Interlobe mooring

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X-ray diagnosis of pleurisy, page 42

X-RAY DIAGNOSIS OF PLEURAL SCHARTS

Pleural adhesions can be the result of both fibrinous and exudative pleurisy. Purulent pleurisy especially often leaves behind massive pleural layers.

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Long-term and widespread pleurisy, as a rule, leads to the formation of massive cpa-i

genies; Transudates are significantly less prone to mooring.

Pathologically, pleural cords appear in the form of fibrinous layers, which are quickly replaced by young connective tissue, initially relatively rich in vessels, and later almost avascular. The thickness and density of these layers are very different: from fractions of a millimeter to several centimeters.

CLASSIFICATION OF PLEURAL MOORTS

Pleural adhesions can form: 1) between the visceral and parietal pleura; 2) between individual areas of the visceral pleura, for example in interlobar fissures;

3) between different parts of the parietal pleura, for example, between its costal part and the diaphragmatic part. This happens especially often in spare spaces, where the costal and diaphragmatic pleura, due to the inflammatory process, stick together and the costophrenic sinuses are sealed. In pneumothorax, when the lung is pressed to the root, such adhesions are also common; 4) between the parietal pleura and the pericardium; 5) between the parietal and visceral pleura, on the one hand, and the connective tissue of the mediastinum, on the other; 6) between the pleura and intrathoracic fascia, diaphragm, etc. Various combinations of pleural adhesions are often observed: for example,

pleuro-pericardial-phrenic, pleuro-mediastino-pericardial, etc.

According to the shape and length, pleural layers can be divided into: a) planar layers, i.e. fusion of pleural layers with each other over a significant extent; b) adhesions in the form of cords, even those having a small spatial extent.

b) adhesions in the form of cords, strands having a small spatial extent.

N. G. Stoyko divides the latter into membranous and cord-like; they are often stretched between the lung and the chest wall.

N.V. Antelava distinguishes three main types of pleural adhesions: planar, membranous and cylindrical-conical.

A detailed classification of pleural moorings was proposed by A.I. Rozanov. In this classification, groups are distinguished, with two subgroups in each:

A. Round commissures: 1) string-like, 2) cord-like.

B. Membranous adhesions: 1) ribbon-shaped, 2) curtain-shaped.

B. Planar fusions: 1) true, 2) false-planar.

In addition to differences in nature, pleural moorings are also divided according to their location in relation to the lobes of the lungs and neighboring organs.

Thus, M.A. Volkova distinguishes apical commissures, lateral, middle adhesions, diaphragmatic, interlobar and mediastinal (the latter can be attached with their medial edge to the pericardium, aorta or vena cava).

Popper subdivides apical fusions into apical, apical-medial, apical-lateral, subapicales, subclavian, anterior, posterior and lateral.

Askanasy divides pleural fusions according to their localization into: a) upper lobe (including apical, fusion of the middle part of the upper lobe and fusion of the base of this lobe); b) middle lobes (including anterior and posterior); c) lower lobes; d) mediastinal; e) infralobar and f) diaphragmatic.

A similar grouping is used by Xalabander with the difference that it distinguishes dorsal ones from the group of lower lobe fusions.

In cases where the entire pleural cavity is obliterated and the moorings are located in all its sections, they are called total.

Regarding the frequency of pleural adhesions, information in the literature is very contradictory. According to pathologists, pleural cords are found at autopsies in 8-27% of cases. Among patients with tuberculosis, they are observed much more often, especially with active forms of tuberculosis requiring collapse therapy. Thus, according to F. A. Mikhailov, pleural moorings occur in 80-90% of cases, E. E. Klebanova noted them in 89% of cases, I. Z. Seagal - in 97.5%, P. P. Pekar with co-authors - in 69.5%, M.D. Burlachenko and co-authors - in 90.7%, Xalabander - in 80% of cases.

The frequency of different types of pleural moorings varies. :

Most authors believe that, with a few exceptions, most often pleural adhesions are found in the upper parts of the pleural cavity, where the excursion of the ribs and pulmonary lobes is less than in the lower parts (Fig. 152).

The frequency of pleural adhesions located within the upper lobe, according to Askanasy, is 60%. Xalabander noted it in 63%, Dumarest in 75%. Askanasy found actual apical adhesions in 40% of cases, Xalabander in 34%, Kraemer in 29%,

Diaphragmatic fusions occur, according to Askanasy, in only 4.5% of cases, and according to Xalabander - in 2.3%. At the same time, M. Rostoshinsky believes that the diaphragmatic surface of the lung is, like the area of ​​the apexes, the favorite place for the formation of pleural adhesions in patients with tuberculosis. M.R. Rokitsky found diaphragmatic fusions in 18.5% of cases.

Mediastinal pleural adhesions are found quite often: for example, M. R. Rokitsky - in 15% of cases, D. L. Bronstein - in 32.3%.

Rice. 152. Frequency of various localizations of pleural adhesions. a - according to Askanasy; b—by Xalabander; c—according to R. Rokitsky.

Interesting observations based on the study of 1378 patients subjected to thoracoscopy and thoracocaustics were cited by I. Z. Seagal (1961). According to his data, pleural adhesions very often (43.8%) occur in the region of the posterior and posterolateral sections of the II-IV ribs, which is associated with the frequency of tuberculosis affecting the posterior-superior, posterior and apical segments. In the area of ​​the apex, adhesions were found in 17% of cases, mediastinal adhesions in 14.9%.

