Pokemon pleurisy. Pleurisy. Causes, symptoms, signs, diagnosis and treatment of pathology. Symptoms of various types of disease

Pleurisy of the lungs Symptoms and treatment are well understood, but hospitalization and strong anti-inflammatory drugs may be required.

If you ignore the symptoms, then there is a high risk of serious complications or even death.

Pleurisy. What it is?

Pleurisy of the lungs - This is a disease of the respiratory system, with the development of which the pulmonary (visceral) and parietal (parietal) layers of the pleura, the connective tissue that covers the inner part of the chest and lungs, become inflamed.

With pleurisy of the lungs, fluids such as blood, pus, putrefactive or serous exudate can be deposited in the pleural cavity (between the layers of the pleura).

Causes of pleurisy of the lungs

The causes of grafts can be divided into infectious and inflammatory or aseptic (non-infectious).

Infectious causes include:

Fungal lesions (candidiasis, blastomycosis);
Bacterial infections (staphylococcus, pneumococcus);
Syphilis;
Tularemia
Typhoid fever,
Tuberculosis;
Surgical interventions;
Chest trauma.

Non-infectious pleurisy of the lungs has the following causes:

Metastasis to the pleura (in the case of lung cancer, breast cancer, etc.);
Malignant neoplasms of the pleural sheets;
Diffuse connective tissue lesions (systemic lupus erythematosus, scleroderma, systemic vasculitis), pulmonary infarction;
TELA.

The following factors increase the risk of developing pleurisy of the lungs:

Hypothermia;
Stress and overwork;
Poor nutrients, unbalanced diet;
Drug allergies;
Hypokinesia.

The course of pleurisy of the lungs can be:

Acute: Less than 2-4 weeks
Subacute course: 4 weeks - 4-6 months;
Chronic: from 4-6 months.

Microorganisms enter the pleural cavity in different ways.

The causative agents of infection can enter by contact, through the lymph or blood.

Their direct entry into the pleural cavity occurs during wounds and injuries, during operations.

Classification

Dry (fibrous)

If pleurisy has developed, a doctor should identify all symptoms. In most cases, fibrous pleurisy is a symptom of another disease, therefore, a complete diagnosis must be carried out.

In this case, the patient feels a sharp stabbing pain in the side, in the lungs, cough, tension in the press.

With this type of pathology, the patient has shallow breathing, and every movement causes unpleasant sensations. Inflammation of the pleura of this type threatens the appearance of adhesions, so treatment cannot be ignored.

Exudative (exudative) pleurisy

With the accumulation of fluid in the pleura, exudative pleurisy develops. Only one part of the organ is affected, as a result of which the pain is localized to the left or right. It is accompanied by a dry cough, increasing shortness of breath, a feeling of heaviness.

The signs are:

Decreased appetite;
Weakness;
Temperature increase;
Swelling of the face, neck.

The pain is relieved by rolling over on the other side while lying down.

The peculiarity of the disease is the accumulation of fluid in the pleura, so the lungs swell, which gives irradiating pain and causes a deterioration in the general condition.

The fluid in the lungs varies, and sometimes blood accumulates.

Tuberculous

Privrit is one of the signs of tuberculosis. There are several types of this disease: perofocal, allergic or empyema. In some cases, inflammation of the pleura is the only symptom of the disease.

The disease is not acute, and the pains, and with them the cough, disappear, but even the absence of symptoms may not be evidence of a cure.

With such symptoms, severe shortness of breath, fever, weakness, and chest pain appear. Sometimes the disease is chronic.

Purulent

If pus accumulates in the pleura, then it is effusion pleurisy, but it is isolated separately, since the disease passes only in an acute form.

Symptoms of this disease: chest pain, cough, fever, shortness of breath, a gradual increase in blood pressure due to pressure on the heart of the accumulated mass.

A purulent form of the disease occurs more often in the elderly or young children, requires hospitalization and specialist supervision.

Encapsulated pleurisy

This is one of the most severe forms of pleurisy of the lungs, in which the adhesion of the leaves of the hymen leads to the accumulation of extrudate.

This form develops as a result of prolonged inflammatory processes in the pleura and lungs, which lead to adhesions, and also delimit the exudate and the pleural cavity. So, the effusion accumulates in one place.

Symptoms of pulmonary pleurisy

In the case of pleurisy, the symptoms may differ depending on the course of the pathological process.

Dry pleurisy is characterized by the following symptoms:

Gentle and shallow breathing, while the affected side visually lags behind in breathing;
Stitching pain in the chest, especially when coughing, violent movements and deep breathing;
When listening - weakening of breathing in fibrin deposits, pleural friction noise;
Fever, intense sweating and chills.

With exudative pleurisy, the manifestations are somewhat different:

Dry, excruciating cough
Dull pain in the affected area
Strong lag in the area of the chest lesion during breathing;
Shortness of breath, a feeling of heaviness, swelling of the intercostal spaces,
Weakness, profuse sweat, severe chills and fever.

The most severe course is noted with purulent pleurisy:

Severe chest pain;
High body temperature;
Body aches, chills;
Tachycardia;
Weight loss;
Earthy skin tone.

If the course of pleurisy of the lungs becomes chronic, changes in the form of pleural adhesions are formed in the lung, preventing the complete expansion of the lung.

It is accompanied by a decrease in the perfusion volume of the lung tissue, thereby aggravating the symptoms of respiratory failure.

Diagnostics

Before determining the course of treatment for pleurisy of the lungs, you should undergo an examination and identify the causes of its occurrence.

To diagnose pulmonary pleurisy, the following examinations are carried out:

Clinical examination of the patient;
Questioning and inspection;
X-ray examination;
Analysis of pleural effusion;
Blood test;
Microbiological research.

Diagnosis is usually not difficult. The main difficulty in this pathology is to determine the exact cause that provoked the inflammation of the pleura and the formation of pleural effusion.

How is pleurisy treated?

If pleurisy is suspected, the patient is hospitalized. Depending on the type of disease, the attending physician prescribes medications to relieve inflammation and reduce symptoms.

But full organ recovery requires more than pills: you need proper nutrition and exercise.

Bed rest and a gentle diet

Until the inflammation is relieved, the patient is forbidden to leave the bed. He needs recovery from fever and rest. In this case, it is necessary not to burden the stomach and heart, therefore, a diet with a high content of vitamins is prescribed.

The basis of food is fruits, vegetables and cereals. It is also important not to worry and eliminate any stressful situations.

Drug therapy

Doctors prescribe different groups of drugs to patients with pleurisy:

Pain relievers and non-steroidal anti-inflammatory drugs;
Antibiotics;
Immunostimulants, glucocorticosteroids;
Antitussives and diuretics;
Cardiovascular drugs.

Prescribing drugs is associated with the characteristics of the patient and the course of the disease:

If pleurisy is triggered by pneumonia (pneumopleuritis), then it is treated with antibiotics.
If the disease is caused by rheumatic causes, nonsteroidal anti-inflammatory drugs and pain relievers will be needed.
If the plevitis is tuberculous, then the duration of treatment is 3-6 months and special drugs are used.

Physiotherapy procedures

During treatment, mustard plasters and a tight bandage on the chest are shown, since pleurisy sometimes becomes the cause of the fusion of the organ cavity. In order to prevent these complications, the patient is prescribed breathing exercises.

Also, physiotherapy exercises are additionally needed if the patient has been in the hospital for more than 2 months.

The purulent variant of the pathology is sometimes treated for more than 4 months under the supervision of doctors.

Surgical intervention

With purulent pleurisy of the lungs, surgical intervention is sometimes necessary. The surgeon performs drainage and rinsing with an antiseptic solution. More serious operations can be performed for the chronic form of the disease.

Video

Easy and smooth breathing is provided by such an important organ as the lungs. To make this process also painless, the lungs are covered with a double film - pleura.

If pathogenic microorganisms enter the body or a mechanical disturbance occurs, the pleura becomes inflamed. The space between the two films is filled with pus, which is why a person experiences painful sensations when inhaling, active movements, sneezing and coughing.

Pleurisy symptoms depending on the type

The initial symptoms of pleurisy are similar to the common cold, so the disease is often not recognized at the first stage. At a later stage, specific symptoms of different types of pleurisy appear:

Dry pleurisy is manifested by painful sensations in the chest with a deep breath, leaning the body to the side, or coughing. In the evening, the body temperature rises to 38 ° C. Symptoms such as increased, weakness, decreased performance are manifested;
With exudative pleurisy, a feeling of heaviness in the chest is added to cough, drowsiness and lethargy. It seems to the patient that the chest is clamped in a vice. Breathing becomes heavy and shallow, shortness of breath appears. The skin turns pale, and around the lips and nose it becomes cyanotic. Raising the chest during breathing is asymmetric: the second part of the body rises with a delay;
Purulent pleurisy is characterized by a high temperature (up to 40 ° C), which is much harder to bring down than in other forms of the disease. Human skin becomes cold, pale and slightly damp. Breathing is difficult, the cough is getting worse.

