Pulmonary emphysema: what it is, symptoms, treatment. Diagnosis and treatment of emphysema

What is emphysema

Emphysema is a chronic lung disease in which the pulmonary vesicles (alveoli) expand, accompanied by destruction of lung tissue. Enlarged air spaces are formed in them, which leads to a narrowing of the airways and a decrease in the gas exchange function of the lungs. At the same time, oxygen absorption decreases and remains in the dilated pulmonary vesicles. carbon dioxide, which leads to shortness of breath.

There are primary and secondary emphysema. The first develops without a previous lung disease, while the second is usually a complication of chronic bronchitis. Primary emphysema is quite rare and affects mainly men in at a young age. In elderly patients, the disease is most often combined with bronchitis or asthma.

Patients with emphysema suffer from shortness of breath, they “puff” with little exertion or even at rest, and exhale with their lips closed. They have low mobility chest on inspiration, and over time it takes on a characteristic “barrel-shaped” shape (widening of the intercostal spaces, bulging of the supraclavicular areas).

Predisposes to the development of emphysema: smoking, including passive smoking ( main factor risk); disturbances of microcirculation of pulmonary vessels; congenital deficiency of the enzyme alpha-1-trypsin; adverse effects environment, mainly polluted air (dust, cadmium compounds, nitrogen oxides, etc.); frequent viral infections; alcohol abuse.

The most dangerous complications of emphysema are chronic respiratory failure, frequent infections, pulmonary hypertension and development pulmonary heart - pathological change structure of the heart (enlargement of the right ventricle and right atrium due to the fact that the pulmonary vessels lose elasticity under the influence high blood pressure in the lungs and cannot “adjust” to changes in blood output).

Treatment of emphysema

Since emphysema in most cases is associated with smoking, you need to give up this bad habit. Inhalation tobacco smoke, including passive, inhibits the function of macrophage cells, destroys the pulmonary membranes and slows down the discharge of mucus. Absolutely quitting smoking can prolong life. Even if you take this step at age 50 or 60, you can slow down the process of lung decay. In addition, quitting smoking makes it possible to engage in physical exercise, which can bring positive effect with emphysema.

Physical activity for emphysema should include exercises to tone the upper body. The fact is that the muscles of the chest, shoulders and neck can participate in breathing movements, which will help to slightly reduce shortness of breath. Second important component medical complex- breathing exercises that activate the diaphragm. The movements of this strong muscle should form the basis of inhalation and exhalation. Most adults breathe incorrectly - their diaphragm does not work enough, which causes the oxygen supply to the body to deteriorate. Take a closer look at how babies perform breathing movements: their stomach protrudes and retracts - this is the work of the diaphragm. If you fully integrate it into the process of inhalation and exhalation, the breathing process will become more productive and you will suffer less from shortness of breath. Do it daily breathing exercises aimed at strengthening the respiratory muscles, and be sure to learn rational breathing with maximum participation of the diaphragm.

To treat emphysema, try to avoid contact with allergens, especially if you are allergic to any substances that spread through the air, and also change your place of work if it is associated with any occupational hazards (high humidity/dry air, the presence of particles in it dust or chemicals and so on).

An important factor in the treatment of emphysema is maintaining normal weight bodies. At overweight Usually fluid is retained in the body, which creates additional load to the lungs. To reduce body weight, adjust your diet and perform a feasible set of physical activities, not forgetting to breathe properly. In some patients with emphysema, on the contrary, it happens underweight- due to the fact that breathing movements require a lot of energy. Increasing the nutritional value of the diet by complex carbohydrates and protein foods may improve your condition somewhat.

Therapeutic nutrition for emphysema

For emphysema, foods that increase mucus formation are contraindicated - dairy products (especially cheeses, yogurt, milk), starchy fruits and vegetables (bananas, potatoes). An excess of pasta not made from whole grain flour, polished rice, oily, wet and cold foods (meat, nuts, baked goods and confectionery, sweets, fruit juices). You must strictly avoid any stimulants (alcohol, coffee, strong tea, cocoa), as well as products containing preservatives, flavors, dyes and other synthetic additives.

To treat emphysema, reduce the amount of salt in cooking and drink enough fluids, first warm water- it is necessary to thin mucus and facilitate its removal from the lungs.

The basis of the diet in the treatment of emphysema should be based on whole grains and plenty of seasonal vegetables. Warm meals and moderately hot drinks are preferred, which help remove mucus (if emphysema is combined with bronchitis) - herbal teas, berry decoctions (rose hips, black currants, raspberries, etc.), weak green tea, diluted lemon juice with honey and fresh ginger, cinnamon, basil and clove teas.

The stability of the lung membrane and additional protection against infections are provided by beta-carotene, vitamin E, vitamin C and zinc. To sufficient quantity to obtain these substances, eat brightly colored vegetables (carrots, zucchini, pumpkin, broccoli, bell peppers, tomatoes, citrus fruits, leafy vegetables), unrefined vegetable oils, seafood (if well tolerated). Instead of confectionery, use dried fruits in tea - raisins, dried apricots, figs, prunes.

For weakened patients, the protein component in the diet is important when treating emphysema. Replenish it with fresh cottage cheese, soy products, small portions of legumes (for better digestibility they need to be cooked with spices and add spicy herbs at the end), lean fish and lean meat 1-2 times a week. It is recommended to consume fish and meat boiled or baked, combined with a large portion of vegetable salad.

