brew 20 grams of crushed dried plant in half a liter of boiling water. Place the container in a warm place for four hours. Drink a quarter glass of filtered drink four times a day. The duration of the treatment course is one and a half weeks.

5. Willow bark against pathology. This product has pronounced antimicrobial and bactericidal properties. Grind the dry bark, then steam 50 grams of raw material in 300 ml of boiled water. Leave the product to sit for six hours. Filter and take according to the following scheme: on the first day - 30 ml three times a day, on the second - 40 ml, on the third - 50 ml. The maximum dosage is 70 ml of medication. Course duration is a week.

6. Collection that helps normalize respiratory functions. Combine a spoonful of dried calendula flowers with bird cherry, immortelle, tansy and currant leaves - the same amount. Brew 20 grams of the mixture in two hundred milliliters of boiling water. Leave for two hours. Drink 50 ml of the drink three times a day.

7. An old reliable recipe - honey with radish against pleurisy. Combine in equal proportions freshly squeezed juice radishes with natural honey. Take 10 ml of the drug three times a day.

8. Rubbing agent. Mix 300 grams of badger fat with the same amount of finely chopped aloe leaves and a glass of honey. Simmer the mixture in a low-heat oven for a quarter of an hour. Cool the product and use it to rub the chest and back.

9. Oils in the fight against inflammation. Mix camphor oil - 30 ml with three milliliters of lavender and eucalyptus oil. Rub the product into the chest twice a day.

The use of massage and breathing exercises

Along with taking medications and drugs alternative medicine a good effect can be achieved by using breathing exercises and massage.

Such events will contribute to:

• rapid resorption of infiltrates and removal of accumulated fluid;
• activation of blood and lymph supply to the lungs;
• stimulation of chest mobility;
• increasing the protective properties of the body.

The sequence of massage at home is as follows.

1. First, you need to warm up the paravertebral areas.
2. Next you need to start rubbing the latissimus dorsi muscles.
3. The next stage is warming up and stroking the sub- and supraclavicular areas.
4. The last stage is a massage in the area of ​​both the chest and diaphragm.

After the massage, experts advise lung breathing gymnastics Effective exercise- inflating balloons. At first, the process will be difficult, and there may even be pain. Over time, gymnastics will become easier and easier.

The general massage course is 15 procedures, lasting twenty minutes. You can do it at least every day, even every other day.

Proper nutrition is the key to excellent health

Adequate and balanced nutrition during pleurisy plays an important role in complex therapy. It is recommended to eat food in small portions at least five times a day. Food should be fortified and high in calories.

The main goal of effective nutrition when this disease is to eliminate inflammation in the lungs, as well as to minimize the volume of exudate in the pleural cavity.

First of all, it is recommended to reduce the consumption of salts and carbohydrates, which negatively affect lung function. It is important to minimize the amount of liquid consumed. People suffering from this disease can drink no more than 600 ml of liquid per day. The maximum calorie content of consumed foods is 2500 thousand kcal.

The diet must be enriched with the following products and dishes:

• boiled eggs;
• butter;
• rosehip;
• fermented milk products: sour cream, kefir, cottage cheese;
• sea ​​fish;
• cheese;
• walnuts;
• milk porridges (oatmeal, rice, buckwheat);
• boiled or steamed beef and pork;
• wheat bread;
• fresh salads and vegetables (radish, parsley, potatoes, carrots, onions, cabbage, carrots);
• fruits (grapes, apples, cherries, apricots, currants, bananas);
• vegetable soups and borscht.

A diet, along with taking medications and products made from natural ingredients, as well as using massage and breathing exercises, will contribute to a speedy recovery, increase the protective properties of the body, and normalize condition and well-being.

Prognosis and prevention

Ignoring the manifestations of the disease, as well as the lack of treatment, is fraught with thickening of the pleural sheets, vascular and respiratory failure, and the formation of adhesions in the lung cavity. Correct and appropriate treatment helps quick elimination unpleasant symptoms and improved well-being.