The disease occurs in three stages. In the first phase, changes are practically not manifested by external symptoms, however, in the second stage, it becomes difficult to breathe, work and perform active actions. At this point, it is very important to see a doctor for a diagnosis and prevention of further complications.

General principles of pleurisy treatment

The main treatment for pleurisy is conservative. The help of a surgeon is required only in advanced and severe cases. The therapy is carried out according to the following rules:

At the beginning of treatment, the doctor prescribes antibacterial drugs of a wide spectrum of action, means to reduce pain and relieve pain. Selectively acting drugs are prescribed after the test results are received.
In the presence of neoplasms, glucocorticosteroids and drugs are prescribed to slow tumor growth.
Auxiliary drugs - diuretic tablets, cough syrups and medicines that strengthen blood vessels and support their work.
To strengthen the obtained effect, the patient is prescribed warming up and other physiotherapeutic procedures.

If the internal organs are squeezed by a large amount of fluid, lymphatic drainage is performed. At a time, you can pump out no more than 1 liter from the body, otherwise the internal organs will shift. For this reason, lymphatic drainage is often performed several times.

Medicines for the treatment of pleurisy

Medicines are prescribed to influence the causes of the disease - the penetration of pathogenic microorganisms into the body. The doctor prescribes the following drugs:

Acetylsalicylic acid (Aspirin). It has an analgesic effect, soothes inflammation and relieves heat. Contraindicated in heart failure, erosive and ulcerative diseases of the gastrointestinal tract and under the age of 15 years. During pregnancy, the drug should be taken only with consideration of the risks and potential benefits to the mother. The daily dose of Aspirin is 8 g. Take up to 6 times a day;
Analgin. Indicated for the relief of acute pain. It is not recommended to take in case of bronchial and aspirin asthma, blood diseases, renal and hepatic insufficiency, during the period of childbearing. The remedy can be given to children from 3 months. The maximum dose is 2 g per day. Take as a tablet or solution 2-3 times a day;
Benzylpenicillin is an antibiotic that interferes with the growth and development of pathogenic bacteria. Contraindicated in case of sensitivity to penicillins, epilepsy, hay fever and bronchial asthma. Injected intramuscularly every 4 hours for 1,000,000-200,000 units;
Indomethacin. It is used to reduce fever, relieve pain and inflammation. Contraindicated in peptic ulcer disease, internal bleeding, congenital heart disease, arterial hypertension, renal and hepatic failure, bleeding disorders, age up to 14 years. The permissible dose is 25 mg, 3 times a day;
Diclofenac sodium. Refers to non-steroidal anti-inflammatory drugs. Relieves painful sensations and brings down high temperature. Contraindicated under the age of 6 years, with gastric ulcer and duodenal ulcer, liver and kidney pathology, pregnancy and breastfeeding, hypersensitivity to the components of the drug. Take 100 mg per day;
Calcium chloride. Anti-inflammatory agent, reduces capillary permeability, prevents allergic reactions, destroys pathogenic microorganisms. Not recommended for atherosclerosis, increased calcium concentration in the body, hypersensitivity and tendency to thrombosis;
Lefosocacin is a broad-spectrum antibacterial drug. It is rapidly absorbed into the small intestine and has a healing effect, relieves pain, reduces inflammation and fights against pathogens. Contraindicated under the age of 18, with lactose intolerance, epilepsy, bearing and feeding a child. The course and treatment regimen is determined by the attending physician, depending on the degree of the disease and the characteristics of the organism;
Erythromycin is an antibiotic drug that actively treats respiratory diseases, copes with pathogenic microorganisms, relieves painful sensations and has an anti-inflammatory effect. Contraindicated in case of hearing loss, during pregnancy and lactation, while taking terfenadine or astemizole. The maximum daily dose is up to 2 grams. The minimum interval between doses is at least 6 hours.

Talk to your doctor before taking any of these medicines. Remember that the scheme and course of treatment depend on the severity and form of pleurisy. If you take the listed medicines incorrectly, you will cause serious harm to the body and side effects.

Treatment of pleurisy with folk remedies

Folk remedies are an auxiliary method of treating pleurisy. They can be taken to speed up healing. Below we will consider time-tested medicines prepared according to folk recipes:

Take 30 g of camphor and 3 g each of eucalyptus and lavender oils. Stir and rub under your shoulder blades 3 times a day. Apply a warming compress after the procedure. Apply the oil mixture for 2-3 weeks;
Mix 2 tablespoons. chopped marigolds, pour olive oil (200 ml), transfer to a jar and leave for 2 weeks in a dark place. When the product is ready, use it for rubbing;
Take in equal parts the leaves of coltsfoot, flowers of black elderberry and grass of highlander bird. Grind, place in a saucepan, bring to a boil and cook for 15 minutes. Cool and strain. Take 100 ml. every day throughout the treatment;
Take in equal parts peppermint, licorice root and elecampane, marsh cinnamon grass, coltsfoot leaves. Combine and fill with a liter of boiling water. Insist. Take 100-150 ml. until complete recovery;
Take a medium sized onion. Cut it into several pieces and place on a plate. Lean over the onion and inhale the vapors exuded by the vegetable. Cover your head with a towel, and be sure to keep your eyes closed. Repeat the procedure once a day;
Take 50 g of badger fat, 300 g of peeled and crushed aloe leaves and 1 cup of natural honey (200 g). Mix all ingredients thoroughly, put in the oven for 10 minutes. Once the composition is ready, strain it through cheesecloth or a sieve. The raw material is thrown away. The resulting composition should be consumed 2 times a day, half an hour before meals;
Grind 300 g of onion, pour over with dry white wine (500 ml), add 100 g of honey. Stir, leave for 8 days, then take a tablespoon 4 times a day.

Remember that the effect of medicinal herbs is individual. If hypersensitive or misused, they can cause allergic reactions and side effects.

X-ray of the lungs affected by pleurisy

How to treat pleurisy in pregnant women and children

Pulmonary pleurisy is a disease that should be suppressed even before the start. If a pregnant woman is at risk, it is necessary to treat the underlying diseases, avoid overexertion and strengthen the immune system. If pleurisy cannot be avoided, therapy should be carried out under the supervision of a physician. Treatment is aimed at eliminating the inflammatory process. Topical antibiotics, herbal ingredients and other sparing medicines are selected as drugs.

If a child is ill with pleurisy, treatment is carried out in a hospital. If the condition of the small patient is severe, and respiratory failure develops against the background of pleurisy, then treatment is performed in the intensive care unit. A strict bed rest is prescribed, the use of antibiotics and drugs for detoxification (removal of pathogenic microorganisms and toxic substances from the body). If necessary, pumping out of pus and sanitation of the pleural area is prescribed.

Before prescribing an antibiotic drug, the doctor takes into account the general condition of the child, test results and sensitivity to certain drugs. Medicines acceptable for the treatment of children - Methicillin, Ristomycin, Oletetrin, Ristomycin. In severe cases, the doctor may prescribe Tienam, but it is highly discouraged to use it unnecessarily.

Antibiotics are given intravenously or intrapleurally. If pleurisy develops against the background of malignant tumors, chemotherapy drugs are connected to the treatment. With dry pleurisy, anti-inflammatory drugs are prescribed - Aspirin, Butadion, Brufen.

Possible complications of pleurisy

If you do not start therapy in a timely manner or engage in
self-treatment, pleurisy of the lungs can lead to complications. The consequences of improperly provided medical care are severe and in some cases even irreversible. The most dangerous complications include the consequences of purulent pleurisy.

Purulent pleurisy is an acute inflammation of the pleura, which in itself is not a primary disease. As a rule, pleurisy is a complication of other diseases that are purulent lesions of the respiratory system or lung abscesses.

From this video you will learn about the features and clinical manifestations of pulmonary pleurisy. You will also learn about the correct treatments, types of pleural inflammation and anti-inflammatory drugs to treat it.

Types and causes of pleurisy

Depending on the etiology of the disease, there are two types of pleurisy:

Non-infectious (aseptic) -inflammatory process provokes diseases of other organs and systems.
Infectious - result from the invasion of the pleura by infectious pathogens.

Infectious inflammations occur against the background of acute pulmonary diseases and pneumonia. The main causative agents of pleurisy are:

Pneumococcus;
staphylococcus;
gram-negative sticks.

Tuberculous pleurisy provoke tuberculosis microbacteria. In this case, the infection of the cavity with microbacteria occurs from subpleural foci, hilar lymph nodes, or as a result of the breakthrough of cavities (it is dangerous by the formation of pyopneumothorax). Pleural inflammation of fungal etiology is often caused by blastomycosis, coccidioidosis and other severe fungal diseases.

Aseptic pleurisy deserves special attention. Aseptic inflammation can develop against the background of trauma (traumatic pleurisy), hemorrhage, as a result of pancreatic enzymes entering the pleural cavity (enzymatic pleurisy).

