DISEASES OF THE RESPIRATORY SYSTEM : EMPHYSEMA (EMPHYSEMA PULMONUM) - etiology, pathogenesis, symptoms and course of, recognition, prediction and prevention
Emphysema is an irreversible condition in which there is atrophy of the pulmonary alveoli, decreased elasticity and increased airiness of lung tissue.
Emphysema may develop as if the primary (essential emphysema) or as a result of chronic bronchitis, which is difficult exhale as a result of swelling of the mucous bronchial tubes. Concomitant chronic bronchitis peribronchial, interstitial pneumonia, pneumocytes create the conditions for malnutrition and alveoli that contribute to the development of emphysema. Ossification of the costal cartilages, spondiloarthrosis, rigidity of the thorax are favorable for the occurrence of emphysema. Often, however, bone changes are secondary. Describes the occurrence of emphysema after air-injury accompanied by concussion. In these cases the development of emphysema is associated with changes in the Central nervous system. Need to allocate senile emphysema, in which there are atrophic processes in the lung tissue, but no increase in its lightness.
The disease develops most often in men 40-60 years of age and runs a chronic. The main complaint - cough dry or with expectoration, depending on the nature of concomitant bronchitis, shortness of breath mainly expiratory.
Over the lower parts of the lungs sound box; the boundaries of the lungs are omitted, the excursion is reduced, the breath is weak, the exhalation is lengthened. Often defined dry and wet rales. X-ray examination can detect the increase in transparency of the lung fields. Relatively early revealed signs of respiratory distress (dyspnea, cyanosis), in the later stages of developing circulatory disorders, hypertrophy of the right ventricle with subsequent moderate extension of it, the ripple of the epigastrium, venous congestion with increased venous pressure, swelling of neck veins and liver, eventually peripheral edema. Once the onset of decompensation is difficult to treat. The disease duration of 10-15 years.
Is known for trouble only in cases of advanced decompensation in elderly patients, when there is a need for differential diagnosis with cardiosclerosis. Anamnesis, typical changes of a thorax, an examination of the lungs, the epigastric pulsation to avoid error in diagnosis.
Basically the same as when chronic bronchitis. In addition, the use breathing exercises (squeezing of the chest at the output to improve it, massage, "breathing chair"), "pneumatic" treatment - inhalation of a rarefied air. Climatic treatment, bed rest.