To successfully cure emphysema, it is worth restructuring your diet - eat little, but often. As emphysema progresses, the lungs increase in size and leave everything to the stomach. less space for expansion. Therefore, a small portion of food will cause less discomfort, especially since the long process of digestion causes a flow of blood and oxygen to the stomach, pulling them away from other important organs and tissues.

Pulmonary emphysema is a chronic disease that develops against the background of an obstructive lesion bronchial tree and characterized by irreversible expansion of the alveolar sacs with destruction of their wall. Patients report shortness of breath and cough that cannot be treated. Pathology is observed in 4% of the world's population. The main group of people suffering from emphysema are middle-aged men (30–60 years old) who smoke for a long time. This lung disease causes dangerous complications and disability, so it is very important to consult a doctor at the first symptoms. timely diagnosis and therapy.

The occurrence of pathology occurs due to the influence of 2 main reasons, presented:

1. Impaired elasticity and strength of lung tissue:

Congenital deficiency of alpha-1-antitrypsin (a substance that prevents the destruction of the walls of the alveoli by proteolytic enzymes).
Congenital abnormalities of the lung structure.
Inhalation of polluted air (toxic substances damage the vasculature and epithelium, causing inflammation and activating proteolytic enzymes).
Dyshormonal conditions (disturbed estrogen-androgen balance leads to a decrease in the elasticity of the small bronchi, which causes overstretching of their walls and leads to the formation of bronchiectasis).
Infectious diseases (accumulated sputum stretches the alveoli, and released enzymes contribute to the destruction of the walls).
Degenerative changes (associated with deterioration of blood supply).

2. Increased pulmonary pressure:

Chronic obstructive pulmonary disease (COPD) develops due to incomplete ventilation of the alveoli.
Occupational hazards are associated with a decrease in the elasticity of the alveoli and bronchi and a deterioration in blood circulation in them.
Pulmonary tree obstruction ( foreign body, mucus). The air accumulated in the alveoli has no way to escape. This phenomenon leads to acute emphysema.

According to doctors, determine exact reason emphysema is not allowed. The development of this anomaly combines several provoking factors acting simultaneously.

Symptoms of pathology

The disease is characterized by a polymorphism of manifestations, which can be described as follows:

Blue or cyanotic color of the earlobes, nail phalanges fingers, tip of the nose. Over time, due to hypoxia, the skin becomes pale.
Expiratory (on exhalation) shortness of breath. Characterized by a short inhalation and stepwise long exhalation. In the lying position, the symptom does not intensify, unlike shortness of breath due to cardiovascular disorders.
Increasing the intensity of work of auxiliary respiratory muscles(intercostal, diaphragm).
Overfilling of the veins of the neck (intrathoracic pressure increases when coughing or exhaling).
During coughing attacks, the face becomes red and little sputum is produced. These patients are called pink puffers.
Loss of body weight.
Hepatomegaly (liver enlargement) with prolapse. The reason is that blood stagnates in the liver vascular network and for better ventilation of the lungs the diaphragm is lowered.
Changed appearance of the patient (with chronic course). A short neck, barrel-shaped chest, convex supraclavicular areas, fingers and fingernails are noted. drumsticks and watch glasses respectively.

Classification of the disease

Depending on the time of occurrence, emphysema is divided into primary (is an independent disease) and secondary (occurs due to existing pathologies in the lung, which includes COPD).

Depending on the prevalence of the process, there are localized and diffuse pulmonary emphysema.

Considering the degree of disruption of the acini (lungs), they are called following forms diseases:

Panlobular (panacinar). The entire acini is affected.
Centrilobular (centroacinar). The acini centers and respiratory alveoli are affected.
Perilobular (periacinar). The periphery of the acini is destroyed.
Peri-scar (irregular/uneven).
Bullous (bullous formations are detected).

Vicarious emphysema of the lungs (observed in the organ preserved after removal, is normal reaction organism) belongs to a separate group.

Diagnostics

The algorithm for examining a patient for the presence of emphysema is presented in the following stages:

History of the disease (complaints, their onset, under what circumstances they arise, presence of bad habits).
Physical methods: percussion: by tapping the organ, changes in pulmonary sound and downward displacement are determined lower limit; auscultatory: listening to the lungs, weakened rapid breathing, the presence of dry wheezing and tachycardia are noted.
X-ray diagnostics. The method allows us to identify the localization, prevalence and stage of the disease.
MRI of the chest. With this study, fluid, pathological foci and the condition of the bronchial tree are detected.
CT scan of the lungs. This type of diagnosis makes it possible to determine the size, boundaries of pathological foci, dilated areas of the bronchi and blood vessels, and airiness.
The scintigraphy method is carried out as preoperative preparation to exclude a tumor and determine vascular changes in the lung parenchyma.
Spirogram. Research helps identify violations external respiration(content of inhaled and exhaled air).
Peak flow diagnostics is used to determine obstructive lesions of the bronchial tree.
Blood gas composition is prescribed to detect hypoxia (lack of oxygen) and hypercapnia (increased carbon dioxide).
UAC ( general analysis blood). With emphysema, there is an increase in red blood cells, hemoglobin, and blood viscosity, but ESR indicator while reduced.

