Human lungs are covered with a thin serous membrane- pleura, which protects them from various injuries. The space between the sheets of this shell is usually called the "pleural cavity". This area, like all respiratory organs, is involved in the process of breathing the body. Any disruption of normal lung activity is accompanied by the appearance of certain changes in the pleural cavity. One of the most common pathologies of the respiratory system at the moment is pleurisy - an inflammation of the pleura. The reasons for the development of this disease can be several. Most often it develops as a complication of the common cold, pneumonia, pancreatic inflammation, pulmonary tuberculosis. The causes of pleurisy, which have non-infectious origin, include: myocardial infarction, helminthic invasion, myxedema, cirrhosis, leukemia, glomerulonephritis, lung cancer.
Inflammation of the pleura may occur spontaneously withdamage to the chest as a result of a strong blow, getting injured, fracture of the ribs. Specialists distinguish dry and exudative pleurisy. In the first case, the pleural cavity remains dry throughout the period of the disease. In the case of exudative or wet pleurisy, a certain amount of fluid can accumulate in the cavity of the inflamed pleura.
The main signs of pleurisy are considered to be:
- The onset of pain in the chest area. This pain usually increases with a deep breath, can give in the arm or shoulder.
- Temperature increase.
- Strong dry cough.
- Slight palliation of the skin (cyanosis).
A person who does not have problems with the work of organsrespiration, the pleural cavity contains a small amount of serous fluid necessary for the normal functioning of the lungs, the excess of which is removed through the lymphatic and blood capillaries. The development of inflammation contributes to the imbalance between the production of serous fluid and its removal from the pleura. In the first hours of pleurisy development there is an expansion of the liquid from the pleural cavity of the capillaries, an increase in their impermeability and edema. Gradually, there is a complete blockage of the capillaries, the pleura becomes edematous, stagnant exudate (a protein-rich fluid that usually appears in the site of inflammation). As the inflammation of the lung membrane develops, the exudate accumulated in its cavity can gradually dissolve or be transformed into a fibrous tissue. In the presence of purulent exudate, obligatory surgical care is required, the pleural cavity of the patient in this case is subject to mandatory drainage.
Treatment of any form of pleurisy begins with the establishment of an exact cause of the disease. Diagnosis consists in carrying out:
- Chest X-ray.
- Ultrasonic examination of the respiratory system.
- Electrocardiograms (for the exclusion of myocardial infarction).
- A general blood test (with pleurisy there is an increase in ESR, leukocytosis).
One of the main measures for establishingThe diagnosis is a puncture of the pleural cavity, implying a puncture of the chest by a trocar with a diagnostic purpose. The puncture allows to take a pleural fluid for its detailed laboratory study. If there is a suspicion of the presence of a malignant tumor, thoracoscopy is performed - examination of the lung area by means of a special device that is injected directly into the thorax through its puncture.
The method of treating pleurisy is completely dependent oncauses of the disease. In the case of a combination of tuberculosis and pleurisy, antibacterial therapy is prescribed, with rheumatic inflammation of the pleura, hormonal treatment with glucocorticoids is indicated. In the presence of purulent pleurisy, drainage of the pleural cavity (purification from pus and administration of antibiotics directly into the pleura area) is often performed in conditions of thoracic separation of the polyclinic. After the end of the course of treatment, the patient is shown rest in a sanatorium or in a seaside resort.