Exudative pleurisy - treatment of the disease. How to treat pleurisy in adults at home using folk remedies? Bilateral exudative pleurisy

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 is a very dangerous disease that requires 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 to 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, bluish skin, severe shortness of breath and muscle pain.

Folk remedies will help in treating the disease

Along with the methods of traditional medicine, compositions from medicinal plants have proven themselves well in the treatment of pathological processes. 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 freshly squeezed radish juice with natural honey in equal proportions. 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 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 doing light breathing exercises. An effective exercise is 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

A nutritious and balanced diet for 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 for this disease is to eliminate inflammation in the lungs, as well as 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 to quickly eliminate unpleasant symptoms and improve well-being.

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

is a disease of the respiratory system, which is characterized by damage to the pleura of an infectious, tumor or other nature.

Damage to the pleural cavity is accompanied by the accumulation of an excess amount of exudate (effusion), which leads to a feeling of heaviness in the patient, a reflex cough, increasing shortness of breath and an increase in body temperature.

The main treatment for exudative pleurisy consists of removing accumulated fluid from the pleural cavity, as well as conducting pathogenetic and symptomatic therapy.

Depending on the etiology of the disease, exudative pleurisy is divided into two types: infectious and non-infectious.

Most infectious exudative pleurisy occurs as a result of complications of pathologies of the lungs, nearby organs and tissues, as well as severe systemic ailments.

The infectious form of pleurisy appears against the background of the following processes in the lungs:

• lung abscess;

The cause of the disease in this case is the entry of infectious irritants from the listed diseases into the pleural cavity.

In addition, microorganisms from the source of inflammation can circulate through the lymphatic and circulatory systems.

In the case of a disease of tuberculosis etiology, there is an increased reactivity of the body to the effects of the tuberculosis bacillus, as a result of which fluid begins to accumulate even with the penetration of a small number of pathogens.

This type of exudative pleurisy occurs mainly in adult patients.

Causes of aseptic (non-infectious) effusion pleurisy:

• Trauma, chest wound, resulting in hemorrhage in the pleural area;

• Pulmonary infarction due to pulmonary embolism;

• Malignant neoplasms in the pleura and lungs;

• Systemic connective tissue diseases (rheumatoid arthritis, collagenosis);

• Kidney failure;

• Diseases of the circulatory and lymphatic systems;

• Cirrhosis of the liver (provokes right-sided pleurisy);

• Inflammatory process in the pancreas.

Often exudative pleural effusion has a unilateral form, with the exception of metastatic processes, systemic lupus erythematosus and lymphoma, on the basis of which bilateral pleural exudate can develop.

Symptoms of the disease

Symptoms of exudative pleurisy depend on the volume, nature and intensity of fluid accumulation:

Chest pain
At an early stage, when fluid just begins to accumulate, the patient is tormented by increasing pain in the chest. As the disease progresses, the layers of the pleura begin to separate from each other, which reduces the excitation of intercostal nerve fibers and relieves pain.

The pain syndrome is replaced by other symptoms: a feeling of heaviness in the affected side of the chest, a reflex cough and shortness of breath, which forces the patient to take a position on the affected side.

Cough and shortness of breath
These symptoms depend on the volume of accumulated effusion, impaired ventilation of the diseased lung due to pressure and displacement of the mediastinal organs. The cough at the initial stage is dry, but as the disease progresses it becomes wet.

Symptoms of respiratory failure
They are characterized by pale or bluish skin, the appearance of cyanosis and acrocyanosis. If fluid has accumulated not only in the pleural area, but also in the mediastinum, swelling in the neck and face, swelling of the veins, and a change in voice are observed.

Other signs

Tachycardia, decreased blood pressure.

Convexity of the chest in the area of ​​accumulated exudate.

Additional symptoms: febrile temperature, sweating, drowsiness.

Fever, chills, signs of intoxication, headaches, loss of appetite.

The listed symptoms may occur with an infectious form of effusion pleurisy.

Empyema of the pleura. Develops when accumulated exudate suppurates.

