Emphysema of the lung. Causes, symptoms, signs, diagnosis and treatment of pathology. What is pulmonary emphysema, symptoms and treatment of the disease

Like chronic obstructive bronchitis And bronchial asthma, pulmonary emphysema belongs to the group of chronic obstructive pulmonary diseases. This means that with this disease in the respiratory organs there are irreversible changes. Therefore, every hour and day counts. It is necessary to strictly follow all the doctor’s recommendations on how to treat the disease so that emphysema does not have its dire consequences.

With emphysema, the walls of the alveoli are stretched, as a result of which the lung tissue contains increased amount air, the exchange of oxygen and carbon dioxide in the body is disrupted.

This disease is more common in older people. In young people, it leads to early loss of ability to work and disability.

The disease can occur in two forms:

• bullous ( pathological tissue adjacent to healthy ones);
• diffuse (pathology has spread to the entire organ).

Contributes to the development of pulmonary emphysema whole line factors: polluted air, smoking, hazardous working conditions. Heredity also plays a certain role in the development of the disease. But the main cause of the disease is Chronical bronchitis.

As the disease develops, it is revealed in the following symptoms:

• severe shortness of breath;
• cyanosis;
• increase in volume of the chest;
• decreased respiratory movements of the diaphragm;
• expansion and bulging of the intercostal spaces and supraclavicular areas.

The complications of pulmonary emphysema are terrible - respiratory and heart failure, pneumothorax.

Preventive measures

Prevention of the development of pulmonary emphysema, first of all, consists of timely treatment bronchitis and other respiratory diseases.

You should quit smoking once and for all, and do it abruptly, not gradually.

Walking on fresh air, sports and breathing exercises – best prevention respiratory failure.

It is also necessary to increase immunity, including pharmaceutical immunostimulants and folk remedies, for example, honey, echinacea, etc.

Is it possible to cure emphysema?

Treatment of emphysema with both traditional and folk remedies is recommended. At the same time, not a single doctor will approve the replacement of classical therapy with any traditional methods, no matter how effective they may seem.

Only an experienced specialist should decide how to treat emphysema. This is done in the hospital's pulmonary department. Depending on the form of the disease and the severity of the patient’s condition, the doctor decides whether the patient will undergo treatment in a hospital or at home, what drugs will help cure pulmonary emphysema, and what folk remedies can be used.

The irreversibility of the changes that the lung tissue has undergone suggests that it is impossible to completely cure pulmonary emphysema. But timely measures taken and compliance with all medical recommendations will prevent the disease from progressing. If it is possible to reduce the signs of respiratory failure caused by it, the person will be able to live a normal life.

Therapeutic measures are carried out according to plan, they are aimed at eliminating respiratory failure and improving the functioning of the lungs.

1. Improving bronchial patency. For this, patients are prescribed bronchodilators. In acute conditions, aminophylline is injected. In milder cases, medications such as Eufillin, Neophylline, Theophylline, Teopek are taken in tablets.

Inhalation therapy is practiced for the same purpose. Pulmonary patients with pulmonary emphysema breathe Ventolin, salbutamol, Berodural, Berotek and other drugs that dilate the bronchial lumens. Inhalations can be done in a hospital, a physiotherapy office or at home if you have a nebulizer at home.

It is also necessary to take glucocorticoid hormones - hydrocortisone, dexamethasone, corifen, prednisolone.

2. It is necessary to take measures to thin the mucus and facilitate its expectoration. Here the doctor will recommend treatment with the same expectorants that are used for bronchitis. This:

• ambroxol;
• bromhexine;
• lazolvan;
• pectolvan;
• overslept;
• flavomed;
• other.

In order to remove sputum, you can simultaneously try treatment with folk remedies.

3. If the cause of the disease is chronic bronchitis, that is, the constant presence of infection in the bronchi, treatment of emphysema includes antibiotic therapy. It is necessary to identify the pathogen and select an antibacterial agent to which it is sensitive. Usually, medications are prescribed wide range actions based on penicillin, azithromycin, etc.

4. To relieve signs of respiratory failure, oxygen therapy is practiced, i.e. oxygen inhalation from a special cylinder. In especially severe cases, artificial ventilation may be necessary.

5. In some cases of focal (bullous) emphysema, it is recommended to surgery, during which pathological tissue is removed.

6. In order to balance processes in the cerebral cortex, activate trophic processes in the lung tissue, reduce spasms in the bronchi, and strengthen the body as a whole, breathing exercises are recommended to the patient.

As a rule, the course drug therapy lasts three to four weeks. Folk remedies can be used without interruption. Often they help patients with pulmonary emphysema feel satisfactory.

ethnoscience

The patient can use folk remedies to expand the bronchial lumens, remove mucus, improve respiratory function and general strengthening of the body.

