Therapeutic measures in case of symptoms air cavities in the lungs are directed to treatment of the underlying disease, early adequate drainage of the air cavity, the bronchial tree sanitation, stimulation of reparative and regenerative processes in the area of destruction of lung tissue.In cases of chronic or complicated course of an air cavity in the lungs leading role played by surgical methods of treatment.
air cavities in the lungs Treatment
air cavities in the lungs Treatment with antibiotics
the presence of purulent infection in the air cavity in the lung for the treatment carried out massive causal antibiotic therapy in the form of successive replacement treatments.In determining the true pathogen festering for air cavities in the lungs should
replacement immunotherapy for the treatment of air cavities in the lungs
In severe purulent staphylococcus intoxication carried substitution immunotherapy for the treatment of: antistaphylococcal hyperimmune plasma 150 - 200 ml a day (at the rate of 3 - 5 injections), antistaphylococcal gamma globulin intramuscularly3 - 5 ml every other day (5 - 10 injections).From day treatments above the air cavity in combination with the lung detoxification therapy (intravenous gemodeza, poliglyukina, 40% glucose solution, plasma, etc.).With significant amounts of an abscess or a subpleural location, effective transthoracic puncture for the treatment of air cavities in the lungs for the purpose of aspiration purulent masses, followed by washing the cavity with antiseptic solutions, the introduction of enzymes and antibiotics.
Remediation of the bronchial tree for the treatment of air cavities in the lungs
This is an important and indispensable component of complex treatment of contaminated air in the lung cavity.
To apply this treatment inhalation and intrabronchial instillation via laryngeal syringe or bronchoscopy solutions containing antibiotics, antiseptics and mucolytics.
simultaneously used helper methods of treatment air cavities in the lungs, promotes discharge of phlegm, - postural drainage, breathing exercises, vibration massage chest.
are used for the treatment of air cavities in the lungs and expectorant drugs and means of thinning phlegm (thermopsis, marshmallow root, a 3% solution of potassium iodide), proteolytic enzymes (trypsin, himopsin), mucolytic agents (mukaltin, acetylcysteine, bisolvon).
With symptoms of bronchospasm indicated for the treatment of air cavities in the lungs bronchodilators and antispasmodics, which at the same time relieve spastic reactions of the pulmonary vessels:
- eufillin and its derivatives,
- holinoliticheskie means (platifillin, papaverine, no-spa),
- desensitizing agents (calcium chloride 10% solution of 10 ml intravenously, suprastin, diphenhydramine, etc.)
treatment of air cavities in the lungs via catheterization
highly effective rehabilitation method for the treatment of poor drainageContaminated air in the lung cavity is controlled catheter, which allows the catheter to bring the cavity aspirate purulent mass and administered antibiotics in the treatment cavity.To stimulate reparative and regenerative processes in the area of destruction of lung tissue and strengthen the immune-biological body's defenses are shown transfusion of fresh blood of 250 - 400 ml one - two times a week, plasma belkovosoderzhaschih agents (casein, aminopeptid, aminokrovin, albumin), anaboliticheskih hormones (nerbol, retabolil).As the regeneration in the treatment of stimulant in the air cavity light used purine and pyrimidine bases: Riboxinum, metilurotsil, pentoxyl, orotic acid.With the ineffectiveness of conservative surgery is performed: usually resection of the affected lobe and most of the light.
Symptoms of air cavities in the lungs
symptoms and the clinical picture of the air cavity in the lungs
The main symptoms of patients with air cavity in the lungs are productive cough, hemoptysis, and less pain on the affected side, worse when coughing.With the development of respiratory failure may occur shortness of breath and cyanosis.In some cases, the patient coughs infrequently (several times a day), otharkivaya with a large amount of mucus, often unpleasant odor, sometimes fetid.
particularly strong sputum is observed at a certain body position: lying on the right or left side, chest, etc.This cough is characteristic symptoms of bronchiectasis (bronchiectasis caverns, chronic lung abscess), in which the secret accumulates gradually, without causing coughing up until at a certain position of the body outlet bronchus is below the liquid level and the mucous membrane is not irritated by it.