The main causes of aseptic pleurisy:

More than 40% of exudative pleurisy occurs due to the spread of metastatic cancerous tumors in the pleura. Moreover, both a tumor of the thyroid gland or stomach, and the kidney, lung, breast, ovary, lymphoma or bone sarcoma can metastasize. They diagnose pleurisy caused by dissemination of secondary or primary malignant tumors along the pleura - carcinomatous pleurisy.

Sympathetic pleurisy occurs as a result of intoxication of the pleura during inflammatory processes or products of necrosis of neighboring organs, sometimes the source is lymphogenous invasion of enzymes from the affected pancreas.

By the type of exudate (effusion), pleurisy is distinguished:

purulent;
chyle;
serous;
putrid;
fibrinous;
eosinophilic;
cholesterol;
hemorrhagic;
serous fibrinous.

Pathogenesis

The localization and degree of distribution of pleurisy is significantly influenced by:

general and local reactivity of the body;
the way of penetration into the pleural cavity of microorganisms and a type of infection (with infectious pleurisy);
the state of the pleural cavity and the presence of concomitant pathologies.

In clinical practice, there is a division of pleurisy caused by pneumonia into metapneumonic and parapneumonic. Such a separate classification is not entirely correct because metapneumonic pleurisy is actually not an independent disease that occurs after pneumonia. Pathological inflammation develops due to undetected secondary infection and suppuration during the pneumonia itself.

Danger of pleurisy

Productive-regenerative and exudative processes in pleurisy lead to adhesion and subsequent fusion of pleural sheets, as well as other functional disorders.

Pleurisy causes:

sharp pain when inhaling - develops as a result of friction of the pleural sheets affected by inflammation;
compression of the lung and displacement of the mediastinum (the space between the right and left pleural cavities) - this is due to the accumulation of liquid exudate;
violations of ventilation and hypoxemia - occur due to compression in the lung tissue;
displacement of the heart muscle and impaired blood circulation - due to increased pressure in the sternum, compression of the vena cava and deterioration of venous blood flow;
purulent-resorptive intoxication - develop with purulent pleurisy.

Pleurisy symptoms

Dry pleurisy symptoms

Due to the fact that pleurisy is a secondary inflammation against the background of other pathologies, the symptoms of the disease may be implicit.

With dry pleurisy, they are diagnosed:

chills;
weakness;
sleep disturbance;
noise on auscultation;
shallow breathing;
severe pain when coughing;
stitching pains behind the breastbone;
uneven lifting of the chest when breathing.

Typical signs of dry pleurisy of the diaphragm:

hiccups;
flatulence;
pain in the hypochondria;
hypertonicity of the abdominal press;
heaviness in the chest.

The symptomatology of fibrinous pleurisy is identical to the underlying disease that provoked the inflammation.

Symptoms of exudative pleurisy

With pleural exudation, the following are observed:

cyanosis;
weakness;
dyspnea;
sweating;
dry cough,
heaviness in the side;
loss of appetite;
dull pain in the hypochondrium;
noise during inhalation and exhalation;
febrile body temperature;
smoothing of intercostal spaces;
asymmetrical lifting of the chest during breathing.

Paramediastinal (encapsulated) pleurisy is characterized by:

dysphagia;
hoarseness of voice;
swelling of the face and neck.

The pathogenesis of serous pleurisy, which developed as a result of the bronchogenic form of an oncological tumor, is characterized by hemoptysis. If pleurisy is caused by lupus erythematosus, there may be side development of pericarditis, renal and articular abnormalities. For metastatic pleurisy, the danger is asymptomatic accumulation of exudate, as well as disruption of the cardiovascular system (tachycardia, decreased blood pressure) and displacement of the mediastinum.

With exudative pleurisy, symptoms can be isolated or growing and common with other problems in the body. Palpation of the patient's chest allows the diagnosis of characteristic crepitus during breathing.

If you find yourself with similar symptoms, see your doctor immediately. It is easier to prevent a disease than to deal with the consequences.

Diagnosis of pleurisy

When compiling an anamnesis of the disease, the pulmonologist examines the chest and performs auscultation. Exudative pleurisy is characterized by protrusion of the intercostal spaces, asymmetry of the sternum, bronchophonia and weak breathing. The upper boundary of the effusion is determined percussion using ultrasound or radiography.

For the diagnosis of pleurisy and the appointment of therapy, additional studies are carried out:

pleural puncture;
chest x-ray;
pleural biopsy and thoracoscopy;
bacteriological and cytological examination of exudate.

With pleurisy, the following deviations are present in a detailed blood test:

excess ESR;
an increase in seromucoids;
neutrophilic leukocytosis;
excess of fibrin and sialic acids.

In the case of dry pleurisy of the diaphragm, which accompanies basal pneumonia and inflammation in the subphrenic space, it may be difficult to diagnose. For this pathology, pleural friction noise is not characteristic, and pain radiates to the neck and the anterior abdominal wall. Possible pain when swallowing and painful hiccups, as with tracheitis.

A clear symptomatology for pleurisy is painful palpation on examination:

legs of the sternocleidomastoid muscle of the neck;
the first intercostal space;
along the line of the diaphragm (signs of Mussey);
in the area of the spinous ends of the upper cervical vertebrae.

If exudative pleurisy has developed after fibrinous pleurisy, soreness in the chest is replaced by a feeling of heaviness and fullness. In this case, they diagnose: general weakness, shortness of breath, reflex cough. Due to the accumulation of exudate, patients experience a feeling of lack of oxygen, swelling of the neck veins and cyanosis. Also, swelling of the skin in the lower parts of the chest, increased heart rate and Wintrich's symptom are possible.

In clinical pulmonology, it is believed that if the volume of accumulated pleural exudate is more than 300-500 ml, it can be diagnosed percussion. Encapsulated pleurisy is characterized by atypical boundaries of effusion.

One of the most informative diagnostic methods is a pleural puncture, which helps to confirm the accumulation of liquid exudate and its nature. As a rule, the study is carried out in the area of the seventh to eighth intercostal space (along the axillary line and the back). If the resulting puncture reveals the development of pyogenic microflora (when the exudate is cloudy and with sediment), this is a sign of pleural empyema.

In the case of serous-hemorrhagic and serous effusions, bacterial cultures are not informative. Thoracoscopy is of great importance in diagnosing the nature of pleurisy. This study involves visual examination of tissues, morphological analysis and biopsy.

Full diagnostics can be performed in any modern pulmonary center.

Pleurisy treatment

The main therapy for pleurisy is aimed at eliminating the etiology and relieving acute painful symptoms of the disease. For the treatment of pleurisy, the source of which is pneumonia, the pulmonologist prescribes a course of antibiotics and a diet. With tuberculous pleurisy, a thorough diagnosis of body systems, a complex of specific therapy (isoniazid, rifampicin, streptomycin) and control of a phthisiatrician are required.

For the treatment of rheumatic pleurisy, the following are prescribed:

analgesics;
immunomodulators;
physiotherapy course;
diuretic drugs;
glucocorticosteroids,
cardiovascular drugs;
non-steroidal anti-inflammatory drugs.

A danger to life is exudative pleurisy with a large volume of effusion. To remove exudate, thoracocentesis (pleural puncture) or drainage is performed. In order not to provoke cardiovascular complications by a sharp straightening of the lung and its displacement in the pleural cavity, no more than 1.5 liters of effusion can be removed at a time. After removing the acute symptoms of exudative pleurisy, for a better recovery of lung function, the following are recommended: manual and vibration massage, electrophoresis, breathing exercises.

Purulent pleurisy therapy includes:

disinfection of the pleural cavity with antiseptics;
intrapleural injections of antibiotics;
taking enzymes and hydrocortisone.

In the treatment of recurrent exudative pleurisy, the administration of chemotherapy drugs or talcum powder into the pleural cavity is prescribed for gluing the pleural sheets. For the therapeutic correction of dry pleurisy, in addition to symptomatic drug treatment, tight compression of the chest is done, a course of electrophoresis and warming compresses are performed. Active drugs help to cope well with cough: ethylmorphine hydrochloride, codeine and dionine.

Patients diagnosed with dry pleurisy are prescribed:

anti-inflammatory drugs;
breathing exercises;
immunomodulators.

Chronic pleurisy, complicated by other pathologies, requires surgical treatment with lung decortation - pleuroectomy.

Surgical correction (palliative pleuroectomy) is also carried out in oncology clinics when an oncological tumor develops on the lung or pleura.

Treating pleurisy at home

In order not to aggravate the inflammation and prevent the development of irreversible pathologies, the treatment of pleurisy at home should be carried out under the supervision of a doctor, after a thorough diagnosis and the appointment of a course of medication.

The initial task in therapy is to remove the cause of the development of pleurisy (infection, deformation, genetic abnormality). Further, the removal of symptoms is carried out and the provision of conditions for the complete recovery of the body. Patients are prescribed antibacterial and immunostimulating therapy, good nutrition, drinking regimen and rest.