Black radish with honey

In the treatment of pulmonary emphysema, you can use the following folk remedies:

1. Infusion of wild rosemary. In 500 ml of boiling water add 1 teaspoon of dried and crushed herbal preparation, they insist for an hour. Drink 150 ml of warm tincture twice a day.
2. Black radish juice. Fresh vegetable wash and peel. Grate it and squeeze out the juice. 50 ml of juice is mixed with 2 tablespoons of honey. Take 2 tablespoons of the drug twice a day. It is advisable to do this before eating.
3. Infusion of horsetail and fennel. Pour boiling water into a half-liter jar with folk remedies taken in equal proportions (1 tablespoon each). The infusion is kept for an hour. Drink 100 ml three times a day.
4. Milk with carrot juice. In a glass of warmed full fat milk add 1 tablespoon of carrot juice. The drink is consumed on an empty stomach for three weeks.
5. Tea made from mint, sage and thyme. One and a half teaspoons of dried and crushed herbs mixed in equal proportions are poured into a thermos and poured with a glass of boiling water. Drink 70 ml after breakfast, lunch and dinner.

In the process of treating pulmonary emphysema with folk remedies, you can also use onion and garlic juice, propolis, aloe juice and Kalanchoe, etc.

TO unconventional methods It is important to treat the fight against pulmonary emphysema without fanaticism. It must be remembered that an unsuccessful attempt at self-medication can result in serious consequences, and sometimes even cost life.

To quickly cure cough, bronchitis, pneumonia and strengthen the immune system, you just need...

One of the most insidious diseases of the respiratory system is emphysema, the prognosis of life for which is determined by the causes, nature and course of the pathology.

This disease is a chronic disease in which the alveoli stop contracting normally. Often, the precursors of emphysema are diseases such as pneumonia and bronchitis.

The danger of the pathology lies in the fact that it can develop over a long period of time without significant manifestations, both in an elderly person and in a newborn.

What is emphysema?

Emphysema is classified as COPD (chronic obstructive pulmonary disease). It is characterized by damage to the alveoli located in the lung cavity and the endings of the bronchi involved in the breathing process. When you inhale, the alveoli fill and swell, and when you exhale, they return to their original position.

With pulmonary emphysema, this process is disrupted, the air pressure in the alveoli increases, and the bubble-like formations stretch.

When the alveoli stop taking part in the breathing process, the entire respiratory system begins to suffer. Due to impaired gas exchange, the amount of air in the lungs increases, which leads to improper functioning of the organ.

Here it is important to consult a doctor as soon as possible to prevent the development of complications and improve your life prognosis

Types of emphysema

There are two types of emphysema:

• Diffuse. Represents damage to the entire lung tissue. May be caused by allergic or obstructive bronchitis.
• Localized. It is characterized by damage not to all the lungs, but to their individual sections. Often occurs against the background of congenital disorders.

There are also the following forms of pulmonary emphysema:

Causes of emphysema

The disease can develop for the following reasons:

• Violation of microcirculation in pulmonary tissues;
• The presence of an inflammatory process in the bronchi or alveoli;
• Bronchial asthma and other chronic obstructive pulmonary pathologies;
• Congenital α-1 antitrypsin deficiency, due to which alveolar tissue begins to be destroyed by proteolytic enzymes;
• Smoking, including passive smoking;
• Inhalation of toxic compounds into the lungs, for example, when working in industrial production.

These factors contribute to damage to the elastic tissue of the lungs, disruption of its ability to normally stretch and contract during breathing. With emphysema, small branches of the bronchi stick together, the lung tissue becomes stretched and swollen, and bullae or air cysts form. Emphysematous lungs are enlarged and resemble a porous sponge.

Signs of emphysema

Patients suffering from diffuse type emphysema experience the following symptoms:

• Sharp weight loss;
• Protrusion of the supraclavicular fossa;
• Slouch;
• The presence of weakened, and in some places even absent, breathing (detected when listening with a phonendoscope);
• The appearance of shortness of breath during any physical activity;
• Sticky lungs (if a patient has swelling of the lung, it is customary to say that “the lung is stuck together”);
• Widened spaces between ribs;
• Barrel-shaped chest;
• Presence of air traps in the lungs.

In people with diffuse eczema, x-rays show a low-lying diaphragm and increased transparency of the lung area. Respiratory failure increases, the heart takes more vertical position. In localized disease, affected areas put pressure on healthy parts of the lungs. The result is the development of pronounced disorders, including suffocation, and the life prognosis sharply worsens.

When can you expect a favorable outcome?

With pulmonary emphysema, the life prognosis depends on the form of pathology and the person’s lifestyle.

Factors that prolong life with the disease:

• Timely diagnosis, early treatment;
• Emphysema occurs in mild and moderate forms;
• To give up smoking;
• Following a special diet.

