Emphysema of the lungs: what is it, symptoms, treatment. Diagnosis and treatment of emphysema

What is emphysema

Emphysema is a chronic lung disease in which there is an expansion of the pulmonary vesicles (alveoli), accompanied by the destruction of lung tissue. They form expanded air spaces, which leads to a narrowing of the airways and a decrease in the gas exchange function of the lungs. At the same time, the absorption of oxygen decreases and in the expanded pulmonary vesicles remains carbon dioxide, which leads to shortness of breath.

There are primary and secondary emphysema. The former develops without prior lung disease, while the latter is usually a complication of chronic bronchitis. Primary emphysema is quite rare and affects mainly men in young age. In older 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, exhale with closed lips. They have little mobility chest on inspiration, and over time it takes on a characteristic “barrel-shaped” shape (expansion of the intercostal spaces, bulging of the supraclavicular regions).

The following predispose to the development of emphysema: smoking, including passive smoking ( main factor risk); violations of the microcirculation of the vessels of the lungs; 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 cor pulmonale - pathological change structure of the heart (enlargement of the right ventricle and right atrium due to the fact that the pulmonary vessels lose their elasticity under the action of high blood pressure in the lungs and cannot "adjust" to changes in blood output).

Emphysema treatment

Since emphysema in most cases is associated with smoking, this bad habit must be abandoned. Inhalation tobacco smoke, including passive, inhibits the function of macrophage cells, destroys the pulmonary membranes and slows down the discharge of mucus. Categorically 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 provides an opportunity to engage in physical exercise, which can bring positive effect with emphysema.

Physical activity provided 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 respiratory movements, which will help to slightly reduce shortness of breath. The 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 do not breathe properly - their diaphragm does not work enough, which worsens the supply of oxygen to the body. Take a closer look at how babies make breathing movements: their stomach protrudes and retracts - this is the work of the diaphragm. If you connect it fully to the process of inhalation and exhalation, then the respiratory 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 the maximum participation of the diaphragm.

For the treatment of 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 / dryness of the air, the presence of particles in it dust or chemical substances and so on).

An important factor in the treatment of emphysema is to maintain normal weight body. 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 complex of physical activity, not forgetting to breathe properly. In some patients with emphysema, on the contrary, it happens underweight- due to the fact that respiratory movements require a lot of energy. Increasing the nutritional value of the diet complex carbohydrates and protein foods may improve your condition somewhat.

Therapeutic nutrition for emphysema

With emphysema, products that increase mucus formation are contraindicated - dairy products (especially cheeses, yogurt, milk), starchy fruits and vegetables (bananas, potatoes). Adversely affects the condition of an excess of pasta not from whole grain flour, polished rice, oily, wet and cold foods (meat, nuts, baked goods, confectionery, sweets, fruit juices). It is strictly necessary to abandon any stimulants (alcohol, coffee, strong tea, cocoa), as well as products containing preservatives, flavors, dyes and other synthetic additives.

To treat emphysema, cut down on the amount of salt in your cooking and drink plenty of fluids first. warm water- it is necessary to thin the 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 the discharge of mucus (if emphysema is combined with bronchitis) - herbal teas, berry decoctions (rose hips, black currants, raspberries, and so on), 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 provide beta-carotene, vitamin E, vitamin C and zinc. To in enough to get these substances, eat brightly colored vegetables (carrots, zucchini, pumpkin, broccoli, bell peppers, tomatoes, citrus fruits, leafy vegetables), unrefined vegetable oils, seafood (with good tolerance). Instead of confectionery, use dried fruits in tea - raisins, dried apricots, figs, prunes.

For debilitated patients in the treatment of emphysema, the protein component in the diet is important. Replenish it with fresh cottage cheese, soy products, small portions of legumes (for better digestibility they must be cooked with spices and spicy greens added at the end), lean fish and lean meat 1-2 times a week. Fish and meat are recommended to be consumed boiled or baked, combined with a large portion of vegetable salad.