For the treatment of pleurisy of the lungs at home, as an expectorant and anti-inflammatory agent, infusions of herbs are recommended: linden blossom, licorice root, coltsfoot leaves, plantain herb, fennel fruits, white willow bark, knotweed.

Complications of pleurisy

The effectiveness of pleurisy treatment and post-therapeutic complications mainly depend on the etiology, location and stage of the disease. A prolonged inflammatory process in the pleura is dangerous:

the development of the adhesive process;
the formation of bulk moorings;
thickening of the pleural sheets;
limiting the functionality of the dome of the diaphragm;
overgrowth of pleural cavities and interlobar fissures;
the development of respiratory failure and pleurosclerosis.

Recovery from illness and prevention of pleurisy

With a small amount of exudate, fluid resorption, restoration of lung functionality and tissue regeneration pass quickly enough (3-4 weeks). Infectious pleurisy, the therapy of which involves the evacuation of effusion, is dangerous with relapses. Oncological pleurisy is characterized by a progressive course and multiple pathologies. It is quite difficult to recover the body after purulent pleurisy. For patients who have had pleurisy, systematic physiotherapy, sanatorium treatment and dispensary observation for 2 years are recommended.

Prevention of purulent pleurisy consists in the recognition and removal of air, blood, exudate from the pleural cavity. Postoperative empyema can be prevented by sealing the lung tissue, operating asepsis and processing the bronchial stump.
The best prevention of pleurisy is to strengthen the body's immune forces, prevent tuberculosis, acute pneumonia, rheumatism and other pleurisy-causing diseases. To prevent the development of functional respiratory pathologies, one should stop smoking and inhale irritating carcinogens.

This article is posted for educational purposes only and does not constitute scientific material or professional medical advice.

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Pleurisy

Pleurisy- various etiologically inflammatory lesions of the serous membrane surrounding the lungs. Pleurisy is accompanied by chest pain, shortness of breath, cough, weakness, fever, auscultatory phenomena (pleural friction noise, weakening of breathing). Diagnosis of pleurisy is carried out using X-ray (-scopy) of the chest, ultrasound of the pleural cavity, pleural puncture, 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 is an inflammation of the visceral (pulmonary) and parietal (parietal) pleura. Pleurisy may be accompanied by the accumulation of effusion in the pleural cavity (exudative pleurisy) or proceed with the formation of fibrinous overlays on the surface of the inflamed pleural sheets (fibrinous or dry pleurisy). The diagnosis of pleurisy is made in 5-10% of all patients being treated in therapeutic hospitals. Pleurisy can aggravate the course of various diseases in pulmonology, phthisiology, cardiology, and oncology. Pleurisy is statistically more often diagnosed in middle-aged and elderly men.

Often, pleurisy is not an independent pathology, but accompanies a number of diseases of the lungs and other organs. For reasons 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:

malignant tumors of the pleura (pleural mesothelioma), metastases in the pleura in lung cancer, breast cancer, lymphoma, ovarian tumors, etc. (in 25% of patients with pleurisy);
diffuse connective tissue lesions (systemic lupus erythematosus, rheumatoid arthritis, scleroderma, rheumatism, systemic vasculitis, etc.)
PE, pulmonary infarction, myocardial infarction;
other causes (hemorrhagic diathesis, leukemia, pancreatitis, etc.).

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 pathways of penetration are possible from subpleurally located sources of infection (with abscess, pneumonia, bronchiectasis, festering cyst, tuberculosis). Direct entry of microorganisms into the pleural cavity occurs when the integrity of the chest is violated (with injuries, trauma, surgical interventions).

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

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

The acute phase of pleurisy is characterized by inflammatory edema and cellular infiltration of the pleural layers, 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 overlays, leading to partial or complete pleurosclerosis (obliteration of the pleural cavity).

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

By etiology:

infectious (for an infectious agent - pneumococcal, staphylococcal, tuberculous and other pleurisy)
non-infectious (with the designation of a disease leading to the development of pleurisy - lung cancer, rheumatism, etc.)
idiopathic (of unknown etiology)

By the presence and nature of the exudate:

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

In the course of inflammation:

sharp
subacute
chronic

By localization of the effusion:

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

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

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

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

Exudative pleurisy

The onset of pleural exudation is accompanied by a dull pain in the affected side, a reflexive painful dry cough, a lag in the corresponding half of the chest in breathing, 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, smoothing of the intercostal spaces. For exudative pleurisy, general symptoms are characteristic: weakness, febrile body temperature (with pleural empyema - with chills), loss of appetite, sweating. With encapsulated 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 associated 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 from the external respiration and the cardiovascular system (a significant decrease in the depth of breathing, its increased frequency, the development of compensatory tachycardia, a decrease in blood pressure).

The outcome of pleurisy largely depends on its etiology. In cases of persistent pleurisy, further development of the adhesions in the pleural cavity, overgrowth of interlobar fissures and pleural cavities, the formation of massive moorings, thickening of the pleural sheets, the development of pleurosclerosis and respiratory failure, limitation of the mobility of the dome of the diaphragm are possible.

Along with the clinical manifestations of exudative pleurisy, examination of the patient reveals asymmetry of the chest, swelling of the intercostal spaces in the corresponding half of the chest, lagging of the affected side during breathing. The percussion sound over the exudate is dull, bronchophonia and vocal tremors are weakened, breathing is weak or not heard. The upper border of the effusion is determined by percussion, by X-ray of the lungs or by 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 find out the etiology of pleurisy. Pleural effusion is characterized by a relative density above 1018-1020, 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 determined. To clarify the cause of pleurisy, thoracoscopy with pleural biopsy is performed.

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 non-steroidal anti-inflammatory drugs, glucocorticosteroids. With tuberculous pleurisy, treatment is carried out by a phthisiatrician and consists in specific therapy with rifampicin, isoniazid and streptomycin for several months.

With a symptomatic purpose, the appointment of analgesics, diuretics, cardiovascular agents is shown, after resorption of the effusion - physiotherapy and physiotherapy exercises.

With exudative pleurisy with a large amount of effusion, they resort to evacuation by performing a pleural puncture (thoracocentesis) or drainage. It is recommended to evacuate no more than 1-1.5 liters of exudate at once in order to avoid cardiovascular complications (due to a sharp expansion of the lung and reverse displacement of the mediastinum). With 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 shown rest. To alleviate the pain syndrome, mustard plasters, banks, warming compresses and tight bandaging of the chest are prescribed. In order to suppress cough, the intake of codeine, ethylmorphine hydrochloride is prescribed. In the treatment of dry pleurisy, anti-inflammatory drugs are effective: acetylsalicylic acid, ibuprofen, etc. After the 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 (the introduction of talcum powder or chemotherapy drugs into the pleural cavity for gluing pleural sheets). For the treatment of chronic purulent pleurisy, they resort to surgical intervention - pleurectomy with lung decortation. With the development of pleurisy as a result of an inoperable lesion of the pleura or a lung malignant tumor, according to indications, palliative pleurectomy is performed.

A small amount of exudate can dissolve on its own. The termination of exudation after elimination of the underlying disease occurs within 2-4 weeks. After evacuation of 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 reasons have a progressive course and an unfavorable outcome. Purulent pleurisy differs in an unfavorable course.

Patients who have undergone pleurisy are under dispensary observation for 2-3 years. It is recommended to exclude occupational hazards, fortified and high-calorie food, exclude the cold factor 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.

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Pleurisy symptoms

The main symptom of pleurisy is pain in the side, which increases with inhalation. and coughing. The pain may subside in the position on the affected side. Restriction of respiratory mobility of the proper half of the chest is noted. With percussion sounds, weakened breathing can be heard as a result of the patient's sparing of the affected side, pleural friction noise. The body temperature may rise slightly, chills with the appearance of night sweats are not excluded, and weakness is possible.

It is very difficult to diagnose dry diaphragmatic pleurisy. It is characterized by the following symptoms:

Pain in the chest and chest (hypochondrium), as well as in the lower ribs;
Hiccups;
Stomach ache;
Flatulence;
Abdominal muscle tension;
Pain when swallowing.

To recognize diaphragmatic pleurisy, an X-ray examination will help, which will help to identify the presence of indirect symptoms of a functional disorder of the diaphragm, for example: its high standing and limited mobility on the affected side.

Pleurisy reasons

The reason for the appearance of pleurisy of an infectious nature is directly related to the penetration of pathogens:

Specific infections: Mycobacterium tuberculosis, treponema pale;
Nonspecific infections: pneumococcus, staphylococcus, Escherichia coli.

Pathogens enter the pleura by contact, through the blood and inhaled air with a disturbed pleural cavity. A common cause of pleurisy is systemic diseases in connective tissues (systemic lupus erythematosus, rheumatism). The pathogenesis in most pleurisy is allergic. Pleurisy can last from a couple of days to several months.

Pleurisy can be caused by various chest injuries, as well as penetrating wounds and possible rib fractures.

In a similar situation, this disease is often combined with tuberculosis, pneumothorax and lung tumor.

