- Pain behind the sternum
- Chest expansion
- Cyanosis of the lips
- Cyanosis of nails
- Cyanosis of the tongue
- Weight loss
Doctors call pulmonary emphysema a disease of the respiratory tract, characterized by the development of a pathological process in the lungs, which causes a strong expansion of the distal bronchioles, accompanied by a violation of the gas exchange process and the development of respiratory failure.
To date, the frequency of development of this disease has increased significantly, and if earlier it was found mainly among people of retirement age, today people from the age of 30 years suffer from it (men with pulmonary emphysema get sick twice as often). Moreover, the disease (in combination with AD and obstructive bronchitis) belongs to the group of chronic lung diseases that have a progressive course, often become the causes of temporary disability of patients or lead to their early disability. Moreover, a disease such as pulmonary emphysema is characterized by the fact that it can be fatal, so everyone should know its symptoms and basic principles of treatment.
Definition of pulmonary emphysema
Emphysema of the lungs (from the Greek emphisao - “inflate”) is a disease in which irreversible changes occur in the septa between the alveoli and the end sections of the branching of the bronchi expand. Voids form in the lung tissue - specific spaces that are filled with air. The lungs themselves inflate and increase in volume. Alveoli are pulmonary vesicles that are braided by a network of capillary vessels. Through their thin wall, the most important element that is necessary for human life, oxygen, is absorbed. Their lungs contain about 700 million. The bronchi are an element of the pulmonary system through which air flow passes. The main bronchus gives rise to two smaller ones, those, in turn, form already four, but smaller in diameter. This division gradually stops, ending with bronchioles, alveolar passages and alveoli. This final site is called - acinus or structural unit of the lungs. It is in it that destructive changes take place that turn the organ into a useless swollen “bag” that does not fulfill its functions.
It is worth noting that the increased airiness of the lungs in some cases is a physiological state, for example, with intense physical exertion or prolonged cold exposure.
Why does pulmonary emphysema occur?
The risks of emphysema formation in humans are different, for example, they are more prone to:
- people with addictions like smoking. The danger of developing this pathology increases by as much as fifteen times,
- the male sex is more prone to the formation of emphysema. The ratio is 1: 3,
- high risks of developing the disease among residents of northern Europe, due to the congenital lack of specific whey protein.
As provoking factors and the main reasons for the development of the disease can serve:
- infectious diseases of the respiratory tract. Formed by purulent bronchitis or pneumonia (pneumonia) sputum, prevents the release of part of the air outside. The walls of the alveoli, thus, are significantly overstretched. In addition, the cells of our immune system that fight infection (lymphocytes, macrophages) are capable of producing enzymes that partially destroy not only microbial, but also alveolar structures,
- alpha-1-antitrypsin deficiency. Normally, it is needed to neutralize enzymes that destroy the walls of the alveoli. It is a congenital pathology,
- abnormalities in the development of pulmonary structures,
- occupationally harmful. Long work as a musician-oven, glassblower leads to a weakening of the smooth muscles of the bronchi, impaired blood supply. When exhaling, not the entire volume of air is expelled from their alveoli, they are deformed, expand, cavities form,
- chronic obstructive pulmonary diseases - chronic bronchitis, bronchial asthma eventually lead to emphysema,
- contaminated air. The most dangerous are the inhalation of cadmium, sulfur oxide and nitrogen. They are distinguished by transport and thermal stations,
- age-related changes. The transferred lung diseases throughout life, impaired blood circulation, and increased sensitivity to toxic substances are a favorable environment for the development of emphysema,
- the ingress of a foreign body (seeds, buttons, etc.) into the lumen of the bronchi can contribute to the development of an acute form of emphysema.
What is pulmonary emphysema?
Pulmonary emphysema is a disease of the respiratory tract, characterized by a pathological expansion of the air spaces of the distal bronchioles, which is accompanied by destructive morphological changes in the alveolar walls.
The transformation of lung tissue is due to pathological changes that contribute to the formation of voids with air, contributing to an increase in lung size. As a result of emphysema, the septum between the alveoli is destroyed (an anatomical cell in the lung that promotes the respiration process).
The disease is quite common, up to 4% of the world's population suffers from it. The male population after the age of 50 is twice as susceptible to the disease. Currently, pulmonary emphysema is diagnosed in people by the age of 30, there are cases of congenital lung pathology.
Causes, Symptoms and Complications
With emphysema, the walls of the alveoli are stretched, as a result of which an increased amount of air is contained in the lung tissue, the body breaks the exchange of oxygen and carbon dioxide.
