Emphysema

Emphysema lung - lung disease, characterized by a high content of air into them.
Chronic diffuse and severe emphysema. More common chronic diffuse emphysema, which occurs as a complication of chronic bronchitis, bronchial asthma, the pneumosclerosis or the pneumoconiosis, and also due to atrophy of lung tissue in old age (old emphysema).
Acute pulmonary emphysema may occur during an acute attack of asthma and due to the removal of one lung. In rare cases there are so-called lobes pulmonary emphysema newborns, arising out of defect development of the bronchial tree.
When emphysema due to spasm, swelling of mucous membrane and accumulation of viscous sputum violation occurs bronchial patency. In the result of inflammation and degeneration of the wall of the small bronchi and bronchioles, especially respiratory, loses its tone and airway lumen respiratory bronchioles and alveoli extends, metalware walls are broken.
Pathological anatomy. Emphysema lungs vzduchu and not zadayutsya after opening the chest; in the section have a porous. Sometimes there are large bubbles - the size of a cherry, and more (bullous emphysema). For chronic emphysema is characterized by the presence of interstitial sclerosis lung tissue and chronic bronchitis, as well as signs of hypertension small circle; the extension of the lumen of the major branches of the pulmonary artery, a hypertrophy of their walls and wall of the right ventricle of the heart.

emphysema
The contours of the chest with emphysematous (1) and healthy (2) easy and front view; b - side view.

Clinical presentation and course. Patients complain of shortness of breath, initially only on exertion and later at rest. There is a remarkable lengthening of exhalation. Due to bronchitis observed cough, sputum is usually little and she stands out with difficulty. The characteristic appearance of a patient with emphysema: chest barrel form (Fig), the respiratory motion limited, intercostal spaces are smoothed, supraclavicular area will wybuchu. There is cyanosis of the skin and mucous membranes, especially in the late period of the disease. At a percussion of light is determined by the sound box. The bottom border of the lungs is omitted, their mobility is limited. Absolute dullness of heart due to the expansion of the lungs is determined with difficulty. On auscultation - vesicular respiration is weakened, scattered dry and not euphonic moist rales.
X-ray examination is defined by the enlightenment of the lung fields in combination with increased bronchial and vascular pattern, low water and weak respiratory motion of the diaphragm. Functional performance while emphysema is reduced: the vital capacity (VC) is reduced mainly due to a backup volume of breath, increased residual volume of the lungs, reduces forced VC per 1 sec. (sample tiffno).
The disease is chronic. Death occurs from progressive pulmonary-cardiac insufficiency or as a result of outbreaks of pneumonia, which are predisposed patients with emphysema.
Treatment and prevention of emphysema are limited primarily to the treatment of chronic bronchitis and pneumonia. The latter is difficult to diagnose, so at the slightest suspicion of the infection antibiotics should be prescribed injections and inside. If bronchospasm is assigned funds, extending clearance bronchi: teofedrin 1/2-1 tablet 2-3 times a day, eufillin 24% solution 1-2 ml injection 1-2 times a day etc. are provided With pulmonary-cardiac insufficiency prescribed inhalation 40-50% humidified oxygen 10-30 minutes through a mask or nasal catheter. At the same time we use products, stimulating the respiratory center: kordiamin 2 to 4 ml or korazol - 10% solution 1-2 ml intramuscularly. Normalizes heart activity - Inf. herbae Adonidis vernalis 6 : 180 on 1 table. L. 3-4 times a day or drugs naperstanki (see). In a quiet period shown physiotherapy and treatment of expectorants, such as Inf. herbae Thermopsidis 0,6 : 180 on 1 table. L. 4-6 times a day.
When emphysema without severe cardiopulmonary insufficiency shown Spa treatment in the autumn and winter in Crimea, on the Caucasian coast, in Kislovodsk, in the summer - in the Baltic States, as well as in dry areas of the middle zone of the USSR.

Emphysema (gr. emphysema - bloating - group of a variety of pulmonary lesions, United on the basis of the increased content of air.