Pleurisy treatment

Treatment of pleurisy is complex and involves an active effect on the underlying diseases and early suppression of pleurisy. With effusion pleurisy, the patient must be treated in a hospital setting. The course of effective treatment is prescribed by a specialist doctor.

Treatment of patients with pleurisy in the ENT-Asthma clinic is complex and includes the elimination of the causes that caused the development of the disease. If the pleural effusion is not inflammatory in nature, then the treatment is aimed at restoring cardiovascular activity.

Pleurisy treatment in the ENT-Asthma clinic consists of the following components:

Antibiotic therapy is prescribed for infectious and allergic pleurisy, chemotherapy is performed for pleurisy of tumor etiology;
Reorganization of the pleural cavity allows for the evacuation of exudate, if necessary, rinsing with antiseptic solutions is performed;
The positive effect in the treatment of pleurisy is consolidated by the use of desensitizing and anti-inflammatory drugs;
The use of funds that are aimed at mobilizing the protective and immunobiological reactions of the body, that is, to increase immunity.

In addition to the prescribed treatment of pleurisy, phytoapitherapy can be used, which has a special recipe and is chosen by an experienced specialist of the ENT-Asthma clinic. After a full cycle of pleurisy treatment in our clinic, breathing is stabilized, and the lost immunity is restored, the general condition of the patient's body improves.

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Characteristics of the disease and types of pleurisy

Pleurisy is an inflammation of the pleura - the serous membrane that envelops the lungs. The pleura looks like translucent connective tissue sheets. One of them is adjacent to the lungs, the other lines the chest cavity from the inside. In the space between them, fluid circulates, which ensures the sliding of the two layers of the pleura during inhalation and exhalation. Its amount normally does not exceed 10 ml. With pleurisy of the lungs, fluid accumulates in excess. This phenomenon is called pleural effusion. This form of pleurisy is called effusion, or exudative. It occurs most frequently. Pleurisy can be dry - in this case, fibrin protein is deposited on the surface of the pleura, the membrane thickens. However, as a rule, dry (fibrinous) pleurisy is only the first stage of the disease, which precedes the further formation of exudate. In addition, when the pleural cavity is infected, the exudate may be purulent.

As already mentioned, medicine does not classify pleurisy as an independent disease, calling it a complication of other pathological processes. Pleurisy may indicate lung disease or other diseases that do not damage the lung tissue. By the nature of the development of this pathological condition and the cytological analysis of the pleural fluid, along with other studies, the doctor is able to determine the presence of the underlying disease and take adequate measures, but pleurisy itself requires treatment. Moreover, in the active phase, he is able to come to the fore in the clinical picture. That is why, in practice, pleurisy is often called a separate respiratory disease.

So, depending on the state of the pleural fluid, there are:

purulent pleurisy;
serous pleurisy;
serous-purulent pleurisy.

The purulent form is the most dangerous, since it is accompanied by intoxication of the whole body and, in the absence of proper treatment, threatens the patient's life.

Pleurisy can also be:

acute or chronic;
severe or moderate;
affect both parts of the chest or manifest on only one side;
development is often provoked by an infection, in this case it is called infectious.

The list of non-infectious causes of pulmonary pleurisy is also wide:

connective tissue diseases;
vasculitis;
pulmonary embolism;
chest trauma;
allergy;
oncology.

In the latter case, we can talk not only about the lung cancer itself, but also about tumors of the stomach, breast, ovaries, pancreas, melanoma, etc. When metastases penetrate into the lymph nodes of the chest, lymph outflow is slower, and the pleura becomes more permeable.

Fluid seeps into the pleural space. It is possible to close the lumen of a large bronchus, which lowers the pressure in the pleural cavity, which means it provokes the accumulation of exudate.

In non-small cell lung cancer (NSCLC), pleurisy is diagnosed in more than half of the cases. With adenocarcinoma, the frequency of metastatic pleurisy reaches 47%. With squamous cell lung cancer - 10%. Bronchiolo-alveolar cancer leads to pleural effusion at an early stage, and in this case, pleurisy may be the only signal for the presence of a malignant tumor.

Depending on the form, the clinical manifestations of pleurisy differ. However, as a rule, it is not difficult to determine the pleurisy of the lungs. It is much more difficult to find the true cause that caused the inflammation of the pleura and the appearance of pleural effusion.

Pleurisy symptoms

The main symptoms of pulmonary pleurisy are chest pain, especially when inhaling, a cough that does not bring relief, shortness of breath, a feeling of tightness in the chest. Depending on the nature of the pleural inflammation and localization, these signs may be obvious or almost absent. With dry pleurisy, the patient feels pain in the side, which intensifies when coughing, breathing becomes difficult, weakness, sweating, chills are not excluded. The temperature remains normal or rises slightly - no more than 37 ° C.

With exudative pleurisy, weakness and poor health are more pronounced. The fluid accumulates in the pleural cavity, compresses the lungs, prevents them from straightening. The patient cannot fully inhale. Irritation of the nerve receptors in the inner layers of the pleura (there are practically no them in the lungs themselves) causes a symptomatic cough. In the future, shortness of breath and heaviness in the chest only increase. The skin becomes pale. A large accumulation of fluid prevents the outflow of blood from the cervical veins, they begin to bulge, which eventually becomes noticeable. The part of the chest affected by pleurisy is limited in movement.

With purulent pleurisy, noticeable temperature fluctuations are added to all the above signs: up to 39-40 ° in the evening and 36.6-37 ° in the morning. This indicates the need for urgent medical attention, since the purulent form is fraught with serious consequences.

Pleurisy is diagnosed in several stages:

Examination and questioning of the patient... The doctor finds out the clinical manifestations, the duration of the occurrence and the patient's level of well-being.
Clinical examination... Various methods are used: auscultation (listening with a stethoscope), percussion (tapping with special instruments for the presence of fluid), palpation (feeling to identify painful areas).
X-ray and CT... X-ray allows you to visualize pleurisy, assess the volume of fluid, and in some cases, reveal metastases in the pleura and lymph nodes. Computed tomography helps to establish the prevalence more accurately.
Blood test... With an inflammatory process in the body, ESR, the number of leukocytes or lymphocytes increases. This study is necessary to diagnose infectious pleurisy.
Pleural puncture... This is the collection of fluid from the pleural cavity for laboratory research. The procedure is carried out when there is no threat to the patient's life. If too much fluid has accumulated, pleurocentesis (thoracocentesis) is immediately performed - removal of exudate through a puncture using a long needle and electric suction, or a port system is installed, which is the preferred solution. The patient's condition improves, and part of the fluid is sent for analysis.

If, after all the stages, the exact picture remains unclear, the doctor may prescribe a videothoracoscopy. A thorascope is inserted into the chest - this is an instrument with a video camera that allows you to examine the affected areas from the inside. If we are talking about oncology, it is necessary to take a fragment of the tumor for further research. After these manipulations, it is possible to make an accurate diagnosis and start treatment.

Treatment of the condition

Treatment of pleurisy of the lungs should be comprehensive, aimed at eliminating the disease that caused it. Therapy of pleurisy itself, as a rule, is symptomatic, designed to accelerate the resorption of fibrin, to prevent the formation of adhesions in the pleural cavity and fluid "bags", to alleviate the patient's condition. The first step is to remove the pleural edema. At a high temperature, the patient is prescribed antipyretics, for pain - analgesic NSAIDs. All these actions allow to stabilize the patient's condition, normalize the respiratory function and effectively treat the underlying disease.

Treatment of pleurisy in a mild form is possible at home, in complex - exclusively in a hospital. It can include different methods and techniques.

Thoracocentesis ... This is a procedure in which accumulated fluid is removed from the pleural cavity. Assign in all cases of effusion pleurisy in the absence of contraindications. Thoracocentesis is performed with caution in the presence of pathology of the blood coagulation system, increased pressure in the pulmonary artery, obstructive pulmonary disease in a severe stage, or the presence of only one functional lung.