This ailment is more common in older people. In young people, it leads to early disability and disability.
The disease can occur in two forms:
- bullous (pathological tissues coexist with healthy ones),
- diffuse (pathology spread to the entire organ).
The development of emphysema is facilitated by a number of factors: polluted air, smoking, harmful working conditions. A certain role in the development of the disease is also played by heredity. But the main cause of the disease is chronic bronchitis.
As the disease develops, it is detected in the following symptoms:
- severe shortness of breath
- an increase in the chest in volumes,
- decrease in respiratory movements of the diaphragm,
- expansion and bulging of intercostal spaces and supraclavicular areas.
Terrible are the complications of pulmonary emphysema - respiratory and heart failure, pneumothorax.
Pulmonary emphysema almost always occurs in connection with the so-called chronic obstructive pulmonary disease (COPD).
An estimated 5-10 out of every 100 adults suffer from chronic obstructive pulmonary disease. The disease mainly occurs in smokers.
Pulmonary emphysema can also be caused by a hereditary deficiency of a particular protein. This is the so-called alpha-1-antitrypsin, however, it is very rare: only about 10% of people suffer from this in Russia.
Prevention of the development of pulmonary emphysema, first of all, is the timely treatment of bronchitis and other respiratory diseases.
Smoking should be abandoned once and for all, and do it abruptly, and not gradually.
Walking in the fresh air, playing sports and breathing exercises are the best prevention of respiratory failure.
It is also necessary to increase immunity, including pharmacy immunostimulants and folk remedies, for example, honey, echinacea, etc.
Causes of Emphysema
To date, smoking is the most common cause of pulmonary emphysema. Almost always, a disease develops in connection with COPD, which affects mainly smokers. The combination of constant inflammation and inhalation of cigarette smoke leads to the destruction of the alveoli.
The main risk group:
- people with a congenital form of pathology associated with a lack of whey protein in the formation of the fetus (the so-called alpha-1-antitrypsin deficiency),
- smoker, including passive,
- people with chronic obstructive pulmonary disease.
All this violates the plasticity of the tissues of the organ and increases pulmonary pressure, resulting in emphysema.
Here are a few factors that influence the change in tissue ductility:
- changes in the bodyrelated to a person’s age. Violation of blood supply in the body of an elderly person increases its sensitivity to the negative effects of the environment. Lowering the immune system leads to a long recovery after the transfer of infectious diseases of the respiratory system,
- systematic inhalation of contaminated air industrial origin, including cigarette smoke. Vapors of cadmium and nitric oxide are especially dangerous. Microparticles of substances settle on the walls of the bronchioles, which leads to damage to the vessels of the respiratory system,
- respiratory tract infection. Lung diseases (causes: SARS, influenza, pneumonia, bronchitis, etc.) causes the activation of lymphocytes - as immune defenses of the body. The process has a negative effect on the alveoli by dissolving the alpha-1-antitrypsin protein. Mucus does not allow air passage from the cells of the alveoli, which leads to stretching of the lung tissue,
- congenital insufficiency of a group of whey proteins (alpha-1-antitrypsin). Pathology is a violation of the functions of the enzyme of the hydrolysis class, which does not provide a protective function in the body against bacteria, on the contrary, it serves as a destroyer of the walls of the alveoli
- systemic circulatory disorders in the lungs, hormonal disorders. Violation of the ratio of androgens and estrogens leads to a decrease in the ability of the muscles of the bronchioles to contract, which contributes to the formation of air space in the lungs.
Pulmonary pressure rises due to severe respiratory diseases, occupations, penetration of a foreign particle into the bronchi and blockage of oxygen, which cannot find a way out and puts pressure on the respiratory system.
Classification of emphysema
Emphysema is classified according to the following signs:
- nature of the disease: acute form (occurs suddenly, emergency intervention is necessary) and chronic pulmonary emphysema (slowly developing, difficult to diagnose at the initial stage),
- origin of the disease: primary (a self-developing disease, often of a congenital nature) and secondary (complication after a disease),
- level of lung damage: focal (a separate part of the organ is damaged) and diffuse (lung tissue is completely affected, often a complete organ transplant is necessary)
- anatomical feature of the course of the disease: hypertrophic form (severe form of the disease, no inflammatory process, lack of respiratory function) centrilobular form (with an increase in the clearance of trochea, an inflammatory process develops with the formation of mucus in large quantities), paraseptal form due to the patient’s pulmonary tuberculosis (possibly damage and rupture of the organ), pericarp form (formed near scarring of the lungs) subcutaneous form (under the skin is the formation of bubbles) bubble form (bullous pulmonary emphysema, large vesiculate formations on the lung tissue are observed),
- causes of occurrence:age form (change in the state of blood vessels due to age), lobar form (congenital sign of obstruction of one of the bronchi), compensatory form (occurs when the lobe of the lung is removed, the body tries to compensate for the created space by increasing the other lobe).