Summarizing the contradictory information about the comparative frequency of pleural adhesions, it should be emphasized that adhesions can occur in any part of the pleural cavity, more often in its posterior and lateral parts and somewhat less frequently in the anterior ones. As for the level of their location, it to a certain extent depends on the nature of the underlying disease. Thus, in tuberculosis, pleural moorings in the upper parts of the pleural cavity are more common than in the lower ones, and in bronchiectasis, as X-ray-surgical comparisons show, there are inverse relationships. To a certain extent, this is also true with regard to the nature of pleural adhesions: if in tuberculosis both planar and cord-like adhesions are found quite often, then with

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Naive look

for a serious life

Adhesions in the lungs

The moorings are most difficult to separate within the affected areas of the lung, as well as near pleurobronchial fistulas. Hello! Pleuroapical and pleurocardial adhesions arise as a consequence of a previous inflammatory process in the lungs of various origins. Usually, already in the process of exposing the lung from the mooring, you can see how it straightens out and, as it is released, fills all the free space.

After pneumolysis, the next, no less difficult stage of the operation begins - separation of the mooring from the lung. V.K. Beletsky believes that with empyema, in addition to massive mooring, there is a significant thickening of the pleura. This creates optimal conditions for subsequent expansion of the lung. In most cases, you have to use both methods. The possibility of separating the moor from the lung depends on the age of the empyema.

In these cases, we remove only the surface layers of the moorings using a diathermy loop. With old empyema, the expansion of the lung at the site of collapse is insignificant, but those areas of the lung tissue that were not collapsed by the purulent cavity are well expanded. After removing the mooring from the surface of the lung, resection of its affected areas or suturing of pleurobronchial fistulas is performed.

Causes and mechanism of development of pleurisy

The affected areas of the lung are determined either before surgery based on accurate x-ray studies, or by palpation after pneumolysis. For extensive lung lesions, pleuropneumonectomy is performed instead of decortication.

However, you can inflate the lung with the help of an ordinary pillow if you tightly hold the patient’s nose and insert the mouthpiece between the teeth. The diagnosis of “pleurisy” is made in 5-10% of all patients undergoing treatment in therapeutic hospitals.

Often, pleurisy is not an independent pathology, but accompanies a number of diseases of the lungs and other organs. Based on the causes of occurrence, pleurisy is divided into infectious and non-infectious (aseptic). The causative agents of infectious pleurisy directly affect the pleural cavity, penetrating into it in various ways. Direct entry of microorganisms into the pleural cavity occurs when the integrity of the chest is violated (in case of wounds, injuries, surgical interventions).

If the formation and accumulation of effusion in the pleural cavity exceeds the speed and possibility of its outflow, then exudative pleurisy develops. In tuberculosis, the course of pleurisy is long, often accompanied by exudation of exudate into the pleural cavity.

Forecast and prevention of pleurisy

The upper limit of the effusion is determined by percussion, chest x-ray or ultrasound of the pleural cavity. When performing a pleural puncture, a fluid is obtained, the nature and volume of which depends on the cause of pleurisy. It is recommended to evacuate no more than 1-1.5 liters of exudate at a time in order to avoid cardiovascular complications (due to a sharp straightening of the lung and reverse displacement of the mediastinum).

In order to treat recurrent exudative pleurisy, pleurodesis is performed (injection of talc or chemotherapy into the pleural cavity to glue the layers of the pleura). To treat chronic purulent pleurisy, they resort to surgical intervention - pleurectomy with decortication of the lung. The cessation of exudation after elimination of the underlying disease occurs within 2-4 weeks.

As for the signs indicating the presence of an adhesive process in the lung area, these include shortness of breath and pain in the chest area, as well as rapid heartbeat.

The most important thing in this case is not to rely on your own intuition and knowledge in this area. Self-medication in such cases is inappropriate. Operations are performed on patients only when adhesions in this area threaten his life. In most cases, electrophoresis and heating are used.

We are waiting for your questions and recommendations:

The most important thing is not to forget that the course of therapy in this case should not be postponed under any circumstances. It should also be noted that in the presence of adhesive processes in this area, it is very important to protect your body from various types of colds. In this case, there is no way to do without the help of traditional medicine, namely special vitamin teas. Right now we will present to your attention two such recipes.

Diagnosis of pleurisy

Marina, I don’t smoke and have never even tried, I’m only 16, and these adhesions were discovered in me... If they were formed in small quantities after pneumonia, then there is no reason to worry. But when adhesions are accompanied by a cough, fever, or feeling unwell, treatment may be needed. Hello Irina. If you described everything correctly, then the changes in your lungs are similar to residual changes from tuberculosis.

There you must undergo a series of tests with tuberculin and clinical tests over time. Thus, the emphasis of the interlobar pleura is observed with fibrous changes in it (which is a normal physiological process - replacement of the affected lung tissue with fibrous tissue). Fusion, deformation of the pattern in the lower part on the left” can also be interpreted as changes after suffering from pleuropneumonia.

Good day. In 2010 I suffered from bilateral polysegmental pneumonia, a severe course. In 2013, I consulted a therapist with shortness of breath (difficulty breathing), temperature 38.8. I did a fluorography and showed a residual effect after pleurisy.

X-ray examination will help to identify the presence of adhesions in the lung area. Adhesions in the lungs are a fairly serious process that requires close attention from specialists. The doctor said that there are additional lobes in the right lung. Good afternoon, Olga! The existing x-ray changes are most likely the result of a pathological process in the lungs suffered the day before. If pleurisy develops as a result of inoperable damage to the pleura or lung by a malignant tumor, palliative pleurectomy is performed according to indications.