Local anesthesia is used for the procedure. A needle is inserted into the pleural cavity on the side of the scapula under ultrasound control and exudate is taken. The compression of the lung tissue is reduced, and it becomes easier for the patient to breathe.
Often, the procedure needs to be repeated; for this, modern and completely safe interpleural port systems providing constant access to the pleural cavity both for evacuation of exudate and for administration of drugs, including in the framework of chemotherapy.
This is a system consisting of a catheter, which is inserted into the pleural cavity, and a titanium chamber with a silicone membrane. Installation requires only two small incisions, which are later sutured. The port is placed in the soft tissues of the chest wall, under the skin. In the future, it does not cause any inconvenience to the patient. The manipulation takes no more than an hour. The patient can go home the very next day after the port is installed. When it is necessary to evacuate the exudate again, it is enough to pierce the skin and the silicone membrane under it. It is fast, safe and painless. With a sudden need and lack of access to medical care, with a certain skill and knowledge of the rules of the procedure, even relatives are able to independently free the patient's pleural cavity from fluid through the port.
Another type of intervention is pleurodesis ... This is an operation to artificially create adhesions between the sheets of the pleura and destroy the pleural cavity so that there is nowhere for fluid to accumulate. The procedure is usually prescribed for cancer patients if chemotherapy is ineffective. The pleural cavity is filled with a special substance that prevents the production of exudate and has an antitumor effect - in the case of oncology. These can be immunomodulators (for example, interleukins), glucocorticosteroids, antimicrobial agents, radioisotopes and alkylating cytostatics (derivatives of oxazaphosphorine and bis -? - chloroethylamine, nitrosourea or ethylenediamine, platinum preparations, alkyl sulfonates, triazines or tetrazines) ...
If the above methods fail, it is shown removal of the pleura and placement of the shunt ... After shunting, fluid from the pleural cavity passes into the abdominal cavity. However, these methods are classified as radical, capable of causing serious complications, so they are resorted to last.
Drug treatment ... In the case when pleurisy is of an infectious nature or complicated by an infection, antibacterial drugs are used, the choice of which depends entirely on the type of pathogen and its sensitivity to a specific antibiotic. Medicines, depending on the nature of the pathogenic flora, can be:

natural, synthetic, semi-synthetic and combined penicillins (benzylpenicillin, phenoxymethylpenicillin, methicillin, oxacillin, nafcillin, ticarcillin, carbpenicillin, "Sultasin", "Oxamp", "Amoxiclav", mezlocillin, azlocillin, mecillam);
cephalosporins ("Mefoxin", "Ceftriaxone", "Keyten", "Latamokcef", "Cefpirom", "Cefepim", "Zefter", "Ceftolosan");
fluoroquinolones ("Microflox", lomefloxacin, norfloxacin, levofloxacin, sparfloxacin, moxifloxacin, gemifloxacin, gatifloxacin, sitafloxacin, trovafloxacin);
carbapenems ("Tienam", doripenem, meropenem);
glycopeptides ("Vancomycin", "Vero-Bleomycin", "Targotsid", "Vibativ", ramoplanin, decaplanin);
macrolides ("Sumamed", "Yutatsid", "Rovamycin", "Rulid");
ansamycins ("Rifampicin");
aminoglycosides (amikacin, netilmicin, sisomycin, isepamycin), but they are incompatible with penicillins and cephalosporins with simultaneous therapy;
lincosamides (lincomycin, clindamycin);
tetracyclines (doxycycline, "Minolexin");
amphenicols ("Levomycetin");
other synthetic antibacterial agents (hydroxymethylquinoxalindioxide, fosfomycin, dioxidine).

For the treatment of pleural inflammation, anti-inflammatory and desensitizing drugs are also prescribed (electrophoresis of a 5% solution of novocaine, analgin, diphenhydramine, a 10% solution of calcium chloride, a 0.2% solution of platifillin hydrotartrate, indomethacin, etc.), regulators of water-electrolyte balance ( saline and glucose solution), diuretics ("Furosemide"), electrophoresis of lidase (64 units every 3 days, 10-15 procedures per course of treatment). They can prescribe funds for the expansion of the bronchi and cardiac glycosides that enhance the contraction of the myocardium ("Euphyllin", "Korglikon"). Pulmonary pleurisy in oncology responds well to chemotherapy - after it, edema and symptoms usually go away. Medicines are administered systemically - by injection or intrapleurally through the membrane valve of the port system.

According to statistics, courses of chemotherapy in combination with other methods of treatment help to eliminate pleurisy in about 60% of patients sensitive to chemotherapy.

During the course of treatment, the patient must be constantly under the supervision of a physician and receive supportive therapy. After the end of the course, it is necessary to conduct an examination, and after a few weeks, appoint it again.

Disease prognosis

Launched forms of pleurisy of the lungs can have severe complications: the occurrence of pleural adhesions, bronchopleural fistulas, circulatory disorders due to vascular compression.

In the process of development of pleurisy, under the pressure of fluid, arteries, veins and even the heart are able to shift in the opposite direction, which leads to an increase in intrathoracic pressure and a violation of blood flow to the heart. In this regard, the prevention of pulmonary heart failure is the central task of all therapeutic measures for pleurisy. If displacement is detected, the patient is shown an emergency pleurocentesis.

A dangerous complication is empyema - the formation of a "pocket" with pus, which ultimately can lead to scarring of the cavity and the final bricking up of the lung. A breakthrough of purulent exudate into the lung tissue is fatal. Finally, pleurisy can cause parenchymal amyloidosis or kidney damage.

Special attention is paid to pleurisy when diagnosing it in cancer patients. Pleural effusion aggravates the course of lung cancer, increases weakness, gives additional shortness of breath, and provokes pain. When the vessels are squeezed, the ventilation of the tissue is disturbed. Taking into account the immune disorders, this creates a favorable environment for the spread of bacteria and viruses.

The consequences of the disease and the chances of recovery depend on the underlying diagnosis. In cancer patients, fluid in the pleural cavity usually accumulates in the advanced stages of cancer. This makes treatment difficult, and the prognosis is often poor. In other cases, if the fluid from the pleural cavity was removed on time and adequate treatment was prescribed, there is no threat to the patient's life. However, patients need regular monitoring in order to diagnose a relapse in time when it appears.

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Symptoms of the disease and its diagnosis

The main symptom of pleurisy is pain in the side. It intensifies during inhalation when the patient coughs. If you lie on the affected side, the pain subsides. The inflamed side of the chest is characterized by low mobility; noises are heard when listening. There may be a slight increase in body temperature, chills often appear, the patient sweats a lot at night.

As for dry pleurisy, its symptoms are somewhat different:

pain in the hypochondrium;
the occurrence of hiccups;
abdominal pain;
strong gassing;
pain when swallowing;
tension in the abdominal muscles.

Diaphragmatic pleurisy can be diagnosed with an x-ray. It can show deviations in the position of the diaphragm and its mobility.

Methods for the treatment of pulmonary pleurisy in adults

Pleurisy treatment is a course of measures aimed at relieving symptoms and eliminating the cause of the disease. Pleurisy caused by pneumonia is treated with antibiotics. As for rheumatic pleurisy, the main drugs used to treat it are non-steroidal drugs that relieve inflammation, glucocorticosteroids. Tuberculous pleurisy is treated with the help of a phthisiatrician. Rifampicin, isoniazid, streptomycin are used as therapy. The treatment period is several months. To eliminate symptomatic manifestations, the following are prescribed:

pain relievers;
diuretics;
cardiovascular drugs.

Treatment of exudative pleurisy occurs by collecting an effusion. This procedure is called pleural puncture or drainage. If relapses occur, a pleurodesis procedure is necessary - the pleural area is filled with talcum powder or chemotherapy drugs that stick the pleural sheets together.

Treatment of acute purulent pleurisy consists in flushing the pleural cavity with solutions with antiseptics. Antibiotics are injected into the pleural cavity. Quite often, in the complex, injections of drugs such as hydrocortisone and enzymes are made. Treatment of chronic purulent pleurisy requires the intervention of surgeons. They perform pleurectomy and lung decortication.

Treatment for dry pleurisy requires a state of rest. In order to relieve pain, the patient's chest is tightly bandaged, warming it with lotions. They also carry out drug therapy, prescribing:

codeine;
dionine;
acetyl;
ibuprofen.

If the state of health has returned to normal, the patient is recommended to conduct breathing exercises, which improves the process of pleural fusion.

Traditional methods of treating pleurisy. Preventive measures

Medicinal treatment of pleurisy is allowed to be supplemented with traditional medicine. To alleviate the disease, apply:

onion juice and honey;
insist and take horsetail;
drink a decoction of anise seeds, supplemented with licorice root, marshmallow, sage leaves and young pine shoots;
insist mint, elecampane, licorice root, marsh cinnamon, coltsfoot;
calamus root is brewed quite often;
drink freshly squeezed beet juice.

Patients who have undergone a course of treatment for pleurisy are observed in the dispensary for up to 3 years.

To prevent relapses, it is necessary to monitor nutrition, temperature, and exclude colds.

Preventive measures for the occurrence of pleurisy of various etymologies are the timely treatment of diseases that lead to their development, as well as adherence to a healthy lifestyle. You need to monitor your health, take vitamins and other complexes that keep the human body in good shape.

The main thing is to remember that treating pleurisy at home is unacceptable! Such negligence can cost a person his life.

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Pleurisy is an inflammation of the membranes surrounding the lungs(pleural petals). With it, fluid accumulates in the pleural cavity, which makes it difficult for the lungs to expand and interferes with the mobility of the chest. From this, the work of the respiratory, cardiovascular systems worsens, and after them others.

Pleurisy can be a complication after pneumonia, tuberculosis, or breast surgery. If left untreated, inflammation of the pleura can lead to hypertrophy of the myocardium of the right ventricle of the heart(called cor pulmonale) or respiratory failure, and then death.