The most dangerous form is bullous pulmonary emphysema. It proceeds secretly, without any obvious symptoms. Bubbles, in medicine called bullae, can reach a size of up to 20 cm. The accumulation of air and gases in the pleural part can be fatal.
Most patients with pulmonary pulmonary emphysema are smokers whose experience exceeds 20 years, the category of people whose work is associated with harmful working conditions.
In humans, there are about 3 million small “sacs” with fragile walls (alveoli) in the lungs. When a person takes a breath, they are filled with air, increasing the volume of the lung, when leaving part of the air remains, but the volume of the lungs decreases.
Gradually, the walls of the alveles are destroyed, which leads to the formation of “sacs” in the cavity, the blood supply to the respiratory tract is disrupted, which subsequently leads to chronic emphysema.
Most smokers with addiction have a chronic lung disease by age 60.
Symptoms and signs of emphysema
A difficult initial diagnosis of emphysema is associated with its symptoms. Many symptoms of emphysema are observed in other pathologies. The individual characteristics of emphysema are:
- dry (unproductive) cough,
- dyspnea on exhalation
- dry wheezing in the respiratory organs,
- a sharp decrease in body weight,
- pain in the chest area,
- disturbance in cardiac activity with a lack of oxygen.
The main signs of pulmonary emphysema are coughing and shortness of breath. Dyspnea at the initial stage is felt only during physical exertion on the body, over time, it develops into shortness of breath when moving without physical exertion, especially responding to weather events. Shortness of breath is temporary.
An individual sign of emphysema is also weight loss. The process is associated with the intense work of the pulmonary muscles during exhalation.
When diagnosing, special attention is paid to the tone of the skin and mucous membrane (bluish tint). Cyanosis is associated with a lack of blood filling of small capillaries in the lungs. The shape of the fingers changes.
The chronic form of emphysema is accompanied by obvious external signs: cropped neck, chest shaped like a barrel.
Complications of emphysema
A change in the work of the respiratory system affects the cardiovascular and nervous system. Due to air starvation, the heart valve begins to pump blood with greater intensity, which creates an additional burden on the heart.
The load on the heart is one of the causes of tachycardia of the heart, cardiac arrhythmias, cardiopulmonary failure, coronary heart disease.
Chronic pulmonary emphysema disrupts the nervous system, contributing to sleep disturbance, brain cell function, and the development of mental illness.
Complications of pulmonary emphysema lead to chronic infectious diseases of the respiratory system, pneumothorax, and heart failure of the right ventricular form.
Diagnostic methods for the study of emphysema
If there is a suspicion of pulmonary emphysema, a person needs an urgent appeal to a physician or a pulmonologist, which are determined by the choice of a method for confirming the diagnosis (diagnosis).
The main methods of diagnosis:
- questioning the patient, a detailed conversation with the patient about the symptoms of the disease,
- listening to the thoracic region and examination of the skin of the patient,
- general blood test, including gas composition,
- MRI or CT
- survey radiography,
- determination of the heart border,
- topographic percussion and auscultation.
When collecting information (history), information is found out: on the presence of shortness of breath, bad habits (smoking), the duration of cough, the state of the body during physical exertion. It is necessary to carry out percussion (tapping on the body), in which the following signs are revealed, indicating the presence of pulmonary emphysema:
- difficulty setting heart boundaries,
- restriction in lung mobility,
- prolapse of the lower edge of the lung,
- a dull sound in the lungs.
Listening through a phonendoscope gives the specialist the opportunity to establish: wheezing that is dry, rapid breathing, signs of tachycardia, muffled tones of the heart, increased exhalation, and weakened breathing.
Instrumental examination of the lungs is carried out using: x-rays (radiography), radio waves (magnetic resonance imaging), a computer with the introduction of a special contrast medium, radioactive isotopes (scintigraphy), a spirometer, analysis of the gas composition of the blood using puncture of the ulnar artery, research blood (general analysis).
Therapy (how to treat pulmonary emphysema)
In the treatment of emphysema, pulmonologists have three main goals:
- eliminate symptoms (shortness of breath, weakness, etc.),
- stop the further development of the disease,
- prevention of mild insufficiency.