For a successful cure for emphysema, it is worth restructuring the diet - eat a little, but often. As the 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 a long process of digestion causes an influx of blood and oxygen to the stomach, pulling them away from other important organs and tissues.

Emphysema is a chronic disease that develops against the background of an obstructive lesion. bronchial tree and characterized by an irreversible expansion of the alveolar sacs with the destruction of their walls. Patients report shortness of breath and cough that is not treatable. Pathology is observed in 4% of the world's population. The main contingent of people suffering from emphysema is long-term smoking middle-aged men (30-60 years). Such a 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 the lung tissue:

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

2. Increased pulmonary pressure:

Chronic obstructive pulmonary disease (COPD) develops due to incomplete ventilation of the alveoli.
Occupational hazard is associated with a decrease in the elasticity of the alveoli and bronchi and a deterioration in their blood circulation.
Obstruction of the pulmonary tree ( foreign body, slime). The air that has accumulated in the alveoli cannot escape. This phenomenon leads to acute emphysema.

According to doctors, to determine exact reason emphysema is impossible. The development of this anomaly combines several provocative factors acting simultaneously.

Symptoms of pathology

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

Bluish or cyanotic earlobes nail phalanges fingers, tip of the nose. Over time, due to hypoxia, blanching of the skin occurs.
Expiratory (on exhalation) shortness of breath. Characterized by a short breath and a stepped long breath. In the supine position, the symptom does not increase, in contrast to shortness of breath on the background of cardiovascular disorders.
Increasing the intensity of work of auxiliary respiratory muscles(intercostal, diaphragm).
Overfilling of the veins of the neck (when coughing or exhaling, intrathoracic pressure increases).
At the time of coughing fits, the face becomes red, little sputum is separated. Such patients are called pink puffers.
Weight loss.
Hepatomegaly (enlarged liver) with prolapse. The reason is that the blood stagnates in the liver vasculature and for better ventilation of the lungs, the diaphragm is lowered.
Changed appearance of the patient chronic course). Note the short neck, barrel-shaped chest, convex supraclavicular regions, fingers and nails in the form drumsticks and watch glasses, respectively.

Disease classification

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

According to the prevalence of the process, there is localized and diffuse emphysema of the lungs.

Given the degree of violation of the acini (lungs), they call the following forms diseases:

Panlobular (panacinar). The entire acinus is affected.
Centrilobular (centroacinar). Affected centers of acini and respiratory alveoli.
Perilobular (periacinar). The periphery of the acini is destroyed.
Peri-scarring (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 pulmonary emphysema is represented by the following steps:

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

Treatment Methods

Medicines

To effectively combat 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, relieve swelling of the bronchial mucosa.
Mucolytics ("Bromhexine", "ACC"). Provide liquefaction of sputum and facilitate its discharge.
Antitussives ("Tusuprex", "Libeksin").
Antibiotics ("Azithromycin", "Amoxicillin"). The use of these drugs is necessary in case of emphysema against the background of inflammatory lung diseases (pneumonia, bronchitis).
Multivitamin complexes ("Duovit", "Supradin").

Therapy medicines it is necessary to spend at least 3-4 weeks without a break.

Sulfur is used as homeopathy in various dilutions.