Examination of the chest, as a rule, determines shallow, rapid breathing, asymmetry of the chest, and lag of the affected side in the process of respiratory movements.

Palpation gives the patient painful sensations, weakened vocal sounds are noted on the affected half of the chest.

There are three phases of the disease:

• Exudation lasts up to three weeks, during which time up to 10 liters of exudate can accumulate.

• Stabilization, with the onset of which the formation of effusion stops, but the process of its absorption does not yet occur.

• Resorption, which is characterized by resorption of exudate. In most weakened patients, this stage lasts up to two to three weeks.

Diagnosis of the disease

Before prescribing treatment for effusion pleurisy, the doctor conducts a comprehensive diagnosis that establishes the causes of the disease and determines the main pathology.

Percussion of the lungs
Detects dull sounds over effusion. Topographic percussion notes a displacement of the lower edge of the lungs, as well as a decrease in respiratory mobility.

Auscultation
At an early stage, it notes a place with weak vesicular breathing, as well as noises resulting from friction of the pleura.

It can and does determine the main pathology, which has become focal and complex diagnosis of the disease, which, as a result of friction of the pleura, can determine the presence of leukocytosis, neutrophilia, a shift of leukocytes and formula to the left, as well as an increased ESR.

Analysis of pleural effusion
Serous fluid is characteristic of pleurisy of the tuberculosis form, purulent exudate is formed during gangrene of the lung and enters the pleural space.

Liquid of a serous-purulent nature and containing fibrin protein is characteristic of the rheumatoid and tuberculous nature of pleurisy. Microscopic examination reveals the presence of leukocytes, neutrophils, lymphocytes and eosinophils.

Radiography
Reveals darkening and shift of organs of the mediastinal system to the healthy side.

Therapy of the disease

The main treatment for exudative pleurisy is to evacuate fluid from the pleural space, as well as to influence the main pathology that provoked the consequences.

Most often, pleural exudate is observed on the right, but a more severe variant of development is also possible - exudative pleurisy of a bilateral form.

If there is an excessive volume of effusion, puncture or drainage of the pleural cavity is performed, allowing to evacuate fluid, straighten the deformed lung, reduce shortness of breath, lower body temperature, etc.

Surgical removal of fluid is performed if the following symptoms are observed:

• Large volume of pleural fluid, reaching the 2nd rib;

• Exudate puts pressure on surrounding organs;

• There is a risk of pleural suppuration.

Taking into account the cause of pleurisy, drug treatment is prescribed:

• Tuberculostatic drugs (for the tuberculous form of exudative pleurisy);

• Antibacterial agents (for pneumatic pleurisy);

• Cytostatic agents (for tumors and metastases);

• Glucocorticoid drugs (for lupus erythematosus and rheumatoid arthritis)

• Diuretic treatment for pleurisy caused by cirrhosis of the liver (usually the lung located on the right is affected).

Regardless of the etiology of the disease, analgesics, anti-inflammatory, antitussive, and desensitizing agents are prescribed.

At the stage when the effusion occurs, auxiliary treatment is added to the main therapy:

• Halotherapy (oxygen therapy);

• Transfusion of plasma-substituting compounds;

• Treatment based on chest massage, vibration massage;

• Physiotherapeutic treatment, for example, compresses based on paraffin applications (in the absence of contraindications);

Complications due to empyema are treated by introducing antiseptic drugs and antibiotics into the pleural cavity.

Chronic exudate suppuration is eliminated by surgical intervention through thoracostomy, pleurectomy, which involves decortication of the lung.

Exudative pleurisy, provoked by malignant neoplasms, involves treatment based on chemotherapy and chemical pleurodesis.

Prevention of exudative pleurisy is aimed, first of all, at timely diagnosis and proper treatment of pathologies that cause the formation of exudate in the pleural cavity.

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

With 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.