It is impossible to talk about the full cure of the disease, especially in the chronic stage.
Treatment consists of several groups of drugs. The first group includes drugs that reduce the level of enzymes that contribute to the destruction of lung tissue. The second group (mucolytic action) promotes the discharge of mucus, reduces cough, protects the respiratory system from infectious diseases.
Preparations of the third group contribute to the improvement of the metabolic process in the respiratory system, additionally nourishes the lung tissue. The fourth group - bronchodilators, reducing swelling of the bronchial mucosa.
Additionally, the use of the following drugs is necessary:
- theophylline remedies for relieving muscle load on the muscles of the respiratory system,
- glucocorticosteroids for the expansion of the bronchi, providing anti-inflammatory effect.
Physiotherapy and other methods of therapy
Effective medical procedures in the form of electrical stimulation, oxygen inhalation, special physical education.
Oxygen inhalation is a long-term procedure (up to 18 hours per day) of being in an oxygen mask, where an oxygen stream is supplied at a maximum speed of 2 to 5 liters per minute.
Gymnastics for breathing consists of specially selected exercises that help strengthen the respiratory muscles. Classes must be held 4 times a day, lasting 15 minutes. The complex is as follows:
- exhalation with an obstacle: Exhale 20 times slowly into a glass of water through a straw for a cocktail,
- diaphragm breathing: take a deep breath at the expense of 1,2,3, inflate the stomach at the expense of 4, exhale, cough with simultaneous tension of the press,
- squeezing: lie on your back, bend your legs, clasping your hands with your knees, while inhaling, draw as much air as possible into your lungs, while breathing in, raise your stomach, straighten your legs, cough with a tense press.
Electrical transdermal stimulation is performed using a current that helps with the exhalation process. The current pulse is selected individually and helps to relieve fatigue of the muscles of the lungs.
In exceptional cases, a decision may be made on surgery. The following types of operations are applied:
- replacement of the affected lung with a donor organ. The operation is used in rare cases, since there is a risk of organ rejection, a high priority for transplantation,
- removal of the affected area of the organ using thoracoscopy. Under the control of special video equipment, the affected area of the lung is removed. The technique allows the operation to be performed using 3 small intercostal sections.
- surgical removal of a part of the lung (removal of up to 25% of the organ is possible)
- bronchoscopic surgery carried out using a special device, which is introduced to the patient through the oral cavity and removes the affected area.
Food and folk remedies
An important role in the treatment is diet. Preference should be given to vegetables and fruits containing micronutrients and vitamins vital to the body, eating foods low in calories, excluding fatty, fried foods from the diet.
The patient's drinking regimen should be up to 1.5 liters of water per day.
In addition to drug treatment, alternative medicine can be used as an addition to the main treatment.
The main recipes recommended in the treatment of emphysema are based on decoctions of herbs:
- coltsfoot (1 tbsp.spoon of dried leaves for 2 cups boiling water, use up to 6 times a day for 1 tablespoon),
- potato flowers (1 teaspoon per glass of boiling water, drink half a glass up to 3 times a day).
It is possible to carry out potato inhalations by inhaling vapors from potatoes cooked in their uniforms.
Prevention and recommendations
To prevent emphysema, the government has developed a smoking control program.
Smokers need help in the fight against a bad habit, including medical treatment.
Do not neglect the treatment of the respiratory tract and prevent the transition of the disease into a chronic form.
Timely vaccination of the population, annual examination and undergoing fluorography is one of the main conditions for the prevention of pulmonary emphysema.
Life prognosis for patients with pulmonary emphysema
Not one specialist can accurately say about the life expectancy of a patient with a diagnosis of pulmonary emphysema. The prognosis of life largely depends on the patient himself, his psycho-emotional mood for treatment.
An important role is played by the stage of the disease, the right treatment, timely diagnosis.
Do not self-medicate, this can be fatal. The prognosis of life in patients with pulmonary emphysema is unpredictable in this case.
Despite the nature of the disease and its chronic form, it is possible to delay the onset of human disability by taking specially prescribed drugs. Such drugs are prescribed to the patient for life.
In severe forms of the disease, the prognosis of the patient’s life is more than 1 year from the moment the disease is detected.