To enhance the effect of ongoing therapy, it is possible to use alternative 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 a homogeneous consistency. Glassware and a dark place are necessary to store the mixture. After 7 days, the drug is taken orally 4 tablespoons a day.
Inhalations with honey-garlic infusion. Dissolve baking soda in water and add healing mixture. Pairs of garlic with honey improve sputum discharge, you can use propolis.
Juice of potato leaves. It is necessary to drink the remedy on the first day, 0.5 tsp, with daily increase half teaspoon dose. After 7 days, the total amount of the substance taken at a time should be 0.5 cups.
An infusion containing cumin and fennel - 1 tbsp. l. And horsetail- 2 tbsp. l. Herbs insist on a glass boiled water. You need to take the drug 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. The therapy is carried out 3 times a day for half a cup for 3 months.
Meadow sivets (20 g) and dried lemon balm (50 g) per 1000 ml of dry white wine. The mixture is infused for a day, shaking occasionally. You need to take the drug 2 times a day, 100 ml. Effective in exacerbations.
Collection of licorice rhizomes, sage leaves, pine buds, anise fruits and marshmallow root insist on a glass of boiling water and take 50 ml 4 times a day before meals.
Potato flowers (1 tablespoon) per 200 g of boiled water. Such an infusion should be drunk three times a day, 100 ml for a month and with attacks of shortness of breath.
Peppermint, eucalyptus, sage, elecampane, thyme (1 tablespoon of all components) pour a glass of boiled water and drink 3 times a day.

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

Surgery

In the absence of the effect of conservative therapy, severe disease and massive damage to the lung tissue, surgical methods are used. Carry out the following operations:

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

After surgical treatment, pulmonary ventilation is restored due to the lack 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 to fight hypoxia at an early stage of the disease.

A patient with pulmonary emphysema should adhere to a special general strengthening and detoxifying diet, consisting of the following principles:

you need to eat up to 6 times a day in small portions;
per day it is recommended to consume up to 90 g of vegetable or animal (high-fat milk) fats;
proteins in daily diet must be at least 120 grams, half of which are of animal origin;
the 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;
observe the salt regime (limit the amount of salt to 6 grams per day);
it is necessary to exclude alcohol, fried meat, cooking fats, confectionery from consumption.

Prognosis of the disease and possible consequences

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

With severe lesions 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 of emphysematous lesions.

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

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

What is emphysema? Symptoms and treatment 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, the likelihood of death is high.

Description of the disease

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

WITH Greek the word "emphysema" is translated as "swelling". It most often affects the elderly, as well as men. The disease has no acute course, it is chronic. It should also be noted that it is always rapidly and strongly progressing.

Due to the fact that the inflammation lasts quite a long time, and also narrow Airways, lung tissue does not stretch, so after exhalation, air remains that should have been expelled.

Types of emphysema

Before considering the methods of treating emphysema, it is necessary to pay attention to what types of it people can suffer from. The disease can be localized and 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.

In addition, some other forms of emphysema are also known.

Distinguish senile, which develops due to the age of a person. 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 all changes are irreversible. Therefore, the treatment of emphysema in this case will be quite difficult.
The interstitial form is characterized by the fact that when it accumulates air under the pleura. This is due to the fact that the bronchi begin to rupture. It is not uncommon for lung tissue to swell after a lung is removed from a person, or after an asthma attack.
The vicarious form is different in that one section of the lung increases, and the second remains normal, while the alveoli are also in perfect order.
The last form is Macleod's 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 causes of emphysema can be called asthma and any other diseases that have an obstructive type. Quite often, such diseases can be caused by smoking, while passive too. If a person is constantly under the influence of any toxins, then the likelihood of developing emphysema is also huge. If the microcirculation in the lung tissue is disturbed, then, most likely, a person develops emphysema. Influenced similar factors the lungs begin to be damaged, respectively, 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, emphysema is treated surgically. Cysts may form and lung tissue swells. When the first ones rupture, the person develops a pneumothorax. In patients who suffer a similar disease, the lungs resemble a sponge with large pores.

Symptoms

Among the symptoms of emphysema, weight loss, stoop, protrusion of the dimples that are located above the collarbones, problems with listening to breathing, barrel-shaped chest, and severe shortness of breath should be noted. If we are talking about the development of diffuse emphysema in adults (its treatment is rather complicated), then on the x-ray you can see that the diaphragm is too low, and the zone of the lungs is too transparent. The heart changes its position, it becomes more vertical, and severe respiratory failure occurs. The symptomatology of localized emphysema is due to the fact that the injured areas of the lungs put pressure on healthy ones, so a person can even experience asthma attacks.