In order to prevent the development of pleurisy, it is recommended to avoid hypothermia and overwork, give up bad habits, and treat on time and completely. accompanying pathologies, strengthen the immune system.

Exudative pleurisy is a disease of the respiratory system, the consequence of which is pleural cavity filled with an excessive amount of fluid and all this occurs against the background of inflammatory processes. In the most common cases, inflammation of the pleura is side effect after the main pathological process.

Mechanism of disease development

During the course of the disease, which occurs with damage to the serous membrane, the functions of the cells lose their properties and cannot absorb the secreted fluid. In addition, the process of fluid appearance occurs more intensely, which is caused by changes in the body. And the circle joins, leading to an excessive amount of pleural exudate between the layers of the pleura.

Under microscopic observation, swelling and accumulation of leukocytes can be seen in part of the pleura.

You should not start the disease, because exudate collects between the pleural layers, in the form of colorless, purulent, dirty or bloody content. Over time, the colorless one resolves, and the fibrinous one transforms into scars.

Causes of pleurisy

The disease is divided into two types: non-infectious and infectious, it all depends on the causes of the disease. Exudative pleurisy of an infectious type, in most cases, occurs due to the worsening of pathologies of the lungs, adjacent tissues and organs, as well as complicated chronic ailments. This form occurs against the background of the following processes:

• pneumonia;
• purulent inflammation of the lung tissue;
• death of a body part;
• tuberculosis.

In such cases, the causes of pleurisy are infectious bacteria penetrating the pleural cavity. In addition, the “culprits” can penetrate the lymphatic and circulatory systems. The causes of the non-infectious form are:

• bruises, wounds to the sternum, resulting in bleeding into the pleural cavity;
• pulmonary infarction, which causes left-sided pleurisy;
• malignant tumors in the respiratory organs;
• chronic connective tissue diseases;
• renal failure;
• blood and lymph diseases;
• foci of inflammation in the pancreas;
• cirrhosis of the liver.

Symptoms of the disease

The persistence of the symptoms shown is directly related to the pathological course of development, volume and characteristics of the exudate. The main symptoms of exudative pleurisy:

• pain and pressure in the chest area;
• feeling of lack of air, hoarse breathing;
• constant shortness of breath;
• dry cough.

Symptoms also include pain in the sternum, which is caused by a violation of the pleura, and can be either tolerable or too painful. At moments when the exudate accumulates, the pain practically goes away or turns into shortness of breath.

Additional complaints:

• constant fatigue;
• increased body temperature;
• I lost my appetite and started sweating.

Differential shortness of breath is characterized by mixed symptoms. Its intensity directly depends on the volume of exudate in the pleura, the rate of its accumulation, and the level of lung ventilation disorder.

The cough, as a rule, appears in the early stages, sometimes it is dry, if the disease worsens, it is liquid.

When observing the chest, rapid shallow breathing is visible; its appearance is asymmetrical, because the affected half of the lung grows, and it lags behind in the breathing process. On palpation, pain occurs.

Diagnosis of pleurisy

Diagnosis of the disease involves an x-ray and physical examination, and a puncture of fluid is taken in the pleural cavity.

Physical indicators are characterized by the lag of the inflamed side of the chest of the cell during breathing, the percussion sound becomes dull, breathing becomes weaker, noises when coughing, the intercostal spaces expand and bulge. In a blood test for biochemistry, a violation of the relationship between various fractions of blood proteins is noted, the level of sialic acid and fibrin increases.

An accurate diagnosis is established only after confirmation by X-ray data or a fluoroscopic procedure of the lungs, which accurately reveal intense homogeneous darkening and movement of the heart to the healthy side. Sometimes an ultrasound examination is performed to determine the volume of exudate in the pleura. If the volume of effusion is excessive, it is removed through a puncture - a puncture in the chest.

Puncture of the parietal pleura is elevated to mandatory procedures for diagnosing the disease, in order to extract effusion for its further study in the laboratory, which has a differential value. In a number of situations when the clinical picture of exudative pleurisy is severe, magnetic resonance imaging of the respiratory organs is performed.