Studies have shown that disease survival depends on severity:
- a mild form of emphysema, provided that it is properly treated and has a healthy lifestyle, allows the patient to live for more than 4 years in 80% of cases,
- a moderate form of emphysema with proper treatment and a healthy lifestyle allows the patient to live more than 4 years in 73% of cases,
- in severe cases of the disease, subject to proper treatment and a healthy lifestyle, in 54% of cases it allows patients to live longer than 4 years,
- in the most severe form of pulmonary emphysema, provided that it is properly treated and has a healthy lifestyle, in 26% of cases, the life expectancy of patients is more than 4 years.
The patient himself must strive for life. To give up smoking and alcohol, to conduct daily walks in the fresh air, to comply with the doctor’s instructions, all this can live much longer than the period indicated in the statistics.
Etiology, pathogenesis and varieties of the disease
One of the features of pulmonary emphysema is that as a separate nosological form, it occurs only in a small percentage of patients. In most cases, pulmonary emphysema is the final pathological process that occurs against the background of severe morphological lesions of the bronchopulmonary system, which occur after diseases such as:
In addition, pulmonary emphysema can become ill as a result of prolonged smoking or inhalation of certain toxic compounds of cadmium, nitrogen or dust particles that are in the air (for this reason, this disease is often found in builders).
The mechanism of the development of the disease
Under normal conditions, gas exchange in the human body takes place in the alveoli - these are small “bags” pierced by a large number of blood vessels located at the end of the bronchi. During inhalation, the alveoli are filled with oxygen and bloat, and when exhaled, they contract. However, with emphysema, certain disorders occur in this process - the lungs stretch too much, their tissue becomes denser and loses its elasticity, which leads to an increase in the air concentration in the lungs and causes a disruption in their functioning. Over time, pulmonary emphysema progresses, which is manifested by the development of respiratory failure, so you need to start treating it as soon as possible.
Depending on the reasons that lead to the development of a pathological process in the lung tissue, pulmonary emphysema is classified into:
- the primary (diffuse) that is caused by tobacco smoke, dust or inhalation of nitric oxide is characterized by a loss of elasticity of the lung tissue, a morphological change in the respiratory department of the lungs and an increase in pressure in the alveoli,
- secondary (obstructive) - occurs against a background of stretching of the alveoli and respiratory bronchioles caused by airway obstruction,
- vicarious - it is a kind of compensatory reaction of one lung to some changes (and sometimes the absence) of another, as a result of which a healthy lung increases in volume, but only in order to ensure normal gas exchange in the human body (vicar lung emphysema occurs only in within one lung and is not considered a pathological process, the prognosis is favorable).
There is also bullous pulmonary emphysema, which differs in that it proceeds unnoticed, is often detected already at the stage of pneumothorax (accumulation of air in the pleural cavity) and requires immediate surgical intervention, the prognosis is unfavorable (often leads to death of the patient).
The clinical picture of the disease
Speaking about the main symptoms of pulmonary emphysema, doctors primarily mention:
- shortness of breath
- visual enlargement (expansion) of the chest against the background of a decrease in its excursion during breathing (emphysema can be determined from the photo, which shows that the chest is in a phase of deep inspiration)
- cyanosis (blue tint) of the tongue, nails and lips, occurs against the background of oxygen starvation of tissues,
- expansion of intercostal spaces,
- smoothing of supraclavicular areas.
At the very beginning, pulmonary emphysema is manifested by shortness of breath, which initially occurs during sports (mainly in winter) and is characterized by inconstancy, and then it disturbs a person with the slightest physical effort. The characteristic signs of the disease include the fact that patients take short breaths with closed lips and pouting cheeks, and you should also pay attention to the fact that neck muscles are involved during inspiration (in a normal state this should not be). Also, pulmonary emphysema is accompanied by cough, pain behind the sternum and weight loss (the latter is due to the fact that patients spend too much energy on maintaining the normal functioning of the respiratory muscles).
Patients often occupy a forced position of the body on the abdomen (head down), because this position brings them relief, but this is in the early stages of the disease. As pulmonary emphysema develops, changes in the chest prevent patients from being in a horizontal position, as a result of which they even sleep in a sitting position (this makes the diaphragm easier).
The main methods for diagnosing pulmonary emphysema
The diagnosis of pulmonary emphysema must be exclusively dealt with by a pulmonologist who makes an initial diagnosis based on data from a patient examination and auscultation of pulmonary respiration using a phonendoscope. These are the main diagnostic methods, but they do not allow to compile a complete clinical picture of the disease, therefore, as additional research methods, the following is carried out:
- X-ray of the lungs (shows the density of the lung tissue),
- computed tomography (considered one of the most accurate methods for diagnosing pulmonary emphysema),
- spirometry (examination of the function of respiration, in order to identify the degree of impaired lung function).