Treatment methods

Medicines

To effectively combat pulmonary emphysema, treatment with the following drugs is mandatory:

Bronchodilators (Atrovent, Salbutamol, Theophylline, Teopek). They are prescribed both in tablet forms and in the form of inhalers (severe stage of the disease).
Glucocorticosteroids (“Triamcinolone”, “Prednisolone”). They have an anti-inflammatory effect, reduce the viscosity of mucus, and relieve swelling of the bronchial mucosa.
Mucolytics (“Bromhexine”, “ACC”). Provides liquefaction of mucus and facilitates its removal.
Antitussives (Tusuprex, Libexin).
Antibiotics (Azithromycin, Amoxicillin). The use of these drugs is necessary in case of development of emphysema against the background of inflammatory lung diseases (pneumonia, bronchitis).
Multivitamin complexes (“Duovit”, “Supradin”).

Therapy medicines must be carried out for at least 3-4 weeks without a break.

Sulfur is used as homeopathy in various dilutions.

To enhance the effect of the therapy, it is possible to use traditional methods.

Alternative medicine recipes

To treat emphysema at home, there are numerous remedies, the most effective of which are:

Honey-garlic infusion. Garlic (10 peeled and chopped heads) with honey (1 kilogram) and lemon (squeeze juice from 10 pieces) are mixed until smooth. Glassware and a dark place are necessary to store the mixture. After 7 days, the drug is taken orally, 4 tablespoons per day.
Inhalation with honey and garlic infusion. Dilute baking soda in water and add healing mixture. Steaming garlic with honey improves sputum discharge; you can use propolis.
Potato leaf juice. You need to drink the product on the first day, 0.5 tsp, with daily increase doses per half teaspoon. After 7 days, the total amount of the substance taken at a time should be 0.5 cups.
Infusion containing cumin and fennel - 1 tbsp. l. And horsetail– 2 tbsp. l. Herbs infused in a glass boiled water. You need to take the product 3 times a day, 75 ml.
Buckwheat (3 tablespoons) per 0.5 liters of boiled water. Warm infusion, take half a glass 4 times a day.
Juniper fruits, dandelion root - 1 tbsp. l. And birch leaves-2 tbsp. l. for 200 ml of boiling water. Therapy is carried out 3 times a day, half a glass for 3 months.
Meadow greenweed (20 g) and dried lemon balm (50 g) per 1000 ml of dry white wine. The mixture is infused for 24 hours, shaking occasionally. You need to take the product 2 times a day, 100 ml. Effective for exacerbations.
A collection of licorice rhizomes, sage leaves, pine buds, anise fruits and marshmallow root is infused in a glass of boiling water and taken 50 ml 4 times a day before meals.
Potato flowers (1 tbsp) per 200 g of boiled water. This infusion should be drunk three times a day, 100 ml, for a month and during attacks of shortness of breath.
Pour mint, eucalyptus, sage, elecampane, thyme (1 tablespoon each of all ingredients) into a glass of boiled water and drink 3 times a day.

Treatment of emphysema with folk remedies is possible only after consultation with a doctor.

Surgery

In case of lack of effect from conservative therapy, severe course of the disease and massive damage to the lung tissue, surgical methods are used. The following operations are carried out:

Lung transplantation (lobar or including heart). The procedure is indicated for patients with massive impairment and numerous bullae.
Excision of the affected area of the lungs with the application of sealing sutures.
Thoracoscopic removal (minimally invasive: the ribs are not dissected) of part of the lung.
Bronchoscopy. The method is the least invasive and is possible when the affected areas are located near large bronchi.

After surgical treatment, pulmonary ventilation is restored due to the absence of compression by the pathologically enlarged area. Period postoperative rehabilitation lasts about 3 months.

Breathing exercises are also effective in the fight against emphysema. It helps fight hypoxia at an early stage of the disease.

A patient with pulmonary emphysema must adhere to a special restorative and detoxifying diet, consisting of the following principles:

You need to eat up to 6 times a day in small portions;
It is recommended to consume up to 90 g of vegetable or animal (high-fat milk) fats per day;
proteins in daily ration must be at least 120 grams, half of which is of animal origin;
carbohydrate content should be 350–400 grams;
fruits, vegetables and bran are also a necessary component of the diet;
drink at least 2 liters of fluid per day;
maintain a salt regime (limit the amount of salt to 6 grams per day);
Alcohol, fried meat, cooking fats, and confectionery products should be excluded.

Prognosis of the disease and possible consequences

In the case of a stable, uncomplicated course of pulmonary emphysema, the outcome is favorable.

With severe damage and the development of complications, the prognosis of the disease is less optimistic.

To determine life expectancy, it is necessary to take into account the patient’s age, the presence of concomitant pathology and the degree of compensation for emphysematous lesions.

If the disease enters the decompensation stage, the following life-threatening complications may develop:

Pneumothorax (accumulation of air in the pleural cavity).
Bacterial infections (due to decreased immunity).
Right ventricular failure (with increased pulmonary pressure and the development of pneumosclerosis).

What is emphysema? Symptoms and treatment of this disease pretty serious. It is accompanied by shortness of breath, heavy cough, respiratory failure. The disease affects the heart and lungs, so if left untreated, there is a high probability of death.

Description of the disease

Pulmonary emphysema is a disease in which the alveoli in the lungs begin to expand. Walls of this body are destroyed. Therefore, the lung tissue completely changes in structure. This disease can be classified as an obstructive disease, just like bronchitis with asthmatic syndrome and asthma.