Forecast

If you refuse to treat emphysema (in Germany - best clinics who accept patients with this pathology), then it begins to progress strongly. A person develops heart and respiratory failure. Therefore, the patient may remain disabled. Disability develops. Unfortunately, emphysema death inevitable, it can come even earlier than three or four years. Accordingly, the prognosis is poor.

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

Whether it is possible to recover completely?

Emphysema can be treated with both traditional medicine and folk medicine. However, it should be noted that the second option is not very effective and they can only eliminate the symptoms. IN without fail you should consult a doctor. This is due to the fact that it is he who can appoint effective treatment. Depending on the condition of the patient, it will be decided where to carry out therapy: in outpatient settings or in a hospital. Due to the fact that the change in lung tissue cannot be reversed, it must be concluded that emphysema is not completely cured. However, if you start effective treatment, it is possible to prevent the development of pathology. In some cases, in the treatment of emphysema, surgical treatment is the only true option.

Medications that are prescribed should improve bronchial patency. For this, inhalations are also prescribed. If there is a nebulizer at home, then this can be done directly at home, it is allowed to come to the hospital.

Be sure to take glucocorticoid hormones. Also, the doctor will prescribe drugs that allow you to thin the sputum and expectorate it. Most often, those drugs that are prescribed for bronchitis are used.

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

If there is respiratory failure, then oxygen therapy will have to be used. Traditional medicine can be used without a pause, but drug therapy should last no more than a month. The methods are described in more detail below. traditional medicine, as well as folk.

Treatment Methods

In the treatment of 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 he must first of all give up this bad habit. At the same time, you can use special preparations and allowed to seek the help of a psychologist.

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

Also, patients are prescribed air supply in the lungs. As a rule, depending on the symptomatology, 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 failure respiratory process, then it is necessary to do inhalation using pure oxygen. If the situation is completely neglected, then ventilation of the lungs is used.

Bullous emphysema is treated with surgical intervention. In this case, the doctor must remove all existing cysts. The operation is performed using an endoscope or the classic way. If carried out on time, it is possible to avoid the development of pneumothorax.

ethnoscience

Treatment of pulmonary emphysema with folk remedies improves the breathing process, strengthens the body, some methods easily remove sputum, and also expand the bronchi.

First of all, you need to pay attention to infusions and decoctions. With the help of them you can do inhalation, they can also be taken orally. Before you start using folk 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 onion, garlic, honeycomb, aloe, kalanchoe and so on. Consider some other options that are the most popular.

Often, in the treatment of emphysema, folk remedies use milk, to which carrot juice is added. The first should be warmed up, and also be high in fat. Add one tablespoon of carrot juice to it. It is necessary to take this drug 3 weeks before eating.

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

Horsetail and fennel tincture - 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 three times a day, 100 ml.

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

It will be an efficient way. This vegetable must be washed and peeled. Next, squeeze the juice out of it, mix with a spoonful 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 according to the method of Dr. Bubnovsky 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 muscles of the ribs work. Stretching the chest is quite difficult, but it is possible. It is necessary 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 the knees of the legs, lying on the bench. You should take a dumbbell with your hands, which should weigh no more than 2 kg, lower it behind your head, while inhaling. You need to do it only through the nose. The dumbbell should be raised above your head and lowered as you exhale. It should sound like "ha". The diaphragm is stretched, and the intercostal muscles are also contracted. Every day you need to put your hands on your head more and more.

When a person begins to increase the amplitude of movements, the intercostal muscles are stretched. Thus, it also engages thoracic region spine. This effect quite palpable. Reviews of the treatment of pulmonary emphysema according to the Bubnovsky method make it possible to understand that the exercise really helps in many cases. They need to be taken before meals. Repeat about 15 times, divided into two sets. Every month you need to increase the weight of the dumbbells.