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Pleurisy

Pleurisy is an etiologically different inflammatory lesion of the serous membrane surrounding the lungs. Pleurisy is accompanied by chest pain, shortness of breath, cough, weakness, fever, and auscultatory phenomena (pleural friction noise, decreased breathing). Diagnosis of pleurisy is carried out using radiography (scopy) of the chest, ultrasound of the pleural cavity, pleural puncture, and diagnostic thoracoscopy. Treatment may include conservative therapy (antibiotics, NSAIDs, exercise therapy, physiotherapy), a series of therapeutic punctures or drainage of the pleural cavity, surgical tactics (pleurodesis, pleurectomy).

Pleurisy

Pleurisy is inflammation of the visceral (pulmonary) and parietal (parietal) layers of the pleura. Pleurisy can be accompanied by the accumulation of effusion in the pleural cavity (exudative pleurisy) or occur with the formation of fibrinous deposits on the surface of the inflamed pleural layers (fibrinous or dry pleurisy). The diagnosis of “pleurisy” is made in 5-10% of all patients undergoing treatment in therapeutic hospitals. Pleurisy can aggravate the course of various diseases in pulmonology, phthisiology, cardiology, rheumatology, and oncology. Statistically, pleurisy is diagnosed more often in middle-aged and elderly men.

Causes and mechanism of development of pleurisy

Often, pleurisy is not an independent pathology, but accompanies a number of diseases of the lungs and other organs. Based on the causes of occurrence, pleurisy is divided into infectious and non-infectious (aseptic).

The causes of pleurisy of infectious etiology are:

Pleurisy of non-infectious etiology causes:

The mechanism of development of pleurisy of various etiologies has its own specifics. The causative agents of infectious pleurisy directly affect the pleural cavity, penetrating into it in various ways. Contact, lymphogenous or hematogenous routes of penetration are possible from subpleurally located sources of infection (abscess, pneumonia, bronchiectasis, festering cyst, tuberculosis). Direct entry of microorganisms into the pleural cavity occurs when the integrity of the chest is violated (in case of wounds, injuries, surgical interventions).

Pleurisy can develop as a result of increased permeability of lymphatic and blood vessels during systemic vasculitis, tumor processes, acute pancreatitis; violations of lymph outflow; reducing general and local reactivity of the body.

A small amount of exudate can be reabsorbed by the pleura, leaving a fibrin layer on its surface. This is how dry (fibrinous) pleurisy forms. If the formation and accumulation of effusion in the pleural cavity exceeds the speed and possibility of its outflow, then exudative pleurisy develops.

The acute phase of pleurisy is characterized by inflammatory edema and cellular infiltration of the pleura, accumulation of exudate in the pleural cavity. When the liquid part of the exudate is absorbed, moorings can form on the surface of the pleura - fibrinous pleural deposits, leading to partial or complete pleurosclerosis (obliteration of the pleural cavity).

Classification of pleurisy

The classification of pleurisy proposed in 1984 by St. Petersburg State Medical University professor N.V. is most often used in clinical practice. Putov.

  • infectious (by infectious agent - pneumococcal, staphylococcal, tuberculous and other pleurisy)
  • non-infectious (indicating a disease leading to the development of pleurisy - lung cancer, rheumatism, etc.)
  • idiopathic (of unclear etiology)

According to the presence and nature of the exudate:

  • exudative (pleurisy with serous, serous-fibrinous, purulent, putrefactive, hemorrhagic, cholesterol, eosinophilic, chylous, mixed effusion)
  • fibrinous (dry)

According to the course of inflammation:

According to the location of the effusion:

  • diffuse
  • encysted or limited (parietal, apical, diaphragmatic, costodiaphragmatic, interlobar, paramediastinal).

Symptoms of pleurisy

  • Dry pleurisy

As a rule, being a secondary process, complication or syndrome of other diseases, the symptoms of pleurisy can prevail, masking the underlying pathology. The clinical picture of dry pleurisy is characterized by stabbing pain in the chest, aggravated by coughing, breathing and movement. The patient is forced to take a position, lying on the painful side, to limit the mobility of the chest. Breathing is shallow, gentle, the affected half of the chest noticeably lags behind during respiratory movements. A characteristic symptom of dry pleurisy is a pleural friction noise heard during auscultation, weakened breathing in the area of ​​fibrinous pleural overlays. Body temperature sometimes rises to subfebrile levels, and pleurisy may be accompanied by chills, night sweats, and weakness.

Diaphragmatic dry pleurisy has a specific clinical picture: pain in the hypochondrium, chest and abdominal cavity, flatulence, hiccups, tension in the abdominal muscles.

The development of fibrinous pleurisy depends on the underlying disease. In a number of patients, manifestations of dry pleurisy disappear after 2-3 weeks, however, relapses are possible. In tuberculosis, the course of pleurisy is long, often accompanied by exudation of exudate into the pleural cavity.

The onset of pleural exudation is accompanied by a dull pain in the affected side, a reflexively occurring painful dry cough, a lag in breathing of the corresponding half of the chest, and a pleural friction noise. As the exudate accumulates, the pain is replaced by a feeling of heaviness in the side, increasing shortness of breath, moderate cyanosis, and smoothing of the intercostal spaces. Exudative pleurisy is characterized by general symptoms: weakness, febrile body temperature (with pleural empyema - with chills), loss of appetite, sweating. With encysted paramediastinal pleurisy, dysphagia, hoarseness, swelling of the face and neck are observed. With serous pleurisy caused by a bronchogenic form of cancer, hemoptysis is often observed. Pleurisy caused by systemic lupus erythematosus is often combined with pericarditis, kidney and joint damage. Metastatic pleurisy is characterized by a slow accumulation of exudate and is asymptomatic.