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 the clinical picture: the clinic includes not only general, but also symptoms characteristic of 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 will 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 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 a sharp drop in the patient's blood 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 the physical properties of blood in the pulmonary vessels, usually due to heart failure or renal failure. Transudate is a clear, yellowish liquid that is usually odorless.

Always, if an effusion is recognized as an exudate, its bacteriological examination should be carried out in order 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.

Pleurisy is a disease of the respiratory system characterized by inflammation of the pleura - a thin, transparent, two-layer membrane consisting of connective tissue fibers and designed to restrict the movement of the lungs. In healthy people, there is a lubricant in the pleural cavity that allows the pleural layers to slide during breathing. As the disease develops, the fluid becomes inflammatory in nature, contains pus or blood, the leaves rub against each other, which is manifested by chest pain, which is called pleural.

Typically, pleurisy is a secondary disease that develops against the background of respiratory or cardiovascular pathology. In children, pleurisy accompanies.

There are several classifications of this disease:

• By origin, pleurisy can be infectious and aseptic,
• According to the location of the source of inflammation - right-sided, left-sided, diffuse, bilateral, encysted,
• According to the course - acute, subacute, chronic,
• According to the nature of the pathology - dry or fibrinous and exudative or effusion.

Etiology

Pleurisy is a polyetiological disease, the causes of which are: specific and nonspecific infection, allergies, systemic diseases, radiation, neoplasms, traumatic injury.

Infection

Microbes penetrate into the pleural cavity in any way: hematogenous and lymphogenous in infectious diseases of the lungs, as well as directly in case of injuries, operations on the organs of the chest cavity.

Tuberculous pleurisy is classified as a separate group, since it is highly contagious and rapidly spreading. The pathology complicates the course of the primary or secondary or other organs. Mycobacteria penetrate the pleura with the flow of lymph or blood from the affected lungs, organs of the digestive system, lymph nodes, and bones. In children, tuberculous pleurisy is much less common than in adults.

In rare cases, pleurisy is a contagious disease: viruses and bacteria that cause the pathology spread from sick people to healthy people who were in close contact.

Non-communicable diseases

Impact of environmental factors

• Chemicals have an aggressive effect on the serous membrane, which leads to the development of reactive inflammation.
• Radiation causes dysfunction of pleural cells, the development of local inflammation, and accumulation of exudate.
• In case of chest injuries, infection of the affected tissues occurs, the process of absorption of pathological fluid is disrupted, which leads to the development of exudative pleurisy.

Despite the fact that pulmonary pleurisy occurs with the same frequency among both men and women, the causes of the pathology are fundamentally different. In women, the causes of pleurisy are usually breast or ovarian cancer, collagenosis, and in men - chronic pancreatitis or rheumatoid arthritis.

Factors contributing to the development of pathology:

1. Endocrine pathology - diabetes mellitus.
2. Alcoholism.
3. Chronic diseases of the bronchi and lungs.
4. Reflux esophagitis.
5. Immunodeficiency states.
6. Hypothermia.
7. Stress.
8. Overwork.
9. Poor nutrition.
10. Allergy.

Pathogenesis

Inflammation of the pleura develops in response to the introduction of pathogenic microbes and consists of 3 stages: exudation, formation of purulent discharge and recovery.

Symptoms

Fibrinous pleurisy begins sharply. Patients complain of burning pain in the chest, the intensity of which increases with deep inspiration, coughing, sneezing and weakens or completely disappears when standing still. Pleural pain lasts from several hours to several days. To relieve it, you should breathe slowly and shallowly.

Inflammation of the pleura is usually accompanied by a state of hypoxia and is manifested by corresponding symptoms: chronic fatigue, depression, insomnia, chest and head pain, tachypnea, tachycardia, shortness of breath, nausea and vomiting, deterioration of hearing and vision.

Patients show signs of intoxication: low-grade fever, malaise. Breathing becomes more frequent, and on the affected side the excursion of the lungs is limited. Pain in the abdomen or side, hiccups and sore throat may occur.

Exudative pleurisy manifests itself as unilateral chest pain, which, as fluid accumulates, is replaced by a feeling of heaviness and pressure.