If emphysema is bullous, life expectancy is short. If a patient with this disease manages to live more than four years from the moment the diagnosis was made, the outcome is considered favorable.

When is an unfavorable outcome possible?

The process of change in lung tissue is irreversible and continuous. Ultimately, the disease affects the lungs completely. However, even in the most severe cases, patients with emphysema manage to live for more than a year.

To answer the question of how many people live with emphysema, you need to pay attention to the nature, course and causes of the disease. The most unfavorable outcome has primary pulmonary emphysema, which develops with congenital defects of the enzyme system.

Aggravating factors include cell damage cigarette smoke, inhalation of industrial dust and toxic substances, especially if this occurs over several years and does not stop after diagnosis.

Helps delay death from emphysema early diagnosis diseases and adequate therapy. The situation is complicated by the fact that the disease does not manifest itself in any way for a long time, so its diagnosis occurs when there is significant damage to the lung tissue. The first signs of pathology (shortness of breath, cough) appear when the disease progresses.

Simply put, an unfavorable outcome is possible in the cases described below:

• At untimely treatment emphysema;
• In people with congenital enzyme defects;
• In the presence of bad habits(smoking);
• If the patient is under the influence of dust and toxic substances.

Life expectancy with emphysema

Some people ask the question, “What is mortality?” Mortality from emphysema or any other pathology is understood as the number of deaths caused by a given disease.

Data on life expectancy and mortality of patients with emphysema are obtained from medical statistics, but they are limited. However, doctors do not advise drawing conclusions based on this information. The fact is that the dynamics of the development of emphysema is individual for each patient.

Life expectancy depends on:

• General physical condition of the patient;
• Lifestyle;
• Heredity;
• Age;
• Availability of other systemic diseases, such as bronchial asthma, tuberculosis, chronic bronchitis.

If a person has several factors from the above list, it is possible to give an accurate and correct forecast of life expectancy only after a detailed examination.

At the same time, it will not be possible to do without evaluation criteria. To make a diagnosis, the severity of the pathological process must be determined. To achieve this, attempts have been made to standardize the stages of the disease. To do this, tests are used that evaluate a set of indicators: body mass index, exercise tolerance, the presence of shortness of breath, as well as the volume of air exhaled over a specific period of time.

• Very heavy;
• Heavy;
• Moderate;
• Easy.

The more severe the form of pathology, the worse prognosis life.

If a relatively favorable diagnosis is considered to be a life expectancy of more than 4 years from the date of diagnosis, the averaged and generalized conclusions look like this:

• At mild form More than 80% of patients manage to survive the disease for more than 4 years;
• With moderate – up to 70%;
• For severe cases – up to 50%.

Treatment of emphysema

If you are wondering how to treat emphysema, it will be useful for you to know that the pathology can be treated by giving up bad habits, following a special diet, oxygen therapy, massage and exercise therapy. Inhalations are also possible. The main thing in this case is to choose the right inhaler (this issue should be discussed with your doctor).

Drug treatment of emphysema is also practiced. The specialist’s task is to conduct a thorough examination and select drugs that will help eliminate the symptoms of the disease.

When answering the question “How is emphysema treated?”, do not forget about the possibility of using folk remedies. Self-medication should not be practiced. Before taking any medications, you should consult with a pulmonologist and therapist.

Complications of emphysema

In both adults and children, emphysema can lead to negative consequences in the form of:

• Pulmonary hypertension;
• Failure ;
• Oncology (cancer);
• Cardiac right ventricular failure and its consequences, such as hepatomegaly, edema of the lower extremities, ascites.

The most dangerous complication is spontaneous pneumothorax, requiring drainage of the pleural cavity and aspiration of air.

Improving life prognosis with emphysema

To stop the development of the disease and stabilize a person’s condition, you should:

• Balance your diet (include more vegetables, boiled fish and meat, reduce salt intake);
• Give up bad habits such as alcohol abuse and smoking (tobacco smoke is the main destructive factor that destroys the lungs);
• Take daily walks in the fresh air;
• Avoid hypothermia, cold air and respiratory infections;
• Train the respiratory muscles 4 to 5 times a day for 15 minutes. (there is special gymnastics for this).

Emphysema is a chronic disease and is progressive. Prolonged inflammation and narrowing of the lumen respiratory tract leads to a decrease in the elasticity of lung tissue. As for the prognosis of life with the disease, it depends on the form of the disease, the severity of its course and some other factors.

Emphysema implies chronic pathology lungs, the alveoli are affected, they lose their natural ability to contract. The disease in 90% of cases is accompanied by respiratory failure. Frequent precursors of emphysema are prolonged diseases of the respiratory system, such as bronchitis and pneumonia. Pathology in medical environment It is considered insidious, since it does not have bright manifestations and can develop for quite a long time without causing severe discomfort to the patient.