A large amount of exudate leads to a displacement of the mediastinum in the opposite direction, disturbances in the external respiration and cardiovascular system (a significant decrease in the depth of breathing, its increase in frequency, the development of compensatory tachycardia, a decrease in blood pressure).

Complications of pleurisy

The outcome of pleurisy largely depends on its etiology. In cases of persistent pleurisy, the development of adhesions in the pleural cavity, fusion of interlobar fissures and pleural cavities, the formation of massive moorings, thickening of the pleural layers, the development of pleurosclerosis and respiratory failure, and limited mobility of the dome of the diaphragm cannot be ruled out in the future.

Diagnosis of pleurisy

Along with the clinical manifestations of exudative pleurisy, when examining the patient, asymmetry of the chest, bulging of the intercostal spaces on the corresponding half of the chest, and lag of the affected side when breathing are revealed. The percussion sound over the exudate is dull, bronchophony and vocal tremor are weakened, breathing is weak or cannot be heard. The upper limit of the effusion is determined by percussion, chest x-ray or ultrasound of the pleural cavity.

When performing a pleural puncture, a fluid is obtained, the nature and volume of which depends on the cause of pleurisy. Cytological and bacteriological examination of pleural exudate makes it possible to clarify the etiology of pleurisy. Pleural effusion is characterized by a higher relative density, a variety of cellular elements, and a positive Rivolt reaction.

In the blood, an increase in ESR, neutrophilic leukocytosis, an increase in the values ​​of seromucoids, sialic acids, and fibrin are detected. To clarify the cause of pleurisy, thoracoscopy with pleural biopsy is performed.

Treatment of pleurisy

Therapeutic measures for pleurisy are aimed at eliminating the etiological factor and alleviating symptoms. For pleurisy caused by pneumonia, antibiotic therapy is prescribed. Rheumatic pleurisy is treated with nonsteroidal anti-inflammatory drugs and glucocorticosteroids. For tuberculous pleurisy, treatment is carried out by a phthisiatrician and consists of specific therapy with rifampicin, isoniazid and streptomycin for several months.

For symptomatic purposes, the prescription of analgesics, diuretics, and cardiovascular drugs is indicated; after resorption of the effusion, physiotherapy and physical therapy are indicated.

In case of exudative pleurisy with a large amount of effusion, they resort to its evacuation by performing pleural puncture (thoracentesis) or drainage. It is recommended to evacuate no more than 1-1.5 liters of exudate at a time in order to avoid cardiovascular complications (due to a sharp straightening of the lung and reverse displacement of the mediastinum). For purulent pleurisy, the pleural cavity is washed with antiseptic solutions. According to indications, antibiotics, enzymes, hydrocortisone, etc. are administered intrapleurally.

In the treatment of dry pleurisy, in addition to etiological treatment, patients are advised to rest. To relieve pain, mustard plasters, cupping, warm compresses and tight bandaging of the chest are prescribed. To suppress cough, codeine and ethylmorphine hydrochloride are prescribed. Anti-inflammatory drugs are effective in the treatment of dry pleurisy: acetylsalicylic acid, ibuprofen, etc. After normalization of health and blood counts, a patient with dry pleurisy is prescribed breathing exercises to prevent adhesions in the pleural cavity.

In order to treat recurrent exudative pleurisy, pleurodesis is performed (injection of talc or chemotherapy into the pleural cavity to glue the layers of the pleura). To treat chronic purulent pleurisy, they resort to surgical intervention - pleurectomy with decortication of the lung. If pleurisy develops as a result of inoperable damage to the pleura or lung by a malignant tumor, palliative pleurectomy is performed according to indications.

Forecast and prevention of pleurisy

A small amount of exudate can resolve on its own. The cessation of exudation after elimination of the underlying disease occurs within 2-4 weeks. After evacuation of the fluid (in the case of infectious pleurisy, including tuberculous etiology), a persistent course with repeated accumulation of effusion in the pleural cavity is possible. Pleurisy caused by oncological causes has a progressive course and an unfavorable outcome. Purulent pleurisy has an unfavorable course.

Patients who have suffered pleurisy are under clinical observation for 2-3 years. It is recommended to exclude occupational hazards, fortify and high-calorie nutrition, and exclude colds and hypothermia.

In the prevention of pleurisy, the leading role belongs to the prevention and treatment of the main diseases leading to their development: acute pneumonia, tuberculosis, rheumatism, as well as increasing the body's resistance to various infections.

Pleurisy - treatment in Moscow

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What are adhesions in the lungs and how is it treated?

When adhesions in the lungs are diagnosed, what they are is the first question that arises in the patient. Not everyone, unfortunately, understands the seriousness of the problem of the occurrence of these formations in the lungs. But this is not just mild discomfort during inhalation - it is a problem that can lead to serious consequences. First you need to understand that such formations appear not only in the lungs, but in all human organs.

Adhesions are fibrous or connective tissue that forms in organs for a number of reasons. Why are adhesions in the lungs dangerous? The fact is that with prolonged growth of adhesions, their own nerves and blood vessels can form. As the connective tissue adhesions grow, they block the blood vessels, thereby disrupting blood circulation in the lungs. Also, enlarged formations can block the bronchi. And this also affects the oxygen saturation of the blood. Thus, adhesions in the lungs are a disease that can seriously impair the functioning of the respiratory system.