Varieties of the disease

Purulent pleurisy- This is a disease that provokes the accumulation of purulent effusion in the pleura of the lungs. At the same time, the parietal and pulmonary membranes become inflamed.
At exudative type between the layers of the pleura, fluid is formed and retained. This may be due to a lesion of an infectious, neoplastic or other nature.
Dry (fibrous) type often a complication of other diseases of the lungs or organs located near the pleural cavity, or serves as a symptom of general diseases. There may be a slight discharge of fluid, and the surface of the pulmonary pleura is covered with a layer of fibrin (protein).
Tuberculous pleurisy affects the serous membranes that form the pleural cavity and cover the lungs. The main symptom of the disease is increased fluid secretion or fibrin deposition on the pleural surface.

The disease is called unilateral with damage to one lung(left-handed or right-handed), bilateral with two.

Acute pleurisy is usually accompanied by an accumulation of pus in the pleura, and is a secondary disease in inflammatory lung diseases, including croupous and postinfluenza pneumonia. With contributing factors, the acute form of the disease becomes chronic.

This classification is rather arbitrary, since one species can pass into another. Moreover, dry and exudative (effusion) pleurisy are considered by most pulmonologists as different stages of the same disease. It is believed that at first dry pleurisy is formed, and effusion develops only with the further development of the inflammatory reaction.

Pleural cavity of the lungs - what is it?

The pleural cavity is a narrow gap located between the pulmonary pleura (the membrane that covers the lungs) and the wall pleura. It contains a small volume of pleural fluid, which serves as a kind of lubricant; when breathing, it reduces friction. The pleural cavity is closed from above by the chest wall (with ribs), and from the base by the diaphragm.

Causes of the disease

Pleurisy can be primary in nature - when the inflammation is isolated and includes only the pleura (without the involvement of the pulmonary parenchyma). However, it is most often a complication of diseases occurring in the surrounding tissues, such as:

pneumonia;
tuberculosis;
pulmonary embolism;
lung cancer.

The disease can also be caused by heart, liver and kidney failure, hormonal imbalances, pancreatitis and gastrointestinal diseases. Trauma to the chest with fractured ribs can contribute to its development.

Symptoms

Pleurisy symptoms can appear suddenly. First, there is a sharp, burning pain in the chest, which is located in a certain part of it. Characterized by pain, aggravated at the top of inhalation (which makes it impossible to inhale correctly, deeply and freely), as well as with any vibrations in the chest area, for example, when coughing, sneezing. The pain disappears when breathing stops, as well as when the patient takes a lying position on the affected side.

Concomitant symptoms are, as a rule, dry cough and low-grade fever or fever. As fluid accumulates in the cavity, the pain disappears, but shortness of breath appears, breathing becomes difficult and accelerates.

Diagnostic methods

If you suspect pleural inflammation, a specialist examination with a stethoscope, blood tests and a chest x-ray are performed. The doctor can also refer the patient for ultrasound and tomography. The final diagnosis is made after puncture of the pleural cavity and examination of the loaded fluid.

Pleurisy treatment

Medication

The method of treatment is selected in accordance with the cause of the disease. One of the primary tasks is to reduce and eliminate the inflammatory process. In case of accumulation of a large volume of fluid in the lungs, puncture and drainage are used.

Antibiotics are effectively used to treat pleurisy. Most often, drugs such as cefazolin and abactal.

Any treatment should be carried out under the guidance of a physician.

Folk remedies

At home, pleurisy can be treated if the disease is mild. They can be helpful, but they must be used with caution.

Pleurisy Aloe Recipe

Aloe can be an excellent remedy for treating a mild form of the disease.

Fresh aloe leaves need to be washed and thorns cut off. Then finely chop. Take 300 grams of chopped aloe leaves and add 250 grams of badger fat, and 300 grams of natural honey. Mix everything thoroughly and put in the oven for 15-20 minutes. As a result, a liquid should appear, which must be drained, filtered and poured into a glass container.
Take this liquid after meals 3 times a day for 1/3 cup.

Radish recipe

Also, radish juice is used to treat pleurisy at home. They get it like this: chop the radish and squeeze the juice. Mix the juice with natural honey in equal proportions. Take medicated syrup 3 times a day for 1 tbsp. spoon.

Grind 150 g of horseradish and add the juice of 3 lemons. Mix. For treatment, take 1 teaspoon in the morning and evening.

However, I repeat: all these tools must be used only after consulting a doctor and refer to mild forms of the disease... More severe forms, as well as purulent pleurisy is treated only in a hospital medications such as antibiotics.

Prophylaxis

Keep your lungs. Chemical contamination of the respiratory system is considered one of the main causes of tuberculosis, which in turn can lead to inflammation of the pleura.
Practice breathing exercises: a few deep breaths after waking up fill the lungs with oxygen, strengthen the tone, etc. This significantly reduces the risk of respiratory diseases.
Monitor your immunity. Get tempered, breathe fresh air, eat well.
In order not to infect the mucous membranes of the respiratory tract, and then into the pleural cavity, try at the first symptoms of their appearance.
If it is not uncommon for you, then try not to change the climate. Sea, forest and mountain air can play a good role in the prevention of pleurisy and other diseases.
If you have symptoms of serious illness, see your doctor, do the necessary tests, fluorography and examinations. Correct treatment reduces the risk of complications.

Disease code according to ICD 10 (International Classification of Diseases): R09.1

Also interesting:

- it is dangerous for its complications, which can significantly worsen a person's condition. These are serious conditions that require treatment in a hospital setting, often using surgical techniques. The article will focus on the most common complications of pleurisy and how to treat them.

Formation of adhesions in the pleural cavity

The pleural cavity is the space that surrounds each lung and is limited by the parietal, or parietal (lining the chest from the inside), and pulmonary, or visceral (covering each lung), pleura.

Exudate components and fibrin can cause pleural adhesions

Normally, the pleural cavity contains 2-5 ml of synovial fluid, which has a shock-absorbing function during breathing. With various diseases of the lungs, the disease sometimes affects the pleural cavity, then an inflammatory fluid (exudate) can accumulate in it; in this case, exudative pleurisy develops. Or fibrin (dry fibrinous pleurisy) is deposited on the walls of the pleural cavity. As the patient recovers, the inflammation in the pleural cavity subsides, the fluid (if it was present in a small amount and did not need to be removed) is absorbed. However, the components of the exudate and fibrin can be retained in the pleural cavity. In this case, they are the reason for the formation of adhesions in the pleural cavity - adhesions between the visceral and parietal pleura.

Adhesions prevent the lungs from fully functioning during breathing.

Adhesions prevent the lungs from working fully during breathing: they expand on inhalation and subside on exhalation. This affects the respiratory function and the person's well-being: shortness of breath occurs when performing physical activity, which was previously well tolerated, a feeling of "incomplete inhalation", the word something interferes with "inhaling deeply". Due to insufficient breathing, the body experiences hypoxia, which is manifested by weakness, drowsiness, dizziness, and fainting.

In order to prevent the formation of adhesions in the pleural cavity, you can perform a simple exercise: after a deep breath, exhale deeply, while spreading straight arms to the sides as much as possible and holding your breath (on exhalation) for 15-20 seconds. Performing this exercise, you move the visceral and parietal pleura apart from each other and increase the distance between them, thereby preventing them from sticking together and the formation of adhesions.

Already formed adhesions in the pleural cavity are removed only by surgery.

Circulatory disorder

A large amount of fluid compresses the vessels of the lungs, disrupting the blood flow through them

This complication is typical primarily for exudative pleurisy. The volume of fluid in the pleural cavity may vary. Cases are known when up to 2 liters of exudate were removed during pleural puncture.

A large amount of fluid compresses the vessels of the lungs, disrupting the blood flow through them. Clinically, this is manifested by shortness of breath on exertion (or at rest), cough with sputum (there may be blood streaks), pain in the chest, a feeling of inability to take a “deep breath with a full breast,” a feeling of “bursting” in the chest. Large volumes of fluid are removed from the pleural cavity by pleural puncture.

The essence of the operation: the surgeon pierces the chest and pumps out the fluid from the pleural puncture with a syringe.

A small amount of fluid in the pleural cavity, which does not require removal, resolves, as a rule, on its own. But there is an exercise that helps speed up this process: take a deep breath, wrap your hands around your knees and hold your breath (while inhaling) for 15-20 seconds. In this position, you create increased pressure in the pleural cavity, thereby increasing the absorption of fluid by the pleural layers.

The fluid is removed from the pleural cavity by pleural puncture

Empyema of the pleura

Empyema of the pleura - inflammation of the pleura with the accumulation of pus in the pleural cavity. In 88% of cases, empyema is the result of an infectious lesion of the lungs that occurs with the breakdown of lung tissue (abscess,

The structure of our lungs is thought out by nature to the smallest detail. This organ does not stop its work throughout life, supplying oxygen to the blood and removing carbon dioxide. But, at the same time, he is quite vulnerable and can easily take over infections of other organs. Often these lesions result in a disease called pulmonary pleurisy. What is it, how to treat it, and what are the consequences and symptoms of such a disease? Is traditional medicine able to help treat this disease, and if so, how?

