Chronic nonspecific pneumonia

Under chronic nonspecific pneumonia understand chronic inflammatory lung disease, characterized by periodic outbreaks of the inflammatory process, which arise on the basis of structural changes in the lung tissue and bronchi, and leading to their progression.
The development of chronic pneumonia is most often associated with acute P.: in some cases of acute P., not ending a full recovery, becomes chronic; in others, repeated acute pneumonia, ending a visible recovery, determine the development of chronic.
A very important role in the occurrence of chronic nonspecific P. play chronic bronchitis. Accompanied in many cases, a violation of bronchial obstruction and drainage function of bronchi, chronic bronchitis, first, promote the emergence of a second acute P., secondly, their prolonged course and transition to chronic.
Re-infection bronchial tree is apparently due to sinaitul that detect patients with chronic pneumonia very often.
Finally, it should be borne in mind the possibility of developing chronic P. in the result of harmful influence of professional factors (antracot, silicosis, berillios).
The clinical picture of chronic nonspecific P. extremely polymorphic and varies depending on the stage of the disease, the state of the external respiration and circulation, and the presence of those or other complications.
In the initial period, the only manifestation of the disease can be repeated pneumonia, which in some cases are light, sometimes even viewed or go under a diagnosis of flu; others take a protracted course. Further dynamics of the clinical picture is determined by the accession of pneumosclerosis, pulmonary suppuration and other complications, the condition of external respiration and blood circulation.
It is very difficult sometimes to timely identify exacerbation of chronic inflammatory processes in the lungs, as they often occur without pronounced temperature reaction and without acceleration ROHE.
For the diagnosis of chronic nonspecific P. the great value has carefully assembled history and properly conducted examination of the patient. Despite the great importance of radiological research method, the revaluation of it (with no changes) can lead to incorrect or late diagnosis of chronic pneumonia.
A significant role in the clinical manifestations chronic nonspecific P. play emerging changes of the functional state of the device of external respiration.
In patients with chronic nonspecific pneumonia usually significantly reduced lung capacity, limits and reserves of pulmonary ventilation, which may occur even in cases where the process is limited by one or more segments. More significant decrease of these parameters is observed in patients with chronic nonspecific P. in the diffuse pneumosclerosis (see), and emphysema (see) and especially with the development of lung-heart failure (see). Limitation reserves pulmonary ventilation in patients with chronic nonspecific P. with pronounced symptoms of circulatory failure suggests that even with small physical activity is a need to increase of pulmonary ventilation can exceed the available resources, and the limited confines of ventilation in these cases may be the cause of increasing failure of external respiration.
In patients with chronic nonspecific pneumonia in the diffuse pneumosclerosis in many cases, there are different degrees of severity of arterial hypoxemia, accompanied, as a rule, and blood hypercapnia. The natural development of such patients simultaneously with arterial hypoxemia also arterial hypercapnia gives the basis to consider, that in the Genesis of insufficiency of external respiration essential violations lung ventilation. Classification of chronic P., adopted at the Symposium in 1964, is shown in table. 2.


Therapeutic interventions for chronic nonspecific pneumonia is aimed, first, at the elimination of inflammatory processes in the lungs and bronchi, and, second, to prevent their recurrence.
In the period of exacerbation of chronic nonspecific P. primary importance is the rational antibacterial therapy drugs (antibiotics and sulfa drugs). Antibiotics should enter not only intramuscularly or orally, but also spray. The holding of antibiotic therapy must be combined with the appointment of vitamins, first of all Riboflavin (vitamin B2), thiamin (vitamin B1) and pyridoxine (vitamin B6), which is especially necessary during treatment with broad spectrum antibiotics.
In addition, it is necessary to increase the body's resistance (high-calorie diet, health-protective mode, including the period of remission small walking, in some cases shown periodic blood transfusion, glucocorticoids).
Shown physiotherapy and especially breathing exercises conducted in the volume corresponding to the condition of the patient; various physiotherapeutic procedures to improve the pulmonary circulation and accelerate the resorption pneumonic foci; liquidation event bronchospasm ephedrine, teofedrin or other broncholytic drugs; timely detection and treatment of various diseases of ENT organs, which may be important in the etiology of chronic nonspecific pneumonia (nasal breathing disorders, tinuity and so on); you need Smoking cessation, as the latter supports chronic bronchitis; prevent cooling patients; rational oxygen therapy in violation of external respiration; in the development of the phenomena pulmonary-cardiac insufficiency "cardiaca".
Outside the period of exacerbation good results Spa treatment in the conditions of the warm climate of the southern coast of Crimea or in conditions of a pine-wooded area.
Currently, many authors chronic nonspecific pneumonia is treated as a precancerous condition, therefore, timely treatment is very important as prevention of cancer.

Classification of chronic pneumonia
The stage of the disease Clinical course and options X-ray symptoms Phase of the disease The main symptoms The presence and extent of changes
respiratory function circulatory functions
I Prolonged pneumonia (over 6 weeks), recurrent pneumonia on the background of chronic bronchitis Infiltrative changes in the lungs and peribronchiolar infiltration   Cough, temperature reaction, the Department of sputum and other symptoms of pneumonia You may experience respiratory failure I of a degree There may be a deficiency of blood circulation of I degree
II The frequent recurrence of pneumonia and development of the pathological process by types: A) limited: suppuration, pneumosclerosis, bronchiectasis; B) diffuse: pneumosclerosis, emphysema, asthmatic bronchitis In the period of exacerbation infiltrative changes in the lungs and peribronchiolar infiltration. Pronouncedly pneumosclerosis. Bronchiectasis and emphysema Exacerbation or remission Can show trends in the development process towards multiple bronchiectasis or diffuse pneumosclerosis and emphysema, which determine the clinical symptomatology You may experience respiratory failure I-II degree Degeneration of myocardium, circulation failure of the I or II degree
III Same, when pronounced manifestations Expressed pneumosclerosis different types. Bronchiectasis. Emphysema. Infiltrative changes in the lungs   Persistent pronounced clinical manifestations of the disease on the specified options Usually respiratory failure - II-III degree Degeneration of myocardium with predominant lesion of right heart, circulatory insufficiency II or III degree