Signs of adhesions

The main symptoms of the appearance of connective tissue adhesions are easily identified:

  1. The main sign of the formation of adhesions is the appearance of shortness of breath. Shortness of breath does not occur after physical activity or running, but for no apparent reason.
  2. There may be pain in the chest area. The pain can be sharp or aching.
  3. Often there is an unreasonable increase in heart rate.

Causes of adhesions in the lungs

The causes of mooring in the lungs may lie in the following:

The structure of the lungs.

  1. It is often possible for adhesions to appear in the lungs after pneumonia, especially if it was not treated properly, i.e. was carried on the legs and bed rest was not observed.
  2. The pleural cavities are subject to frequent inflammation, so the formation of adhesive fibers after pleurisy is not uncommon.
  3. Physical damage to the pleura and trauma also lead to the formation of adhesions.
  4. Pleuropulmonary moorings also occur as a result of a chronic infectious disease.
  5. Pleural tissue adhesions in rare cases can be congenital.

You should know that in medicine there is a distinction between single and multiple fusions. Numerous adhesions affect almost the entire organ, causing hypoplasia of the lungs, a decrease in the inhaled volume of air, and shortness of breath is noticeable even with minor physical exertion.

Diagnostic measures and treatment

Pleurisy is known to cause adhesions. Such a disease can be diagnosed only after a comprehensive examination of the lungs and pleural cavities.

Research is carried out using x-rays. Only a specialist analyzes the results obtained. The prescription of treatment depends on its analysis, taking into account the severity of the disease, the size of adhesions and the individual characteristics of the body.

Only a specialist should decide how to treat adhesions. The radical method of treatment is surgery. Removal of formations surgically is carried out only if the pleura is seriously damaged by adhesions and the patient is in danger of death.

Physiotherapy is mainly used for treatment. Physiotherapy helps to cure inflammation and pleurisy.

After completing a course of physical therapy, the adhesions become softer and more elastic. Physiotherapeutic treatment relieves pain.

Electrophoresis and heating also help well in treating adhesions in the lungs. Warming up can be mud, paraffin, or clay. In this case, therapeutic mud, paraffin or clay is used. As a rule, such treatment is prescribed in appropriate sanatoriums.

Traditional methods of treating adhesions are also widely known, but you should not carry out such therapy yourself. A consultation with the attending physician is necessary, and it is advisable to use traditional methods in combination with the same physiotherapy, that is, with traditional treatment.

Here are the two most famous recipes from traditional medicine, which have proven themselves well in the treatment of adhesions in the lungs:

  1. In a thermos container, brew a mixture of the following ingredients: 2 tbsp. l. nettle, 2 tbsp. l. rose hips, 1 tbsp. l. lingonberries. This collection is infused for at least 3 hours. You should drink 2 times a day, morning and evening, 100 g at a time after meals.
  2. In a 1-ml thermos, brew a mixture of the following ingredients: 1 tbsp. l. rose hips, 1 tbsp. l. raspberries, 1 tbsp. l. black currant. This collection is infused for at least 2 hours. You should drink 2 times a day, morning and evening, 100 g at a time after meals.

In fact, there are many similar recipes. The main benefit of these tinctures is, of course, saturating the body with vitamins and softening adhesions in the lungs.

This video talks about various lung diseases and methods of preventing them.

It should be remembered that pleura is not something to joke about. There is no point in delaying treatment. If you have been diagnosed with adhesions in the lungs, then you need to immediately begin therapy. The sooner you start treatment, the greater the chances of completely getting rid of this disease.

Source: http://stronglung.ru/drugie/spajki-v-legkix-chto-eto-takoe.html

Adhesions in the lungs

In January I was suspected of having pneumonia and was treated with Tavanic. In May, I caught a slight cold (snot, cough), and after that the cough did not go away. In July, on the recommendation of a therapist, I took Flemaxin Salutab for 5 days. I had a disgusting reaction to it (allergy to this group of antibiotics: white coverings, weakness, poor health), and this drug also negatively affected the state of the intestinal microflora. The day before yesterday I decided to have a fluorography done to find out the condition of my lungs. The radiologist said that there were some adhesions in the left lung, she wrote “infiltration of m. tk.” in the lower lobe of the left lung.”

Blood and urine tests are normal.

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Source: http://www.health-ua.org/mc/pulmonologiya-ftiziatriya/23/11/

pleural moorings

The costodiaphragmatic sinus (the space between the dome of the diaphragm and the ribs where the lower lobe of the lung enters) is where fluid usually accumulates in cases of pleurisy. The formation of pleural moorings (adhesions) indicates a previous inflammatory process (pleurisy). In all likelihood, the adhesions limited part of the space of the pleural cavity in which connective tissue had accumulated (fibrorothorax).

In itself, this condition is not dangerous and does not threaten anything serious, but it all depends on the cause of the formation of adhesions (pneumonia, tuberculous pleurisy, etc.).

Source: http://polismed.ru/otvety/v1322.html

Treatment of pleural adhesions in the lungs

The high prevalence of pulmonary diseases is explained by the fact that they usually accompany seasonal viral diseases. It’s rare that someone manages to avoid getting sick with acute respiratory infections or the flu at least once a year. As a result, pleural adhesions can form in the lungs, which negatively affect the functioning of the entire body.

In order not to start the disease, you need to consult a doctor in time, who will make a diagnosis and prescribe treatment.

Causes of the disease

Adhesions form in the pleural cavity, which is located between the membranes that cover the inside of the chest and the outside of the lungs. This shell is a smooth surface with a large number of nerve endings. It is filled with fluid that is secreted on the surface of the pleura covering the chest, after which it is absorbed through the membrane adjacent to the lungs.