WITH Greek language The word “emphysema” is translated as “bloating.” Most often it affects older people, as well as men. The disease has no acute course, it is chronic. It should also be noted that it always progresses quickly and greatly.

Due to the fact that inflammation lasts quite a long time, and also narrows respiratory tract, the lung tissue does not stretch, so after exhalation there remains air that should have come out.

Types of emphysema

Before considering treatment methods for emphysema, it is necessary to pay attention to what types of emphysema people may suffer from. The disease can be localized or diffuse. In the first case, all the lungs will be affected, in the second - only some parts. If we consider diffuse type, then the entire tissue is affected, so a person may experience bronchitis.

Apart from this, some other forms of emphysema are also known.

There are senile diseases, which develop due to a person’s age. In this case, the tissues are not destroyed, but only slightly deformed.
The most common form is vesicular. It should be noted that she is one of dangerous forms, since with it all changes are irreversible. Therefore, treatment of emphysema in this case will be quite difficult.
The interstitial form is characterized by the fact that air accumulates under the pleura. This is due to the fact that the bronchi begin to rupture. Lung tissue often swells after a person's lung is removed, or after an asthma attack.
The vicarious form is distinguished by the fact that one part of the lung enlarges, while the second remains normal, while the alveoli are also in perfect order.
The last form is MacLeod syndrome. It differs in that a person develops inflammation, the cause of which cannot be identified. Vessels and tissues are affected only on one side.

Causes of the disease

The reasons for the development of emphysema can be called asthma and any other diseases that are of an obstructive type. Often such diseases can be caused by smoking, including passive smoking. If a person is constantly under the influence of any toxins, then the likelihood of developing emphysema is also huge. If microcirculation in the lung tissue is impaired, then most likely a person develops emphysema. Under the influence similar factors the lungs begin to be damaged, and accordingly, it is difficult for them to fill with air and remove it. The disease is constantly progressing, so over time the branches of the bronchi will stick together. In this case, pulmonary emphysema is treated surgically. Cysts may form and the lung tissue may swell. When the first ones rupture, the person develops pneumothorax. In patients who suffer similar disease, the lungs resemble a sponge with large pores.

Symptoms

Symptoms of emphysema include weight loss, stooping, protruding dimples that are located above the collarbones, problems with listening to breathing, barrel-shaped chest, and severe shortness of breath. If we're talking about about the development of diffuse pulmonary emphysema in adults (its treatment is quite complicated), then on the x-ray you can see that the diaphragm is located too low and the lung zone is too transparent. The heart changes its position, it becomes more vertical, and severe respiratory failure also occurs. The symptoms of localized emphysema are due to the fact that injured areas of the lungs put pressure on healthy ones, so a person may even experience attacks of suffocation.

Forecast

If you refuse treatment for emphysema (in Germany - best clinics who admit patients with this pathology), then it begins to progress greatly. The person develops heart and respiratory failure. Therefore, the patient may remain disabled. Disability develops. Unfortunately, with emphysema death is inevitable, it can occur even earlier than three or four years. Accordingly, the prognosis is unfavorable.

If therapy is carried out regularly, and inhalations are also done, then the quality of life can be improved and its duration can be increased. A favorable prognosis is already considered to be a life expectancy of up to 5 years with this disease, however, with good therapy and correct observance According to all doctor's recommendations, this period increases to 10-20 years.

Is it possible to be completely cured?

Emphysema can be treated using both traditional and folk medicine. However, it should be noted that the second option is not very effective and can only eliminate the symptoms. IN mandatory you should consult a doctor. This is due to the fact that he will be able to appoint effective treatment. Depending on the patient’s condition, it will be decided where to carry out therapy: in outpatient setting or in a hospital. Due to the fact that changes in lung tissue cannot be reversed, it must be concluded that emphysema cannot be completely cured. However, if you start on time effective treatment, then the development of pathology can be prevented. In some cases, when treating pulmonary emphysema, surgical treatment is the only correct option.

Medicines which are prescribed should improve bronchial patency. Inhalations are also prescribed for this. If you have a nebulizer at home, then this can be done directly at home; you are allowed to come to the hospital.

It is imperative to take glucocorticoid hormones. The doctor will also prescribe medications that help thin the mucus and expectorate it. The most commonly used drugs are those prescribed for bronchitis.

If the reason is chronic bronchitis, then you have to take antibiotics. In this case, it will be necessary to identify the pathogen primary disease, and only in this case can you choose a special drug that will completely get rid of the symptoms.

If there is respiratory failure, oxygen therapy will have to be used. Traditional medicine can be used without pause, but drug therapy should last no more than a month. Below we will describe the methods in more detail. traditional medicine, as well as folk.

Treatment methods

When treating pulmonary emphysema, therapy should be aimed at completely eliminating respiratory failure in a person, and the cause of the development of the disease should also be minimized. If the patient smokes, then first of all he needs to stop smoking. bad habit. In this case you can use special drugs and is allowed to seek the help of a psychologist.

If a patient develops emphysema due to some primary disease, then it is initially necessary to treat it. Antibiotics and mucolytics are often used, which must be selected individually. To make breathing easier, you can use special physical exercise. Massage helps remove phlegm. Some drugs will expand the bronchi.