How to treat?
The main methods of treating emphysema include:
- quitting smoking (this is a very important issue to which doctors pay special attention, because if the patient does not quit smoking, it will be impossible to cure lung emphysema, even with the most effective medications),
- oxygen therapy (designed to saturate the patient’s body with oxygen, since the lungs can’t cope with this function),
- gymnastics (breathing gymnastics “enhances” the work of the diaphragm and helps get rid of shortness of breath, which is the main symptom of emphysema)
- conservative treatment of concomitant diseases (bronchial asthma, bronchitis and so on) that cause emphysema, the symptoms of which are determined by the doctor, add antibiotic therapy when the infection is attached to the main treatment for emphysema.
Surgical treatment of pulmonary emphysema is indicated only if the disease proceeds in a bullous form, and it comes down to the removal of bullae - thin-walled blisters filled with air that can be localized in any part of the lung (it is almost impossible to see them in the photo). The operation is carried out by the classical and endoscopic method. The first method involves the surgical opening of the chest, and during the second, the surgeon performs all the necessary manipulations using special endoscopic equipment through small incisions on the skin. An endoscopic method of bull removal for emphysema will cost more, but such an operation has a shorter rehabilitation period.
The majority of conservative methods of treating this disease are not very effective, because unlike lung bronchitis, emphysema causes irreversible structural changes in the lung tissue. The prognosis depends on the timeliness of the treatment started, compliance with the doctor’s recommendations and the correct method of drug therapy for both the underlying and concomitant diseases.
In any case, only a physician should deal with the treatment of pulmonary emphysema. The disease is considered chronic and patients have to take drugs throughout their lives that support the basic functions of the respiratory system. The life expectancy of people with pulmonary emphysema depends on the degree of damage to the lung tissue, the age of the patient and the individual characteristics of his body.
Is there a cure for emphysema
The treatment of emphysema is recommended both traditional and folk remedies. At the same time, no doctor will approve the replacement of classical therapy with any alternative methods, no matter how effective they may seem.
Only an experienced specialist should decide how to treat pulmonary emphysema. This is done in the pulmonology department of the hospital. Depending on the form of the disease and the severity of the patient’s condition, the doctor decides whether the patient will be treated in a hospital or at home, what drugs can help cure pulmonary emphysema, and which folk remedies can be used.
The irreversibility of the changes that the lung tissue underwent suggests that pulmonary emphysema cannot be completely cured. But timely measures taken, compliance with all medical recommendations will not allow the disease to progress. If it is possible to reduce the symptoms of respiratory failure caused by it, a person will be able to live a familiar life.
Therapeutic measures are carried out according to plan, they are aimed at eliminating respiratory failure and improving lung function.
1. Improving patency of the bronchi. For this, patients are prescribed bronchodilators. In acute conditions, aminophylline is injected. In milder cases, drugs such as Eufillin, Neophyllin, Theophylline, Theopec are drunk in tablets.
For the same purpose, inhalation therapy is practiced. Pulmonary patients with pulmonary emphysema breathe ventolin, salbutamol, berodural, berotek and other drugs that expand the bronchial lumens. Inhalations can be done in a hospital, physiotherapy room or at home, if there is a nebulizer at home.
It is also necessary to take glucocorticoid hormones - hydrocortisone, dexamethasone, corifene, prednisone.
2. It is necessary to take measures to dilute sputum and facilitate its expectoration. Here the doctor will advise you to be treated with the same expectorant drugs that are used for bronchitis. It:
In order to remove sputum in parallel, you can try treatment with folk remedies.
3. If the cause of the disease is chronic bronchitis, that is, the constant presence of infection in the bronchi, treatment of pulmonary emphysema includes antibiotic therapy. It is necessary to identify the pathogen and choose an antibacterial agent to which it is sensitive. Usually, broad-spectrum drugs based on penicillin, azithromycin, etc. are prescribed.
4. To stop the signs of respiratory failure, oxygen therapy is practiced, that is, oxygen inhalation from a special container. In especially severe cases, mechanical ventilation is necessary.
5. In some cases of focal (bullous) emphysema, it is recommended that surgery be performed during which the removal of pathological tissues occurs.
6. In order to balance the processes in the cerebral cortex, activate trophic processes in the lung tissue, reduce spasm in the bronchi, strengthen the body as a whole, the patient is recommended breathing exercises.
As a rule, the course of drug therapy lasts three to four weeks. Alternative means can be used without interruption. Often it is they who help patients with pulmonary emphysema feel satisfactory.