The causes leading to pleural disease are very diverse. Inflammatory processes occurring in the body can lead to an increase in the amount of fluid produced. In this case, a protein is released that settles on the surface of the pleura, making it rough. When breathing deeply, the surfaces rub, irritating the nerve endings, which leads to coughing and pain in the sides of the chest. Such symptoms are characteristic of a disease such as pleurisy.

Sometimes the excess fluid in the pleural cavity reaches one and a half liters. This increase occurs when the lining of the lung is damaged and fluid is not absorbed.

This can cause the lung to compress, causing the person to feel short of breath, making it difficult to breathe and causing heaviness in the sides. Such symptoms most often accompany kidney disease or heart failure; this picture is also possible with the development of tuberculosis or a tumor.

However, the development of pleural disease is not necessarily associated with the formation of excess fluid in it, although such diseases are the most problematic. The cause of the disease may be pleural adhesions. Even a small amount of them can cause pain when breathing. Adhesions form after inflammation, when the resulting fluid resolves.

There are cases when adhesions form in large numbers, and the free space decreases. This also leads to decreased mobility of the membranes, which contributes to severe shortness of breath and difficulty breathing. In such cases, urgent treatment is necessary.

Adhesions in the lungs

They are formed anywhere due to the presence of connective tissue. Many organs of the human body are susceptible to the formation of adhesions.

In the pleura, adhesions are connective tissue growing between the linings of the lung and chest.

They can have a single structure, or they can grow so much that they ultimately occupy the entire pleural cavity. In this case, emergency medical care is needed.

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Symptoms that occur when there are adhesions in the pleural cavity:

  • increased heart rate;
  • shortness of breath;
  • pain in the thoracic region;
  • violation of pulmonary ventilation;
  • increased cough;
  • pale skin;
  • elevated temperature.

As a rule, the formation of adhesions is preceded by previous pulmonary diseases, which serve as an impetus for their development. There are main diseases that are the root cause of the formation of adhesions:

Among pleural adhesions, pleurodiaphragmatic adhesions can be distinguished, which are located in the lower part of the chest. Basically, the impetus for their development is bronchial diseases. Scars form where the lung adjoins the diaphragm.

In small quantities, adhesions are not dangerous, but viral diseases that provoke their development and increase in number must be avoided. Which can ultimately lead to pulmonary failure.

As they grow, adhesions can reduce blood circulation in the lungs, blocking blood vessels and bronchi. Blockage of the bronchi leads to a decrease in oxygen levels in the blood. In adhesions with prolonged development, the formation of their own vessels and nerves is possible.

Pleuropulmonary scars, as a rule, can be attributed to tuberculous changes. They mainly occur in the upper part of the pleura, and on x-ray they have an intermittent, uneven appearance. This adhesive process can occur in chronic infectious diseases.

Pleurocostal adhesions mainly form after fibrinous or purulent pleurisy, and they develop very quickly. The resulting thickenings of the pleura mainly occur in the lateral sections, on the walls, towards the surface of the ribs of the lung.

Diagnostics and treatment measures

Fluorography is primarily used to detect pulmonary diseases. This procedure must be carried out annually; it is mainly aimed at identifying the early stage of tuberculosis. However, an experienced radiologist can identify formed pleural adhesions in the image, which appear as shadows. Moreover, their shape does not change depending on inhalation and exhalation.

If necessary, an additional x-ray is prescribed. As a rule, adhesions are located in the lower part of the lung. In this case, there will be a darker picture, and there may also be partial deformation of the chest and diaphragm.

When diagnosing pleural adhesions, further treatment depends on their number and stage of development. As a rule, therapeutic effects accompanied by physiotherapy are sufficient.

However, in case of advanced disease, when pulmonary failure develops and the patient’s life is threatened, surgical intervention is used. In this case, part of the lung is removed, which is filled with adhesions. This operation is called a lobectomy.

In case of exacerbation of inflammatory processes in the lungs, which lead to the formation of adhesions, it is necessary, first of all, to localize them. For this purpose, antibiotics are used, which are administered intravenously or intramuscularly. As a rule, such processes are accompanied by a cough, so medications that improve sputum discharge are needed.

After the inflammation has been stopped, inhalations and electrophoresis can begin. Also, when pleural adhesions form, breathing exercises and chest massage have worked well.

It is important to note that proper nutrition plays an important role in pulmonary diseases.

The diet must include foods containing large amounts of vitamins and proteins. The patient's menu should include:

If the body is predisposed to pulmonary diseases, it is recommended to periodically undergo spa treatment. This will help improve the health of the body. You should also avoid exposing your body to hypothermia, play sports and give up bad habits.

Traditional methods

In addition to medications, it is good to use folk remedies when fighting adhesions. They are inexpensive, do not burden the body like medications, and are also very effective. Here are some recipes that will help get rid of adhesions:

Rose hips, nettles and lingonberries are used to make tea.

After mixing the ingredients, pour boiling water over them and infuse. A decoction containing currants, rose hips and raspberries also helps well.

  • A decoction of St. John's wort has proven to be an effective remedy. You can easily collect it yourself, and then dry and grind it.
  • The use of essential oils quickly helps restore breathing and get rid of cough.

    • It should be remembered that you cannot self-medicate, this can lead to irreversible processes. First of all, you need to consult a specialist.