At first, discomfort and muscle tension may be observed, but over time, these symptoms disappear. This exercise will help with other diseases, and it also affects the functioning of the intestines. If you use this exercise in complex therapy together with medicines, the effect will not keep you waiting.

Possible Complications

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

The most dangerous complication should be called pneumothorax, which develops spontaneously. When it develops, it is necessary to drain pleural cavity and aspirate air.

Prevention

In order to never know what it is - emphysema (symptoms, treatment is 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 abandon this bad habit once and for all.

The best prevention pathologies respiratory system- walks on fresh air as well as sports. You need to take care of your immune system. You can use various folk remedies that will improve defensive forces body, as well as immunostimulants. Then you do not have to think about the treatment of emphysema.

The girl went to the doctor about her father's illness: “Recently, my family was faced with a diagnosis: 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, mostly older men.

The risk of developing the disease:

congenital forms associated with whey protein deficiency. More often detected in residents of Northern Europe;
at people who smoke the risk of developing emphysema is 15 times higher than that of non-smokers, passive smoking just as dangerous;
violations of microcirculation in the tissues of the lungs;
and alveoli;
professional activities 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 the 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 between air and blood occurs, is disturbed, the body experiences an oxygen deficiency. Expanded areas squeeze healthy lung tissue, which further disrupts their ventilation, shortness of breath and other symptoms of emphysema appear.

To compensate and improve respiratory function the respiratory muscles are actively involved.

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

As a rule, shortness of breath begins to disturb the patient after 50-60 years. At first it appears during physical exertion, later and at rest. At the time of an attack of shortness of breath, the face becomes pink. The patient, as a rule, sits, leaning forward, often holding on to the back of the chair in front of him. Exhalation with emphysema is long, noisy, the patient folds his lips with a tube, trying to ease breathing. When inhaling, patients do not experience difficulty, and exhalation is very difficult. Due to the characteristic appearance with 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 clear. The chest is expanded, as if frozen on inspiration. Often it is figuratively called barrel-shaped. A characteristic symptom of emphysema is weight loss. This is due to the fatigue of the respiratory muscles, which work at full strength to facilitate exhalation. A pronounced decrease in body weight is an unfavorable sign of the development of the disease.

The tops of the lungs bulge in the supraclavicular regions, expanding and sinking into the intercostal spaces. The fingers become like drumsticks. The tip of the nose, earlobes, nails become bluish in color. With the development of the disease, the skin and mucous membranes turn pale, because small capillaries do not fill with blood and oxygen starvation occurs.

From this pathology more often, as I said, men suffer, 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 system.

It is important to take into account age-related changes. The 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 expiratory velocity, and spirometry, revealing a change in the respiratory 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 the inhaled (exhaled) air.

X-ray studies of the chest organs reveal dilated cavities and determine the increase in lung volume. CT scan- increased "airiness" of the lungs. Emphysema is classified into several categories. By the nature of the flow - acute (it can be caused exercise stress, an attack of bronchial asthma; requires surgical treatment) and chronic (changes in the lungs occur gradually, and a complete cure can be achieved at an early stage).

By origin - primary (due to the innate characteristics of the body, it is an independent disease, diagnosed even in newborns; difficult to treat, secondary emphysema also progresses rapidly (due to obstructive lung diseases in chronic form; leads to incapacity).

According to anatomical features, there are panacinar(in the absence of inflammation, respiratory failure is noted), periacinar(develops with tuberculosis), peri-cicatricial(manifested near fibrous foci and scars in the lungs) and subcutaneous(air bubbles form under the skin) forms.

The most dangerous bullous(bubbly) shape, in which one large cavity filled with air is formed. Inflammatory and suppurative processes occur in the lungs (chronic abscess, tuberculosis). The danger of bullous emphysema is associated with a strong thinning of the surface shell of the bulla (formations in the form of air bubbles in the lung tissue), the rupture of which is possible with sudden pressure drops 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 respiratory failure and in the event of complications pulmonary hemorrhage, pneumothorax).