The patient can use folk remedies to expand bronchial lumens, eliminate sputum, improve respiratory function and strengthen the body.
First of all, it is recommended to use decoctions and infusions of herbs. They are taken orally or inhaled with them.
Black radish with honey
In the treatment of pulmonary emphysema, you can use such folk remedies:
- Infusion of Ledum. In 500 ml of boiling water, add 1 teaspoon of dried and crushed herbal preparation, insist an hour. Drink 150 ml of warm tincture twice a day.
- Juice of black radish. Fresh vegetables are washed, peeled. Rub it on a grater and squeeze the juice. 50 ml of juice is mixed with 2 tablespoons of honey. Twice a day, take 2 tablespoons of the drug. It is advisable to do this before eating.
- Настоем хвоща полевого и фенхеля. В пол-литровую банку с взятыми в равных пропорциях (по 1 столовой ложке) народными средствами вливают крутой кипяток. Настой выдерживают час. Три раза в день пьют по 100 мл.
- Milk with carrot juice. In a glass of warmed fat milk, add 1 tablespoon of carrot juice. Drink on an empty stomach for three weeks.
- Tea made from mint, sage and thyme. One and a half teaspoons of mixed in equal proportions of dried and chopped herbs are poured into a thermos and pour a glass of boiling water. Drink 70 ml after breakfast, lunch and dinner.
In the treatment of emphysema, folk remedies can also use onion and garlic juice, propolis, aloe juice and Kalanchoe, the like.
It is important to treat unconventional methods of combating pulmonary emphysema without fanaticism. It must be remembered that an unsuccessful attempt at self-medication can lead to grave consequences, and sometimes cost a life.
Changes in lung tissue
Under the influence of these factors, the lung tissue undergoes the following changes:
- the size of the alveoli and bronchioles increases two or more times,
- there is a stretching of the smooth muscles of the bronchi, thinning of the walls of the vessels, their desolation and malnutrition in the structural unit of the lungs - the acinus,
- the walls of the alveoli are destroyed with the formation of cavities,
- gas exchange is disturbed, and in this case the body is in a state of hypoxia (oxygen starvation),
- respiratory muscles are activated to compensate,
- over time, due to the load on the right heart, from which the blood vessels supplying the lungs go, another serious pathology develops - a chronic pulmonary heart.
Varieties of emphysema
The flow distinguishes:
- sharp. It occurs with an attack of bronchial asthma, a foreign body. It is characterized by the reversibility of the state in emergency care,
- chronic. Gradual development is noted, in the initial stages a cure is possible.
In terms of prevalence it happens:
- focal. It develops on the site of postoperative scars, tuberculosis and post-inflammatory foci. For a long time, a person may not even suspect that he has this form of the disease,
- diffuse. A much larger part of the lungs is affected, with advanced cases there is only one treatment option - organ transplantation.
- primary form. It is an independent pathology, often associated with congenital features. It can be diagnosed immediately after birth and in any year of life. The disease is rapidly progressing and poorly treatable.
- secondary. Obstructive diseases of the pulmonary system lead to it gradually. Air cavities can capture a whole lobe of the lungs.
By anatomical features:
- vesiculate (bullous). Instead of the affected alveoli, bubbles form, reaching large sizes, prone to suppuration, compression of neighboring structures and sometimes rupture,
- vesicular (hypertrophic, panacinar). It manifests itself in a severe course affecting the whole lobe, there is no healthy tissue between the damaged acini. It manifests itself as severe respiratory failure,
- paraseptal (perilobular, periacinar, distal). The sections next to the pleura are affected (the serous membrane enveloping the lungs on the one hand, and the internal organs on the other), occurs with tuberculosis,
- centrilobular. The central part of the structural unit of the lungs, the acinus, is affected. In this area, an inflammatory focus is formed with periodic secretion of mucus. Viable lung tissue remains between the damaged areas,
- pericubic. Occurs at the site of post-inflammatory changes. For example, at the site of fibrous tissue formation after pneumonia,
- subcutaneous (interstitial). When the alveoli rupture, air bubbles through the tissue cracks can get to the scalp and neck and remain under it.
How to suspect the onset of emphysema?
- exacerbations of major diseases (chronic obstructive pulmonary disease, bronchial asthma, etc.) are noticeably more frequent,
- they last longer and much harder
- the treatment of these diseases that helped you no longer has a positive effect,
- increased severity of shortness of breath,
- markedly decreased ability to work and ability to physical activity.