Patients are also prescribed air supply to the lungs. As a rule, depending on the symptoms, a solution with either low or normal oxygen content is used. The course of such therapy lasts no more than 3 weeks. If a person has a pronounced disorder respiratory process, then it is necessary to do inhalation using pure oxygen. If the situation is completely advanced, then use ventilation.

Treatment of bullous emphysema is carried out using surgical intervention. In this case, the doctor must remove all existing cysts. The operation is performed using an endoscope or in the classic way. If done on time, the development of pneumothorax can be avoided.

Traditional medicine

Treatment of pulmonary emphysema with folk remedies allows you to improve the breathing process, strengthen the body, some methods easily remove phlegm, and also expand the bronchi.

First of all, you need to pay attention to infusions and decoctions. They can be used for inhalation and can also be taken orally. Before you start using traditional medicine, you need to think about the fact that an unsuccessful attempt to receive any medicinal herbs can cost a person either health or life. You can use onions, garlic, honey from honeycombs, aloe, Kalanchoe and so on. Let's look at some other options that are the most popular.

Often, when treating pulmonary emphysema with folk remedies, milk is used, to which carrot juice is added. The first one should be heated and also have high fat content. You need to add one tablespoon of carrot juice to it. This drug must be taken 3 weeks before meals.

Ledum also treats symptoms well. It is necessary to pour the dried drug into boiling water and leave for an hour. You need to drink 50 ml. Do not take more than twice a day.

Tincture of horsetail and fennel - also good option. It is necessary to fill the jar in equal proportions with these plants and pour in boiling water. Infusions must be kept for at least 60 minutes. Drink 100 ml three times a day.

You can brew tea from thyme, mint and sage. They should also be mixed in equal proportions, crushed, poured into a thermos and poured boiling water. You need to drink 70 ml after each meal.

It will be an effective way. This vegetable must be washed and peeled. Next, squeeze the juice out of it and mix it with a spoon of honey. It is necessary to take two tablespoons twice a day. You need to do this before eating.

Breathing exercises

Treatment of pulmonary emphysema using Dr. Bubnovsky’s method involves special gymnastics. This doctor believes that the body itself is able to overcome all problems with the respiratory muscles. Therefore, you can use breathing exercises.

You just need to make the rib muscles work. Stretching your chest is quite difficult, but it is possible. You need to use an exercise called “Pullover”. In order to perform it, you need to have dumbbells and a bench nearby. It is necessary to bend your knees while lying on a bench. You should take a dumbbell with your hands, which should weigh no more than 2 kg, lower it behind your head, while inhaling. It should only be done through the nose. The dumbbell should be raised above your head and lowered down as you exhale. The sound should be “ha”. The diaphragm stretches, and the intercostal muscles also contract. Every day you need to move your hands further behind your head.

When a person's range of motion begins to increase, the intercostal muscles stretch. This also involves thoracic region spine. This effect quite noticeable. Reviews about the treatment of pulmonary emphysema using the Bubnovsky method make it clear that the exercise really helps in many cases. You need to do it before eating. This should be repeated about 15 times, divided into two approaches. Every month you need to increase the weight of dumbbells.

At first there may be discomfort and muscle tension, but over time these symptoms disappear. This exercise will also help with other diseases, and it also affects intestinal function. If you use this exercise in complex therapy together with medications, the effect will not be long in coming.

Possible complications

If a person does not treat emphysema or the pathology progresses too quickly, then various complications. Among them are problems with ventilation of the lungs and hypertension, as well as insufficiency, as a result of which swelling of the legs, hepatomegaly, and so on develop.

The most dangerous complication is pneumothorax, which develops spontaneously. When it develops, it is necessary to drain pleural cavity and perform air aspiration.

Prevention

In order to never find out what it is - pulmonary emphysema (the symptoms and treatment are quite severe), it is necessary to take preventive measures. First of all, you should always treat bronchitis and other diseases associated with the respiratory system. Also, if a person smokes, then he needs to sharply give up this bad habit once and for all.

The best prevention pathologies respiratory system- walks on fresh air, as well as sports. It is imperative to monitor your immune system. You can use various folk remedies that will improve protective forces body, as well as immunostimulants. Then you won’t have to think about treating emphysema.

The girl consulted a doctor about her father’s illness: “Recently, my family was faced with a diagnosis: pulmonary emphysema. My father, who is only 60 years old, fell ill. The disease progresses rapidly. How dangerous is this disease?

Emphysema is pathological increase lung volume. Up to 4% of the population suffers from this disease, mainly older men.

Risk of developing the disease:

congenital forms associated with whey protein deficiency. More often detected in residents of Northern Europe;
at smoking people the risk of developing emphysema is 15 times higher than that of non-smokers, passive smoking just as dangerous;
microcirculation disorders in lung tissues;
and alveoli;
professional activity associated with a gradual increase in pressure in the bronchi and alveolar tissue,

Under the influence of these factors, the elastic tissue of the lung is damaged and its ability to fill with air is lost.

Stretching of bronchioles and alveoli, their size increases.

Smooth muscles are stretched, the walls of blood vessels become thinner, nutrition in the acinus (the smallest formations that make up the lung tissue), where gas exchange occurs between air and blood, is disrupted, and the body experiences oxygen deficiency. The enlarged areas compress healthy lung tissue, which further impairs their ventilation, causing shortness of breath and other symptoms of emphysema.