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    Source: http://opnevmonii.ru/bolezni/plevrit/chto-takoe-plevralnye-spajki.html

    Mooring line

    1. Small medical encyclopedia. — M.: Medical encyclopedia. 1991–96 2. First aid. - M.: Great Russian Encyclopedia. 1994 3. Encyclopedic Dictionary of Medical Terms. - M.: Soviet Encyclopedia. — 1982—1984

    See what “Shvarta” is in other dictionaries:

    mooring - see Spike ... Big Medical Dictionary

    Pleurisy - I Pleurisy (pleuritis; Pleura + itis) inflammation of the pleura, accompanied by the formation of exudate of various types in the pleural cavity. As a rule, P. is not an independent nosological form, but complicates the course of pathological... ... Medical encyclopedia

    Commissura - I Commissura (i) [commissura (ae); synonym: commissure, synechia, mooring] in pathology, a fibrous cord formed between adjacent surfaces of organs as a result of injury or an inflammatory process. Amniotic adhesions, see Amniotic constrictions.... ... Medical encyclopedia

    SHVART - SHVART, mooring, husband. (see moorings) (sea). Spare anchor on a ship. Ushakov's explanatory dictionary. D.N. Ushakov. ... Ushakov’s Explanatory Dictionary

    SYNECHIA - SYNECHIA, synechia (from the Greek synecho I fasten, I connect), syn. mooring, soldering (lat. ad haesio), a term for various stalemates. connections between adjacent organs or surfaces. Most often S. are observed in the serous cavities of the pleura, ... ... Great Medical Encyclopedia

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    Source: http://dic.academic.ru/dic.nsf/enc_medicine/34724/%D0%A8%D0%B2%D0%B0%D1%80%D1%82%D0%B0

    Pulmonary pleurisy - what is it? Symptoms and treatment

    Pleurisy is an inflammation of the pleura with the formation of fibrous plaque on its surface or effusion inside it. Appears as an accompanying pathology or as a consequence of various diseases.

    Pleurisy can be an independent disease (primary pleurisy), but most often it is a consequence of acute and chronic inflammatory processes in the lungs (secondary pleurisy). They are divided into dry, otherwise called fibrinous, and effusion (serous, serous-fibrinous, purulent, hemorrhagic) pleurisy.

    Often pleurisy is one of the symptoms of systemic diseases (oncology, rheumatism, tuberculosis). However, the striking clinical manifestations of the disease often force doctors to put the manifestations of pleurisy in the foreground, and based on its presence, find out the true diagnosis. Pleurisy can occur at any age, many of them remain unrecognized.

    Causes

    Why does pulmonary pleurisy occur, what is it, and how to treat it? Pleurisy is a disease of the respiratory system; during its development, the visceral (pulmonary) and parietal (parietal) layers of the pleura, the connective tissue membrane that covers the lungs and the inner surface of the chest, become inflamed.

    Also, with pleurisy, fluids, such as blood, pus, serous or putrefactive exudate, can be deposited between the layers of the pleura (in the pleural cavity). The causes of pleurisy can be divided into infectious and aseptic or inflammatory (non-infectious).

    Infectious causes of pulmonary pleurisy include:

    • bacterial infections (pneumococcus, staphylococcus),
    • fungal infections (blastomycosis, candidiasis),
    • syphilis,
    • typhoid fever,
    • tularemia,
    • tuberculosis,
    • chest injuries,
    • surgical interventions.

    The causes of non-infectious pulmonary pleurisy are as follows:

    • malignant tumors of the pleural layers,
    • metastasis to the pleura (in breast cancer, lung cancer, etc.),
    • diffuse connective tissue lesions (systemic vasculitis, scleroderma, systemic lupus erythematosus), pulmonary infarction,
    • TELA.

    Factors that increase the risk of developing pleurisy:

    • stress and overwork;
    • hypothermia;
    • unbalanced, nutrient-poor diet;
    • hypokinesia;
    • drug allergies.

    The course of pleurisy can be:

    • acute up to 2-4 weeks,
    • subacute from 4 weeks to 4-6 months,
    • chronic, more than 4-6 months.

    Microorganisms enter the pleural cavity in different ways. Infectious agents can enter by contact, through blood or lymph. Their direct impact occurs during injuries and wounds, during operations.

    Dry pleurisy

    With dry pleurisy, there is no fluid in the pleura, fibrin appears on its surface. Basically, this form of pleurisy precedes the development of exudative pleurisy.

    Dry pleurisy is often a secondary disease in many diseases of the lower respiratory tract and intrathoracic lymph nodes, malignant neoplasms, rheumatism, collagenosis and some viral infections.

    Tuberculous pleurisy

    Recently, the incidence of tuberculous pleurisy has increased, which occurs in all forms: fibrous, exudative and purulent.

    In almost half of the cases, the presence of dry pleurisy indicates that the tuberculosis process is occurring in a latent form in the body. Pleural tuberculosis itself is quite rare; for the most part, fibrous pleurisy is a response to tuberculosis of the lymph nodes or lungs.

    Tuberculous pleurisy, depending on the course of the disease and its characteristics, is divided into three types: perifocal, allergic and pleural tuberculosis itself.

    Purulent pleurisy

    Purulent pleurisy is caused by microorganisms such as pathogenic staphylococci, pneumococci, streptococci. In rare cases, these are Proteaceae, Escherichia bacilli. As a rule, purulent pleurisy develops after exposure to one type of microorganism, but it happens that the disease is caused by a whole association of microbes.

    Symptoms of purulent pleurisy. The course of the disease varies depending on age. In infants in the first three months of life, purulent pleurisy is very difficult to recognize, since it is masked under the general symptoms characteristic of umbilical sepsis and pneumonia caused by staphylococci.

    From the side of the disease, the chest becomes convex. Shoulder drooping and insufficient arm mobility also occur. In older children, standard symptoms of total pleurisy are observed. You can also note a dry cough with sputum, sometimes even with pus - when a pleural abscess breaks into the bronchi.