What is pleura and what is it for?

The lungs are a bipartite symmetrical organ located in the chest cavity. It is covered with two layers of a thin protective film called pleura. One of them envelops the lung itself, but the other lines the inner side of our chest. A small amount of fluid is formed between these tissues, which is necessary so that the pleural sheets do not rub against each other or against the chest cavity during enlargement and contraction (inhalation and exhalation). Normally, for the normal sliding of these sheets, 2 ml of pleural fluid is enough. But it happens that these membranes become inflamed, and a large amount of exudate (liquid) is formed between them. Such a pathology in medicine is called What is it and how to treat it?

Why is this happening?

In fact, pleurisy is the body's reaction to other diseases, therefore it is correct to call it a symptom, not a disease. Such a course can be caused by completely different factors: mechanical injury to the lung or ribs, infectious lesions, oncological or other general systemic pathologies. The disease is accompanied by hypoxia, pain in the lung area. To prescribe treatment, a specialist must determine which type of disease belongs to and as a result of which it arose. The most common cause of such a disease is precisely infectious diseases that a person becomes infected with when the immune system is weakened.

Several forms are distinguished among the infectious ones:

Specific - the causative agents are syphilis, tubercle bacillus, etc.
Nonspecific - causes of pleurisy of the lungs: putrefactive and any other bacteria, fungi or viruses (staphylococci, pneumococci, streptococci and others).
Purulent - divided by severity. May occur due to (cancer, leukemia, sarcoma and other serious diseases).

Classification of the disease

The disease - pleurisy of the lungs - can also occur due to other diseases not associated with infectious lesions. These are arthritis, diseases of the digestive system, heart disorders or gynecological problems.

By the nature of the lesion, pleurisy is divided into:

escudative - fluid is formed and retained between the layers of the pleura;
fibrous - the secretion of fluid is scarce, but the surface of the pleural walls itself is covered with a layer of fibrin (protein).

Pleurisy is also divided according to the nature of its distribution. It can affect only one lung or both lobes (unilateral and bilateral).

Symptoms

Based on the collection of anamnesis and all accompanying tests, the doctor diagnoses - pleurisy of the lungs. The symptoms and the treatment to be carried out are closely related. Each form of pleurisy is treated with certain medications and may require surgery.

The main symptoms are:

Pain when inhaling in the side where the affected lung is located. It intensifies with a dry cough and can be given to the region of the heart and abdomen.
Difficulty breathing, pain when swallowing, painful hiccups.
The patient may notice a feeling of tightness in the lung area.
Excruciating dry cough and shortness of breath.
Malaise, fever, loss of appetite, headache are symptoms of body poisoning with toxins in the pleural cavity.
The patient's skin becomes cyanotic. The venous veins in the neck enlarge, and the pulse quickens.
In the area of fluid accumulation, swelling may be observed (in the intercostal space).

Diagnostics

There are many pathological processes that are similar in their symptoms to a disease such as pleurisy of the lungs. What it is, the doctor must determine. During the examination, the patient is assigned an X-ray examination and for the collection and examination of fluid. Ultrasound, ECG, CT with a contrast agent can also be performed. A blood test is performed for bacteriology and histology.

Treatment

If you have been diagnosed with pleurisy of the lungs, what is it, how to treat the disease - the attending physician will explain. The inflammatory process in the pleural area is a reason for hospitalization. The patient is prescribed complete or partial rest. Such a lesion is caused by another initial disease, therefore pleurisy is treated symptomatically, but the main treatment will already be aimed at eradicating the root cause of the diagnosis of pulmonary pleurisy. Symptoms and treatment are closely related. The patient may require pleural punctures or drainage of the pleural area. This will allow you to pump out the collected fluid, rinse the cavity with antibiotic-containing solutions and ensure the outflow of pus. Additionally, immunostimulating drugs, antibiotics, anti-inflammatory drugs and vitamins are prescribed. If the patient has a severe dry cough, the chest is bandaged and antitussives are prescribed. In general, doctors give a favorable prognosis for the diagnosis of pulmonary pleurisy. What it is, how to treat - folk medicine also knows well. Let's see how she can help.

ethnoscience

Herbal treatments are used frequently and effectively in home treatments. Many fees are compiled taking into account anti-inflammatory, expectorant and immune-enhancing herbs. But it should be borne in mind that pleurisy is a serious and complex disease that cannot be treated exclusively with herbs. A purulent disease can be fatal and should be treated exclusively under the supervision of a specialist. But in combination with pharmaceuticals, home remedies are quite capable of helping to heal pulmonary pleurisy. What is it, how to treat folk remedies? Here are some guidelines.

Scarlet, honey and badger fat have proven themselves very well in the treatment of respiratory organs. Take a glass of honey and badger fat, add 300 g of chopped scarlet leaves to them. Mix and place in the oven for 15 minutes. Strain the composition and take a tablespoon before each meal.
Radish with honey - this is how our great-grandfathers were treated. Take a large black radish, cut off the tail with a "lid", cut the core at the root so that it looks like a bowl. Pour honey into it, close the "lid" and leave to infuse overnight. Take a tablespoon before meals. This same remedy is great for helping children with colds.
This remedy is good for fibrotic disease. Take 2 cups of white wine, add ½ cup honey and 300 g of chopped onions. Mix and leave in a dark place for a week. You need to take the composition before eating a tablespoon.
For escudative pleurisy: prepare a decoction of linden flowers and birch buds. Pour 100 g of linden and 75 g of buds with 2 cups of boiling water, boil for about 20 minutes. Let cool. Then strain and add to it 100 g of aloe juice and honey. Warm up again, cool and pour in some vegetable oil. Drink 2 tablespoons before meals.

With pleurisy, decoctions of herbs help well: linden, dried cress, coltsfoot, plantain, St. John's wort, licorice root and elecampane, willow bark, fennel fruits. You can brew these gifts of nature and drink instead of tea with the addition of honey.

Complications

Why is pleurisy of the lungs dangerous and how to treat it correctly? The main thing is to seek help in a timely manner and strictly follow the recommendations of a specialist. Only a doctor can prescribe the correct and effective treatment, but self-help medicine can lead to a number of complications. Among them - the formation of adhesions, as a result - respiratory failure. Untimely treatment can lead to intoxication of the body. Purulent infectious pleurisy is especially dangerous. Purulent lesions may require surgical removal. Doctors give a good prognosis with proper and timely treatment. The most difficult cases include oncological manifestations and necrosis of lung tissue.

How not to get sick

According to statistics, every tenth of us annually suffers a disease such as pleurisy of the lungs. What it is, you now know, it remains only to remember a few simple rules that will help prevent the development of this complication.

Always seek medical help promptly if you feel unwell. A common ARI can easily turn into pleurisy.
Follow the rules of hygiene, adhere to a complete and timely diet. In the cold season, include vitamins in your diet. Strong immunity is the key to health.
Get rid of bad habits - smoking will never add health to you or your lungs.
Do not overwork, take the allotted time to sleep and make a good habit of running in the morning or doing gymnastics.

Remember that pleurisy is a consequence of another disease. Never interrupt your treatment halfway because of banal laziness or lack of time, and always try to avoid situations that can provoke an infection. Only a sensitive attitude towards yourself and your loved ones will help you maintain health until a ripe old age.

Pleurisy. What it is?

Causes of pleurisy of the lungs

Classification

Dry (fibrous)

Exudative (exudative) pleurisy

Tuberculous

Purulent

Encapsulated pleurisy

Symptoms of pulmonary pleurisy

Diagnostics

How is pleurisy treated?

Bed rest and a gentle diet

Drug therapy

Physiotherapy procedures

Surgical intervention

Video

Pleurisy symptoms depending on the type

General principles of pleurisy treatment

Medicines for the treatment of pleurisy

Treatment of pleurisy with folk remedies

How to treat pleurisy in pregnant women and children

Possible complications of pleurisy

Types and causes of pleurisy

Pathogenesis

Danger of pleurisy

Pleurisy symptoms

Diagnosis of pleurisy

Pleurisy treatment

Complications of pleurisy

Recovery from illness and prevention of pleurisy

Pleurisy

Exudative pleurisy

Pleurisy symptoms

Pleurisy reasons

Pleurisy treatment

Characteristics of the disease and types of pleurisy

Pleurisy symptoms

Treatment of the condition

Disease prognosis

Symptoms of the disease and its diagnosis

Methods for the treatment of pulmonary pleurisy in adults

Traditional methods of treating pleurisy. Preventive measures

Varieties of the disease

Pleural cavity of the lungs - what is it?

Causes of the disease

Symptoms

Diagnostic methods

Pleurisy treatment

Medication

Folk remedies

Pleurisy Aloe Recipe

Radish recipe

Prophylaxis

Also interesting:

Formation of adhesions in the pleural cavity

Circulatory disorder

Empyema of the pleura

What is pleura and what is it for?

Why is this happening?

Classification of the disease

Symptoms

Diagnostics

Treatment

ethnoscience

Complications

How not to get sick

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