To compensate and improve respiratory function The respiratory muscles are actively activated.

Emphysema is almost always a consequence of diseases such as bronchitis. And only in in rare cases the disease is inherited. It develops unnoticed by the patient. Symptoms appear when there is significant damage to the lung tissue, so early diagnosis emphysema is difficult. If, during periods of remission of chronic lung diseases, shortness of breath increases, and during exacerbations, physical activity is sharply limited, you should immediately consult a doctor. All these symptoms may indicate the development of the initial symptoms of emphysema.

As a rule, shortness of breath begins to bother the patient after 50-60 years. First it appears during physical activity, later at rest. During an attack of shortness of breath, the face turns pink. The patient, as a rule, sits leaning forward, often holding on to the back of the chair in front of him. The exhalation with emphysema is long, noisy, the patient purses his lips into a tube, trying to ease his breathing. When inhaling, patients do not experience difficulty, but exhaling is very difficult. Due to the characteristic appearance During an attack of shortness of breath, patients suffering from emphysema are sometimes called “pink puffers.”

Cough occurs after shortness of breath, which distinguishes emphysema from bronchitis. The cough is not prolonged, the sputum is scanty and transparent. The chest is expanded, as if frozen while inhaling. It is often figuratively called barrel-shaped. A characteristic sign of emphysema is loss of body weight. This is due to fatigue of the respiratory muscles, which work at full strength to facilitate exhalation. A marked decrease in body weight is an unfavorable sign of the development of the disease.

The apices of the lungs bulge in the supraclavicular areas, expanding and sinking into the intercostal spaces. The fingers become like drumsticks. The tip of the nose, earlobes, and nails become bluish. As the disease progresses, the skin and mucous membranes turn pale because small capillaries are not filled with blood and oxygen starvation occurs.

Men, as I already said, suffer from this pathology more often, especially if they work in hazardous industries with high level air pollution.

The second factor provoking the development of the disease, especially with a genetic predisposition, is smoking, since nicotine activates the release of destructive enzymes in the respiratory organs.

It is important to consider age-related changes. The blood circulation of an elderly person changes over the years, sensitivity to air toxins increases, and lung tissue recovers more slowly after pneumonia.

First of all, carry out peak flowmetry, which determines the volumetric flow rate of exhalation, and spirometry, revealing changes in the tidal volume of the lungs and the degree of respiratory failure. The latter is carried out using a special device - a spirometer, which records the volume and speed of inhaled (exhaled) air.

X-ray examinations of the chest organs reveal dilated cavities and determine an increase in lung volume. Computed tomography- increased “airiness” of the lungs. Emphysema is classified into several categories. The nature of the course is acute (it can be caused by physical activity, attack of bronchial asthma; requires surgical treatment) and chronic (changes in the lungs occur gradually, and at an early stage a complete cure can be achieved).

By origin - primary (due to the congenital characteristics of the body, it is an independent disease, diagnosed even in newborns; difficult to treat, and secondary emphysema progresses quickly (due to obstructive lung diseases in chronic form; leads to loss of ability to work).

Based on anatomical features, they are distinguished panacinar(in the absence of inflammation, respiratory failure is noted), periacinar(develops with tuberculosis), peri-scar(manifests near fibrotic foci and scars in the lungs) and subcutaneous(air bubbles form under the skin) shape.

The most dangerous - bullous(bubble) form, in which one large cavity is formed filled with air. Inflammatory and suppurative processes occur in the lungs (chronic abscess, tuberculosis). The danger of bullous emphysema is associated with severe thinning of the superficial membrane of the bulla (formations in the form of air bubbles in the lung tissue), rupture of which is possible with sudden changes in pressure in the chest (cough). A dangerous condition called pneumothorax occurs, which can result in respiratory failure and cardiac arrest.

Treatment is carried out on an outpatient basis under the supervision of a pulmonologist or therapist. Hospitalization is indicated for severe cases respiratory failure and if complications occur ( pulmonary hemorrhage, pneumothorax).

For cupping inflammatory process are appointed antibacterial drugs. At bronchial asthma or bronchitis with attacks of difficulty breathing, bronchial dilators are indicated ( theophylline, berodual, salbutamol). To facilitate sputum production - mucolytics ( ambrobene, lazolvan, acetyl-cysteine, fluimicin). To improve gas exchange at initial stage diseases apply oxygen therapy. This treatment involves inhaling air with a reduced amount of oxygen for 5 minutes. Then the patient breathes air with normal oxygen content for the same amount of time. The session includes six such cycles once a day for 15-20 days.

Nutrition for a patient with emphysema

A balanced diet will help strengthen your immune system and remove toxins from your body. In case of respiratory failure, consuming large amounts of carbohydrates can lead to an even greater lack of oxygen. Therefore it is recommended low calorie diet. The diet is divided, 4-6 times a day.

Fats - at least 80-90 g. This can be vegetable oil, butter, and high-fat dairy products.

Proteins - up to 120 g per day. Eggs, meat of any kind, sausages, seafood and river fish, seafood, liver.

Carbohydrates - about 350 g. Fruits, berries, vegetables, wholemeal bread, honey.

Drinks include juices, kumiss, rosehip compote.

Limiting salt (up to 6 g) to prevent edema and cardiac complications.

The diet of patients with emphysema should not contain alcohol, cooking fats, or high-fat confectionery products.