For cupping inflammatory process appointed antibacterial drugs. At bronchial asthma or bronchitis with bouts of difficulty breathing, bronchial dilators are indicated ( theophylline, berodual, salbutamol). To facilitate sputum production - mucolytics ( ambrobene, lazolvan, acetylcysteine, flumycin). To improve gas exchange initial stage diseases applied oxygen therapy. This method of treatment consists in inhaling air with a reduced amount of oxygen for 5 minutes. Then the same time the patient breathes air with a normal oxygen content. 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 the immune system and remove toxins from the body. In respiratory failure, eating large amounts of carbohydrates can lead to an even greater lack of oxygen. Therefore, it is recommended low calorie diet. Diet - fractional, 4-6 times a day.

Fats - at least 80-90 g. These can be vegetable and butter, dairy products with high fat content.

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

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

From drinks - juices, koumiss, rosehip compote.

Salt restriction (up to 6 g) for the prevention of edema and complications of cardiac activity.

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

With emphysema, the respiratory muscles are in constant tone, so they quickly get tired. Classical, segmental (stroking, kneading, rubbing) and acupressure (pressure on certain points of the body) massages help to expel sputum and expand the bronchi.

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

The patient makes a deep, long exhalation through a tube, one end of which is in a jar of water. The water barrier creates pressure when exhaling.
Starting position: standing, feet shoulder-width apart. sick does deep breath and as you exhale, stretch your arms out in front of you and lean forward. During exhalation, you need to draw in the stomach.
Starting position: lying on your back, hands on your stomach. As you exhale, press down on the anterior abdominal wall with your hands.
Take a deep breath, hold your breath. Exhale air in small bursts through pursed lips. In this case, the cheeks should not be inflated.
Take a deep breath, hold your breath. Then, in one sharp push, exhale 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 hands to your shoulders, slowly spread them to the sides and return to your shoulders again. Repeat 2-3 times, then exhale forcefully.

Forecast

Emphysema leads to irreversible changes in the tissue structure of the lungs. Possible development of right ventricular heart failure, myocardial dystrophy, edema lower extremities, ascites. Therefore, the prognosis directly depends on the timeliness of the start of therapy and the precise implementation of all medical advice. In the absence of the necessary medical measures the disease progresses and leads to disability, and later to disability.

A feature of emphysema is its constant progression, even during treatment. But with the observance of all therapeutic measures, it is possible to slow down the development 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, the so-called passive smoking, is even more dangerous than the process of inhaling tobacco smoke.

get busy active species sports (swimming, running, skiing, football), do breathing exercises, walk in the fresh air, visit the steam room. For lung health, walks in the forest and near salt ponds are very useful. 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, cumin.

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

Inhalations with a decoction of potato roots "in uniform" have an expectorant and relaxing effect on the muscles of the bronchi. The temperature of the liquid should not exceed 85°C to prevent burns of the mucous membrane. To carry out the procedure, take a few potatoes, wash them, put them in a saucepan and cook until tender. Then take the pot off the heat, place it on a stool, cover yourself with a towel, and inhale 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 an ordinary aroma burner (5-8 drops of ether per 15 square meters of the room). The same oils are used for rubbing the feet, palms, and chest. For this, in 1 tbsp. a spoonful of jojoba, vegetable or olive oil, 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 right ventricular heart failure, 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 old - they get sick 2 times more often than women. The development of the disease is based on the following changes in tissues:

violation of the process of filling the alveoli with air;
difficulty in collapsing the alveoli;
adhesion of the smallest bronchi;
violation of ventilation;
overstretching of tissues;
the formation of bulls (cysts);
destruction of the interalveolar septa.