7 typical signs of a person with pulmonary emphysema
With a long-term illness of a person with emphysema, it is easy to recognize at a glance:
- the neck becomes short
- chest is like a “barrel”
- supraclavicular fossae bulging,
- when you try to breathe in, the intercostal spaces become involved due to the active work of the auxiliary respiratory muscles, in particular, the intercostal muscles,
- the belly sags due to the lowering of the diaphragm - the respiratory muscle,
- cyanotic skin,
- the final phalanges of the fingers are similar to “drumsticks,” and the nails are like “watch glasses.”
In addition, the symptoms of emphysema are:
- shortness of breath on exhalation. For a long time it may go unnoticed, but it progresses and becomes more pronounced by 60 - 65 years. Unlike shortness of breath in heart failure, it does not increase in a lying position,
- swelling of the cervical veins due to increased intrathoracic pressure. It is especially distinguishable by coughing, which also accompanies this pathological process,
- pronounced work of auxiliary muscles that help patients to breathe - intercostal, ladder, pectoral and abdominal muscles,
- weight loss due to the expressed work of respiratory muscles.
When a chronic pulmonary heart is attached, edema of various localizations (feet, legs, hips, scrotum, abdomen, face), enlargement of the liver, increased shortness of breath, severe cyanosis (cyanosis) of the skin occur.
During auscultation (listening with a phonendoscope):
- increased exhalation
- respiratory depression
- dry or wet rales with bronchitis,
- muffling of heart sounds due to hyper-airiness of the lung tissue, which absorbs sound,
- increased heart rate (tachycardia). In conditions of oxygen starvation, the heart is trying to correct the situation,
- increased respiratory rate, indicating respiratory failure.
Laboratory and instrumental diagnostics
From laboratory analyzes and instrumental methods of research, it is possible to use:
- chest x-ray. It is a very important method for the diagnosis of emphysema. Areas of increased transparency, an increase in the volume of the lungs, a low location of the diaphragm, a lowering of the lower edges of the lungs,
- computed tomography. The disadvantage is a large radiation load. But it allows a layer-by-layer examination of the lung tissue and revealing the airy areas, even of small sizes, bullae, their volume and location, areas of fused alveoli, changes in the roots of the lungs,
- magnetic resonance imaging. Allows you to determine the areas of compression of the lung tissue, circulatory disorders, even in small vessels, the presence of pleural fluid,
- spirography. It is performed using a spirograph, which takes into account the amount of exhaled and inhaled air. With emphysema, an increase in the residual volume, total lung capacity, a decrease in vital capacity and pulmonary ventilation are determined. Indicators reduced by 25 - 30%,
- peak flowmetry. It is determined using a device that allows you to determine the maximum exhalation rate. It will be reduced by 20%,
- general blood test. There is an increase in red blood cells, hemoglobin, hematocrit (the ratio of blood plasma to red blood cells), a decrease in the erythrocyte sedimentation rate below 2 mm / h,
When determining the gas composition of the blood, there is a decrease in oxygen in arterial blood below 60 mm Hg, an elevated level of carbon dioxide above 50 mm.
Treatment of emphysema. When do I need to be operated on?
There is no specific treatment. Attempts to treat human alpha-1-antitrypsin have not been widely used. Quitting smoking is important. Of the drugs, acetylcysteine preparations are used (ACC, Asist, Asibrox). They are able to counteract the free radicals formed during emphysema. Recently, preference has been given to theophyllines of long action. These drugs act simultaneously on improving blood circulation in the lungs and on the correction of ventilation disorders. In smokers, sensitivity to the drug is reduced, and in people of an older age group, on the contrary, it is increased. In addition, they may have disturbances in the rhythm of the heart when using this drug. Also, to expand the bronchi, drugs such as:
- Ipratropium bromide.
Their combination is more often used. Indication for the appointment of glucocorticoids (Prednisolone) is the rapid progression of the disease, the inefficiency of other groups of drugs. This drug negatively affects the muscles (myopathic effect). More than 25% of people do not respond to hormone therapy. With the development of osteoporosis (destruction of the bone structure), which is a manifestation of emphysema, vitamin preparations are recommended, in particular D3. Physical methods are also shown:
- chest massage
- breathing exercises,
- kinesitherapy - treatment with movement.
Surgical treatment is carried out with:
- multiple bullahs
- severe illness
- with the development of complications,
A diagnosis of pulmonary emphysema is not a sentence. With timely diagnosis and adequate treatment, the duration and effectiveness of life significantly increases. A favorable outcome depends on:
- quitting smoking
- infection prevention
- good nutrition
- a good response to treatment.