In other cases (acute lung abscess) patient hurts dry cough, at a height which extends pus with an unpleasant smell of putrid sputum, sometimes once in a very large number ( "full mouth").Expectoration of sputum may increase gradually, and her daily amount reaches 500 ml or more, preferably in the morning she is separated.In advanced stages of pulmonary tuberculosis in the presence of a cavity is a cough with purulent, sputum monetoobraznoy.
Additional complaints characterizing the toxicity of the body depend on the drainage of the air cavity of fullness in the lung, it is:
- general weakness,
- anorexia (loss of appetite),
- fever with large its scale,
Diagnostics air cavities in the lungs
objective study of symptoms air cavities in the lungs
An objective examination revealed pallor of the skin and visible mucous membranes.If the air cavity of the infected and the nature of the pathological process of chronic, it is observed clubbing as "drumsticks" and nails in the form of "time windows".Detectable sometimes patient delay in physical and sexual smashing may indicate that the air cavity formed in childhood in his lung.
Patients with a large single air cavity and one-sided arrangement of multiple small cavities are lagging behind the mobility of the affected part of the chest.Over the air cavity is defined by strengthening the voice of jitter caused by the most resonating cavity and infiltrative inflammatory lung tissue seal around it.Character percussion sound depends on the ratio of the liquid in the cavity and air, its size and location of the depth.
If the air cavity of small size, preferably filled with liquid and deeply located, the percussion sound dull.On the surface, the location of a cavity on the background of shortening percussion sound may tympanic shade due to the presence of air in the cavity.If the cavity is large, it is shallow, filled with liquid and air, the percussion sound above the liquid zone is shortened, and the air above the area has a tympanic shade.
Auscultation with air cavities in the lungs
Auscultation over the air cavity usually listened bronchial breathing and sonorous rales.Bronchial breathing is due to the resonance cavity and seal the lung tissue around it due to reactive inflammation.If the cavity is smooth walls, it is located close to the chest, large enough and well communicated with the bronchus, it is possible to listen to amforicheskoe bronchial breathing.It resembles a breathing sound that occurs when blowing a vessel with a narrow neck.
sonority wet wheezing due to dense inflammatory tissue surrounding air cavity.Caliber wet wheezing (large, medium and small bubbling) corresponds to the size of the cavity.So, over the large air cavities containing fluid and communicating with the bronchi (cavity, lung abscess), listened local krupnopuzyrchatye crackles.They are more consistently identified in the morning and change significantly after coughing.Above small cavities listened finely crackles.
Instrumental methods of diagnosis of the air cavity in the lungs
From instrumental methods of diagnostics air cavity in the lung are the most common methods of X-ray and bronchoscopy studies.When X-ray air cavity caused by an infectious destruction, gives a characteristic illumination with the liquid level and a zone of perifocal infiltration.Cavities in pulmonary tuberculosis may have a different view.When infiltrative tuberculosis initially infiltration occurs irregularly shaped with irregular contours.It gradually increases and turns into the cavity uniformly thick walls.Cavity (cavity), resulting in Tuberculomas differ irregularly irregular shape and thick walls.When hematogenous-disseminated tuberculosis cavities, which are formed by the merger and dissolution of tuberculous lesions are thin and smooth wall (the so-called "die-cavity").
for tuberculosis caverns characterized by bronchial outlet "track" to the root of the lung.Around the cavern are patchy education.When cystic bronchiectasis (bronchiectasis cavities) in the lungs are determined by multiple thin-walled cavity.Summation shadows of cavities creates a kind krupnosotovy pattern (pattern "small bubbles").If the process is not complicated by inflammation, then no fluid in the cavity.
lung air cyst - a single rounded education with thin walls.If not deteriorated aerocyst inflammatory process, then there is no liquid content, and in lung tissue around it no infiltrative changes.