Causes leading to the development of emphysema

The causes of emphysema in the lungs are:

Violation of the process of formation of elastin.
Smoking.
Inhalation of various chemicals (dust, smoke, aerosols). Most often, the disease is caused by nitrogen and sulfur oxides, as well as cadmium. They enter lung tissue, accumulate in the alveoli, damaging the vessels and epithelium, enhance the formation of elastase (an enzyme that destroys elastic tissue).
infectious diseases (pneumonia, chronic inflammation bronchi).
Obstruction. During exhalation, the air does not leave the alveoli, and during the subsequent inhalation, tissue stretching occurs.
Work during harmful conditions. The risk group for the development of emphysema includes glassblowers and musicians who work with wind instruments.
Congenital features of development.
Violation of blood circulation.
Insufficient production of alpha-1 antitrypsin (a protein that inhibits the activity of proteases).
Asthma.
Hormonal disorders.

Types of disease and their symptoms

There are the following forms of the disease:

Primary. Occurs as a result congenital disorders. Is different early onset 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. The process involves whole lung. It does not subside when the organ is removed.
Localized. A separate area is affected.
Panacinar. The whole acinus is involved in the process (a formation that includes alveoli, terminal bronchiole and alveolar sacs).
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).
Perirubtsovuyu.
Lobar (share).
McLeod syndrome. It affects only one lung. The etiology has not been established.

With emphysema, symptoms include:

Shortness of breath. It is expiratory (it is difficult for patients to exhale air). On early stages it is weak, but as respiratory failure progresses, shortness of breath becomes stronger. Lying down, it does not increase, which is an important diagnostic criterion. These people have difficulty breathing.
Weight loss. The reason is a large load on the respiratory muscles.
Cough. During it, the skin becomes Pink colour. Cough with emphysema is productive with the release of a small amount of sputum.
Bulging of the veins in the neck. The reason is an increase in pressure in the chest cavity. This symptom well expressed when coughing and exhaling air.
Acrocyanosis (blue nose, ears, nails). Caused by tissue hypoxia.
Hepatomegaly (enlargement of the liver).
Change of phalanges according to the type of drumsticks and nails according to the type of watch glasses.
A change in the appearance of a sick person (shortening of the neck, protrusion of pits in the collarbone region, 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 on exhalation.
Puffing during exhalation.

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:

Collection of anamnesis.
Visual inspection. The doctor pays attention to the ribs, the shape of the chest, the neck, the symmetry of the shoulders and the nails.
Physical examination. Percussion reveals a boxed tone of sound, lowering of the lower edge of the lung, and limited mobility. With this pathology, weak breathing, dry rales, muffled heart tones, increased exhalation, increased second heart sound above the pulmonary artery, rapid breathing and heartbeat.
X-ray examination. The picture reveals excessive transparency of tissues, expansion of the spaces between the ribs, bullae, omission of the diaphragm, an increase in the size of the lungs and their proximity to each other.
Assessment of external respiration.
Blood analysis.
Grade gas composition blood (determination of the concentration of oxygen and carbon dioxide).
Electrocardiography.
Ultrasound of the heart.
Tiffno test.
Determination of the level of alpha-1 antitrypsin.

With emphysema, the treatment is complex. It includes:

Breathing exercises.
To give up smoking.
Speleotherapy.
The use of drugs (bronchodilators, systemic corticosteroids). Fenoterol-Nativ, Berotek, Eufillin, Foradil, Formoterol-Nativ, Teopek, Atrovent, Ventolin and Salbutamol-Teva are used to eliminate tissue hypoxia. With emphysema, Budesonide Easyhaler or Prednisolone Nycomed is prescribed for life. Diuretics may be used in heart failure. In the 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 the consumption of sweets, pastries and fatty meats.
Electrical stimulation of the respiratory muscles.
Treatment of existing respiratory diseases.

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

Prognosis for life and prevention

With emphysema, the prognosis for life is relatively unfavorable. If the 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 lifestyle life (sports, smoking cessation), prevention of bronchitis and other respiratory pathologies and exclusion of contact with harmful chemicals.