    Encapsulated pleurisy

    Encapsulated pleurisy is one of the most severe forms of pleurisy, in which fusion of the pleural layers leads to the accumulation of pleural extrudate.

    This form develops as a result of long-term inflammatory processes in the lungs and pleura, which lead to numerous adhesions and delimit the exudate from the pleural cavity. Thus, the effusion accumulates in one place.

    Exudative pleurisy

    Exudative pleurisy is distinguished by the presence of fluid in the pleural cavity. It can form as a result of a chest injury with bleeding or hemorrhage or lymph effusion.

    According to the nature of this fluid, pleurisy is divided into serous-fibrinous, hemorrhagic, chylous and mixed. This fluid, often of unknown origin, is called effusion, which can also restrict the movement of the lungs and make breathing difficult.

    Symptoms of pleurisy

    In the event of pleurisy, symptoms may vary depending on how the pathological process proceeds - with or without exudate.

    Dry pleurisy is characterized by the following symptoms:

    • stabbing pain in the chest, especially when coughing, deep breathing and sudden movements,
    • forced position on the sore side,
    • shallow and gentle breathing, while the affected side visually lags behind in breathing,
    • when listening - pleural friction noise, weakening of breathing in the area of ​​fibrin deposits,
    • fever, chills and heavy sweating.

    With exudative pleurisy, the clinical manifestations are somewhat different:

    • dull pain in the affected area,
    • dry painful cough,
    • severe lag in breathing of the affected area of ​​the chest,
    • feeling of heaviness, shortness of breath, bulging of the spaces between the ribs,
    • weakness, fever, severe chills and profuse sweat.

    The most severe course is observed with purulent pleurisy:

    • high body temperature;
    • severe chest pain;
    • chills, aches throughout the body;
    • tachycardia;
    • earthy skin tone;
    • weight loss.

    If the course of pleurisy becomes chronic, then scar changes form in the lung in the form of pleural adhesions, which prevent complete expansion of the lung. Massive pulmonary fibrosis is accompanied by a decrease in the perfusion volume of lung tissue, thereby aggravating the symptoms of respiratory failure.

    Complications

    The outcome of pleurisy largely depends on its etiology. In cases of persistent pleurisy, the development of adhesions in the pleural cavity, fusion of interlobar fissures and pleural cavities, the formation of massive moorings, thickening of the pleural layers, the development of pleurosclerosis and respiratory failure, and limited mobility of the dome of the diaphragm cannot be ruled out in the future.

    Diagnostics

    Before determining how to treat pulmonary pleurisy, it is worth undergoing an examination and determining the causes of its occurrence. In a clinical setting, the following examinations are used to diagnose pleurisy:

    • examination and interview of the patient;
    • clinical examination of the patient;
    • X-ray examination;
    • blood analysis;
    • pleural effusion analysis;
    • microbiological research.

    Diagnosis of pleurisy as a clinical condition usually does not present any particular difficulties. The main diagnostic difficulty in this pathology is to determine the cause that caused inflammation of the pleura and the formation of pleural effusion.

    How to treat pleurisy?

    When symptoms of pleurisy appear, treatment should be comprehensive and aimed primarily at eliminating the underlying process that led to its development. Symptomatic treatment is aimed at anesthetizing and accelerating the resorption of fibrin, preventing the formation of extensive adhesions and adhesions in the pleural cavity.

    Only patients with diagnosed dry (fibrinous) pleurisy can be treated at home; all other patients should be hospitalized for examination and selection of an individual treatment regimen for pulmonary pleurisy.

    The specialized department for this category of patients is the therapeutic department, and patients with purulent pleurisy and pleural empyema require specialized treatment in a surgical hospital. Each form of pleurisy has its own characteristics of therapy, but for any type of pleurisy, etiotropic and pathogenetic directions in treatment are indicated.

    So, with dry pleurisy, the patient is prescribed:

    1. To relieve pain, painkillers are prescribed: analgin, ketanov, tramadol; if these drugs are ineffective, narcotic painkillers can be administered in a hospital setting.
    2. Warming semi-alcohol or camphor compresses, mustard plasters, and iodide mesh are effective.
    3. Cough suppressants are prescribed - Sinecode, Codelac, Libexin.
    4. Since the root cause is most often tuberculosis, after confirming the diagnosis of tuberculous pleurisy, specific treatment is carried out at the anti-tuberculosis dispensary.

    If the pleurisy is exudative with a large amount of effusion, a pleural puncture is performed to evacuate it or drain it. No more than 1.5 liters of exudate are pumped out at a time, so as not to provoke cardiac complications. For purulent pleurisy, the cavity is washed with antiseptics. If the process has become chronic, they resort to pleurectomy - surgical removal of part of the pleura in order to prevent relapses. After resorption of the exudate, patients are prescribed physiotherapy, physical therapy, and breathing exercises.

    For acute tuberculous pleurisy, the complex may include drugs such as isoniazid, streptomycin, ethambutol or rifampicin. The course of tuberculosis treatment itself takes about a year. In case of parapneumonic pleurisy, the success of treatment depends on the selection of antibiotics based on the sensitivity of the pathological microflora to them. In parallel, immunostimulating therapy is prescribed.

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    One comment

    If you pumped out 1.7 liters of fluid from the pleura

    How difficult is it? 1.5 months have passed since the operation, breast cancer

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    Transcription of analyzes online

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    Only a qualified doctor can treat diseases.

    Source: http://simptomy-lechenie.net/plevrit-legkix-chto-eto-takoe/