With emphysema, the respiratory muscles are in constant tone, so they get tired quickly. Classic, segmental (stroking, kneading, rubbing) and acupressure (pressure on certain points of the body) massages help remove mucus and dilate the bronchi.

An important role is played physical therapy. A set of specially selected exercises to strengthen the respiratory muscles is performed for 15 minutes 4 times a day. It includes exercises for training diaphragmatic breathing and its rhythm:

The patient exhales deeply and slowly through a tube, one end of which is in a jar of water. The water barrier creates pressure when you exhale.
Starting position: standing, feet shoulder-width apart. Ill do deep breath and as you exhale, stretches your arms in front of you and leans forward. During exhalation, you need to pull in your stomach.
Starting position: lying on your back, hands on your stomach. As you exhale, press on the anterior abdominal wall with your hands.
Take a deep breath, hold your breath. Exhale air in small bursts through pursed lips. At the same time, the cheeks should not puff up.
Take a deep breath, hold your breath. Then exhale in one sharp burst through your open mouth. At the end of the exhalation, fold your lips into a tube.
Take a deep breath, hold your breath. Stretch your arms forward, then clench your fingers into a fist. Bring your arms to your shoulders, slowly spread them to the sides and return them to your shoulders again. Repeat 2-3 times, then exhale forcefully.

Forecast

Emphysema leads to irreversible changes in the structure of lung tissue. Possible development of right ventricular heart failure, myocardial dystrophy, edema lower limbs, ascites. Therefore, the prognosis directly depends on the timely start of therapy and the strict implementation of all medical recommendations. In the absence of necessary therapeutic measures the disease progresses and leads to loss of ability to work, and subsequently to disability.

A feature of emphysema is its constant progression, even during treatment. But if all treatment measures are followed, it is possible to slow down the progression of the disease and improve the quality of life.

Prevention of emphysema

The main preventive measure is anti-nicotine propaganda. Quitting smoking, which destroys the structure of the lungs, is the most effective way to prevent the disease. Let me remind you that staying in a smoky room, so-called passive smoking, is even more dangerous than the process of inhaling tobacco smoke itself.

Exercise active species sports (swimming, running, skiing, football), do breathing exercises, walk in the fresh air, visit the steam room. Walking in the forest and near salt ponds is very beneficial for lung health. The air, saturated with the aroma of pine needles and salt, opens the lungs and saturates the blood with oxygen. thyme, lemon balm, anise, buckwheat, coltsfoot, sweet clover, caraway seeds.

Mix dried and crushed mint, sage and thyme in equal proportions. 1 tbsp. spoon. Pour the mixture into a thermos and pour 1 glass of boiling water overnight. Drink 70 ml after breakfast, lunch and dinner.
1 tbsp. Pour a spoonful of dry coltsfoot leaves into 2 cups of boiling water and leave for an hour. Drink 1 tbsp. spoon 4-6 times a day.
Mix 1 part each of marshmallow and licorice roots, pine buds, sage leaves, and anise fruits. 1 tbsp. Pour 1 cup of boiling water over a spoonful of the mixture, leave for several hours and strain. Take a quarter glass with honey 3 times a day.
1 hour pour 500 ml of boiling water over a spoonful of dried and crushed wild rosemary and leave for 1 hour. Take 150 ml of warm infusion twice a day. In a glass of warmed full fat milk add 1 tbsp. spoon carrot juice, drink on an empty stomach for three weeks.
Pour 0.5 liters of boiling water over buckwheat flowers and leave for 1 hour. Drink 0.5 cups 3-4 times a day with honey.
Chopped juniper, dandelion root, birch leaves are mixed in a ratio of 1:1:2. 1 tbsp. Pour 1 cup of boiling water over a spoonful of the mixture and leave for 1 hour. Drink 70 ml after meals 3 times a day.

Inhalations with a decoction of potato root vegetables “in their jacket” have an expectorant and relaxing effect on the bronchial muscles. The temperature of the liquid should not exceed 85°C to prevent burns to the mucous membrane. To carry out the procedure, take several potatoes, wash them, put them in a pan and cook until tender. Then remove the pan from the heat, place it on a stool, cover with a towel and breathe in the steam for 10 to 15 minutes.

Saturation of air with medicinal components essential oils marjoram, dill, eucalyptus, oregano, wormwood, thyme, sage, chamomile, cypress, cedar improves the condition of patients suffering from emphysema.

Use a special device for fine spraying (diffuser) or a regular aroma diffuser (5-8 drops of ether per 15 square meters of room). The same oils are used to rub the feet, palms, and chest. To do this, in 1 tbsp. a spoonful of jojoba oil, vegetable or olive, add 2-3 drops of ether or a mixture of several oils.

Emphysema is a disease characterized by overstretching of the alveoli and excessive airiness. lung tissue. This condition is irreversible and, if not properly treated, leads to heart failure of the right ventricular type, liver enlargement and increased pressure in the pulmonary circle.

What is emphysema

Emphysema is a pathology that most often occurs against the background of another disease. The risk group includes men over 60 years of age - they get sick 2 times more often than women. The development of the disease is based on the following changes in tissues:

disruption of the process of filling the alveoli with air;
difficulty in alveoli collapse;
adhesion of the smallest bronchi;
ventilation disturbance;
overstretching of tissues;
formation of bullae (cysts);
destruction of interalveolar septa.