Exudative pleurisy

Other symptoms of pleurisy include:

1. Pain in the shoulder girdle;
2. Signs of general intoxication;
3. Acrocyanosis, swelling of neck veins, protrusion of intercostal spaces;
4. Shortness of breath is a subjective sensation manifested by tightness in the chest, changes in the frequency and depth of breathing.

The patient takes a forced position - lies on the sore side. This position reduces friction of the pleura and the intensity of pain.

During the examination of the patient, the doctor pays attention to the asymmetry of the chest. Palpation reveals a weakening of vocal tremors and crepitus. On percussion, a dull sound appears above the exudate; on auscultation, weakened breathing with a bronchial hue, fine wheezing, and pleural friction noise, which can be heard at a distance, appear.

Diagnostics

Diagnosis of pleurisy requires a subjective and objective examination of the patient. A subjective examination includes questioning the patient, collecting an anamnesis of life and illness, clarifying allergological status, bad habits and occupational factors. Objective examination – examination, palpation, percussion, auscultation, clinical examination of other organs. Additional methods include: laboratory diagnostics, instrumental examination, pleural puncture.

• Fluid is obtained using pleural puncture. they study it visually and then send it to the laboratory for further research. In a clinical laboratory, the punctate is examined to determine the root cause of the disease.
• Bacteriological examination and direct microscopy of sputum and pleural fluid make it possible to identify the causative agent of the pathology, fully identify and determine its sensitivity to antibiotics.

Treatment

Treatment of pleurisy is carried out in a hospital under medical supervision. Patients are prescribed powerful and effective medications, and, if necessary, surgical intervention is performed.

At home, it is permissible to treat only those patients who approach this issue responsibly, take care of their health and strictly follow the instructions of doctors. If the disease is mild, does not progress, there are no complications, and the patient feels satisfactory, treatment at home is allowed.

Diet therapy is indicated for patients with pleurisy. Products containing large amounts of carbohydrates, which contribute to the development of pathogenic bacteria, are prohibited. You should not drink a lot of fluids or eat foods that make you thirsty. To stimulate the immune system, it is necessary to enrich the diet with fresh vegetables and fruits, as well as juices from them.

Drug treatment

Complex treatment of pleurisy consists of etiotropic, pathogenetic, symptomatic and restorative therapy.

Physiotherapy

In cases of exacerbation of dry pleurisy, patients are prescribed warming of the chest with infrared rays, ultraviolet irradiation of the chest, and daily paraffin applications. After acute inflammation subsides, calcium and iodine electrophoresis is performed. A month after recovery, water procedures, exercise therapy, manual and vibration massage are indicated.

For exudative pleurisy, mud or paraffin applications, UHF, diathermy, inductothermy, ultraviolet irradiation, sun-air baths, and climatotherapy are performed.

ethnoscience

Traditional medicine helps speed up recovery (but does not replace treatment!), alleviate the patient’s condition, and improve respiratory function. All procedures must be carried out with the permission of the attending physician.

Pleurisy can be treated with traditional medicine only in combination with traditional medications, since the disease progresses rapidly and can lead to dysfunction of the respiratory system. Traditional medicine may not be able to cope with such a serious illness on its own.

Complications

Pleurisy itself is a consequence of a number of serious pathologies - pneumonia , tuberculosis, cancer, vascular disorders.

The severe consequences of pleural inflammation include:

Prevention

Persons who have had pleurisy in any form are followed up by a pulmonologist for 2-3 years. It is recommended to exclude occupational hazards, hypothermia and drafts.

Preventive measures for pleurisy:

• Early detection and adequate treatment of pneumonia and other diseases of the respiratory system, the course of which is complicated by pleurisy,
• Regular breathing exercises
• Strengthening the immune system - hardening, prolonged exposure to fresh air, regular exercise,
• Vitaminized and balanced nutrition,
• Fight against smoking
• Climate change with frequent respiratory diseases.

Video: pleurisy - what to do if it hurts to breathe?