Types of treatment for exudative pleurisy

Treatment of exudative pleurisy begins with the removal of the formed fluid in the pleural cavity, and the medicinal effect affects the main process that causes the pleural reaction. In the most common cases, exudative pleurisy occurs on the right, but, in more severe cases, it can be bilateral.

Surgical intervention is performed for the following symptoms:

• the amount of liquid reaches the second rib;
• pressure occurs through exudate on surrounding organs;
• there is a risk of pleural suppuration.

Puncture of the pleural cavity

If the volume of exudate is excessive, the process of pleural puncture is carried out, that is, the pleural cavity is pierced. This event allows you to get rid of excess fluid in the pleura, straighten the transformed lung, lower the temperature, remove or reduce shortness of breath, and more.

With the assistance of such a procedure, the pathological contents of the pleural cavity are sucked out using a hollow needle, it is douched and the required medical substances are injected. For example, antiseptic, antibiotic drugs, proteolytic enzymes, hormonal, antitumor and fibrinolytic agents.

Pleural puncture is carried out in compliance with all sterility rules; as a rule, local anesthesia is used. It is produced in the seventh or eighth intercostal space - to suction fluid in the pleura; second and third intercostal space – air suction. Large amounts of fluid and air are removed slowly to prevent rapid mediastinal shift. The liquid samples taken are sent for laboratory testing.

Drug treatment

When a differential diagnosis has been carried out, the factors influencing the problem have been identified, and medications are used:

• tuberculostatic drugs (for the tuberculosis type, when there is exudative pleurisy on the left);
• antibacterial drugs (in the pneumatic form);
• cytostatic (appearance of tumors, metastases);
• glucocorticoid;
• diuretic treatment, which is caused due to cirrhosis of the liver.

Depending on the differential course of the disease, anti-inflammatory drugs, analgesics, antispasmodics, and antitussives can be additionally prescribed.

At the stage when signs of exudate resorption appear, the following actions are added to the main therapy:

• oxygen therapy;
• infusion of plasma-substituting complexes;
• electrovibration chest massage to ease breathing;
• physiotherapy treatment procedures.

Exudative pleurisy, which appears as a result of malignant tumors, is treated on the basis of chemical therapy and chemical pleurodesis.

The success of recovery from pleurisy depends on the efficiency of identifying the disease at an early stage and the correct selection of medication and physiotherapeutic treatment, taking into account the patient’s sensitivity to such measures.

Rules for caring for patients with exudative pleurisy

Patient care begins with the introduction of fractional high-calorie meals into the diet, with drinking plenty of fluids. A quiet regimen is prescribed and the patient is provided with nursing supervision. Also, all recommendations and advice of the doctor must be followed, not from time to time, but on a regular basis.

If severe pain occurs, pain relief therapy can be used as prescribed by the doctor. Monitor breathing, blood pressure and pulse rate.

Preventive actions

To avoid relapse of the disease, the doctor prescribes special active breathing exercises, in the form of deepest breaths. They should be done 25 times every hour.

Of course, it is impossible to know exactly how the human body will react to one or another circumstance. However, anyone can follow simple preventive measures:

• can't run acute infections respiratory type. To prevent infectious organisms from penetrating the mucous membrane of the respiratory system, and then into the pleural cavity, you should promptly respond to every cold;
• at the first signs of pneumonia, do not put off a chest x-ray;
• For frequent and severe respiratory tract infections, it is recommended to change the climate for a short period of time. It has long been an established fact that sea air prevents many diseases, including pleurisy;
• strengthen immune system. Spend more time on fresh air, lead a mobile and active lifestyle, during warm periods you can engage in hardening of the body;
• give up or minimize bad habits. Smoking is the culprit of pulmonary tuberculosis, which can provoke foci of inflammation in the pleura, and also complicates the breathing process.

In the most common situations, even the most complicated and advanced exudative pleurisy can be successful treatment and complete recovery of the patient.

It is worth knowing that after complete recovery from pleurisy, after six months it is necessary to undergo an x-ray control. And most importantly, do not forget that it is better to prevent any disease than to treat it long and hard. Take care of yourself!