Causes leading to the development of emphysema

The causes of emphysema in the lungs are:

Disruption of the process of elastin formation.
Smoking.
Inhalation of various chemicals (dust, smoke, aerosols). The disease is most often caused by nitrogen and sulfur oxides, as well as cadmium. They enter lung tissue, accumulate in the alveoli, damaging blood vessels and epithelium, and enhance the formation of elastase (an enzyme that destroys elastic tissue).
Infectious diseases (pneumonia, chronic inflammation bronchi).
Obstruction. When you exhale, the air does not leave the alveoli, and with subsequent inhalation, tissue stretching occurs.
Work in harmful conditions. Those at risk for developing emphysema include glassblowers and musicians who work with wind instruments.
Congenital developmental features.
Impaired blood circulation.
Insufficient production of alpha-1 antitrypsin (a protein that inhibits protease activity).
Asthma.
Hormonal disorders.

Types of diseases and their symptoms

The following forms of the disease are distinguished:

Primary. Arises as a result congenital disorders. Different early occurrence symptoms, severe course and rapid progression of respiratory failure. It often occurs in children and adolescents.
Secondary. It is a complication of bronchitis and other chronic diseases.
Diffuse. Involved in the process whole lung. It does not fall off when the organ is removed.
Localized. A separate area is affected.
Panacinar. The whole acinus (a formation that includes the alveoli, terminal bronchiole and alveolar sacs) is involved in the process.
Centriacinar (with damage to the alveoli of the center of the acinus).
Periacinar (the central zone of the acinus is affected).
Bullous (with the formation of air cavities).
Okolorubtsovaya.
Lobar (lobar).
McLeod syndrome. It affects only one lung. The etiology has not been established.

With emphysema, symptoms include:

Shortness of breath. It is expiratory (patients find it difficult to exhale air). On early stages it is weak, but as respiratory failure progresses, the shortness of breath becomes stronger. It does not get worse while lying down, which is an important diagnostic criterion. Inhalation is difficult for such people.
Weight loss. The reason is a large load on the respiratory muscles.
Cough. During it the skin becomes pink color. The cough with emphysema is productive with the release of a small amount of sputum.
Protrusion of veins in the neck area. The reason is increased pressure in the chest cavity. This symptom well expressed when coughing and exhaling air.
Acrocyanosis (blue discoloration of the nose, ears, nails). Caused by tissue hypoxia.
Hepatomegaly (enlarged liver).
Changing phalanges like drumsticks and nails like watch glasses.
Changes in the appearance of a sick person (shortening of the neck, protrusion of the pits in the collarbone area, puffiness of the face, expansion of the chest, retraction of the intercostal spaces during inhalation and drooping of the abdomen).
Tension of the abdominal muscles while exhaling.
Puffing while exhaling.

Diagnosis and treatment of emphysema

Everyone should know why emphysema is dangerous, what it is and how to treat the disease. To make a diagnosis you will need:

Anamnesis collection.
External inspection. The doctor pays attention to the ribs, the shape of the chest, the neck, the symmetry of the shoulders and nails.
Physical examination. Percussion reveals a boxy sound, drooping of the lower edge of the lung and limited mobility. With this pathology, weak breathing, dry wheezing, dull heart sounds, increased exhalation, increased second heart sound above the pulmonary artery are observed. rapid breathing and heartbeat.
X-ray examination. The image reveals excessive transparency of the tissues, widening of the spaces between the ribs, bullae, drooping of the diaphragm, an increase in the lungs in size and their close location to each other.
Assessment of external respiration.
Blood test.
Grade gas composition blood (determination of oxygen and carbon dioxide concentrations).
Electrocardiography.
Ultrasound of the heart.
Tiffno sample.
Determination of alpha-1-antitrypsin level.

For pulmonary emphysema, treatment is complex. It includes:

Breathing exercises.
Quitting smoking.
Speleotherapy.
Use of medications (bronchodilators, systemic corticosteroids). To eliminate tissue hypoxia, Fenoterol-Nativ, Berotek, Eufillin, Foradil, Formoterol-Nativ, Teopek, Atrovent, Ventolin and Salbutamol-Teva are used. For emphysema, Budesonide Easyhaler or Prednisolone Nycomed are prescribed for life. For heart failure, diuretics can be used. In case of cough with sputum, mucolytics are indicated. Additionally, antioxidants and elastase inhibitors may be prescribed.
Inhalations.
Dieting. With emphysema and signs of exhaustion, the daily calorie content of food increases. You should limit your consumption of sweets, baked goods and fatty meats.
Electrical stimulation of the respiratory muscles.
Treatment of existing respiratory diseases.

In severe cases, surgery is required (resection of affected areas of the lungs, bullectomy, lung transplant). Surgical treatment indicated in the presence of complications (hemoptysis, cancer, pneumothorax), multiple air cavities and severe shortness of breath that makes work difficult. The operation is contraindicated in patients over 70 years of age, with severe chest deformation, infectious pathology and asthma.

Life prognosis and prevention

With pulmonary emphysema, the prognosis for life is relatively unfavorable. If symptoms are ignored, the disease progresses and becomes a cause of disability. The consequences of emphysema can be pneumothorax and infection.

Disease prevention measures include promotion and management healthy image life (playing sports, quitting smoking), preventing bronchitis and other respiratory pathologies and avoiding contact with harmful chemicals.