Emphysema comes from the word “to bloat” and represents the process of disruption of gas exchange in the lungs and respiratory function. The alveoli, which are located at the endings, have a responsible function - they help in the breathing process. When a person inhales air, they fill and swell like a small ball; when exhaling, they become the same due to natural contractions.

Emphysema is a violation of this process when, as a result, various diseases respiratory organs, the alveoli begin to perform increased work, the air pressure in them increases, which leads to their stretching. This is where the derivative of the definition comes from – “to inflate”.

When the alveoli lose their ability to participate in the breathing process as before, the lungs begin to suffer. Impaired gas exchange leads to an increased amount of air in the lungs, which contributes to the malfunction of the organ. If the pathology is not noticed and treated in time, it can spread to the heart and lead to complications. Often, every third patient has a history of cardiac or respiratory failure.

Emphysema in medicine has a specific classification. On its basis, the disease is divided according to the nature of its manifestations, prevalence, anatomical features and origin. It is possible to consider the classification of emphysema in more detail using the table presented.

The classification helps specialists understand what to focus on during therapy and which treatment methods to use.

Symptoms and first complaints

Emphysema is a pathology that is difficult to recognize immediately, since initial stage the symptoms are minor. It can be confused with signs of a viral infection or an inflammatory process in the bronchi and trachea. Without medical examination It is extremely difficult to recognize the disease, therefore, if even minor symptoms of cough and accompanying signs of a respiratory infection appear, you must contact a specialist.

Signs of pulmonary emphysema include the following manifestations.

1. Cyanosis. This strange definition speaks of the pathology that often accompanies emphysema. It is expressed in a bluish tint to the earlobes, tip of the nose and nails. The manifestation is associated with oxygen starvation of the body, resulting in pallor skin and a bluish tint. The capillaries cannot fully fill with blood.
2. Shortness of breath, which manifests itself slightly at the initial stage and only with physical activity. Over time, the patient begins to notice strangeness in breathing; during inhalation, it seems that there is not enough air, and the process of exhalation becomes difficult and lengthy. The symptoms are associated with the accumulation of mucus in the lung cavity.
3. “Pink puffer” - this strange definition also refers to the symptoms of the disease. With emphysema, the patient is plagued by coughing attacks. At the same time, the skin of the face becomes pink. This distinguishing feature from COPD, since with the latter illness, during the coughing process, the person’s face takes on a bluish tint.
4. Swelling of the veins in the neck associated with high blood pressure inside the sternum, which is reflected in a coughing attack. During it, the neck veins swell, the same phenomenon can be observed when exhaling.
5. Losing weight. Due to the intense work of the respiratory muscles, a person begins to lose weight over time, which becomes noticeable to others.
6. Intensive functioning of the respiratory muscles is associated with increased work of the diaphragm, intercostal muscles and abdominal muscles. They help the lungs stretch when inhaling, since the organ loses this function with emphysema.
7. Changes in the location and size of the liver. These symptoms can only be detected through diagnosis. It is one of the components in making a diagnosis. When examining the patient, a specific position of the diaphragm may be detected; it should be elevated. As a result, the localization of the liver changes under its influence. The decrease in size of the organ is associated with stagnation of blood in its vessels.

Experienced specialists can diagnose “pulmonary emphysema” just by appearance. They focus on external manifestations that occur in patients with a chronic form of the disease. This is a shortening of the neck, protrusion of the supraclavicular fossa, the patient’s chest looks voluminous. In addition, the specialist may ask the patient to breathe and then note the specific location of the diaphragm and abdomen, which becomes saggy under its pressure. When inhaling, there is a protrusion of the intercostal muscles; they seem to stretch under the pressure of air.

Causes leading to illness

According to statistics, about 60% of patients affected by emphysema had a history of other pathologies of the respiratory system. Pneumonia, chronic bronchitis, bronchial asthma, tuberculosis can cause the development of the disease.

There are other reasons that are worth paying attention to, because many of them are related to a person’s daily lifestyle. For example, the state of the environment in the area where the patient works or lives. If a person is exposed every day to coal dust, smog, toxic substances, nitrogen and sulfur released during the operation of enterprises, then his lungs may eventually fail. In a polluted atmosphere, they function with increased efficiency and are at the same time permeated with harmful substances, which affects their condition.

Separately, it is worth mentioning about smokers, since inhalation of vapors tobacco smoke can lead to disease of the bronchi and lungs. Nicotine lovers may eventually develop bronchial asthma, followed by emphysema, if the person does not stop smoking. A persistent cough should make you think about immediately eliminating the dangerous habit.

The disease can also occur in newborns. This is due to several factors:

• congenital defects in the structure of lung tissue;
• congenital deficiency of α-1 antitrypsin, when the walls of the alveoli are destroyed independently;
• heredity, expressed in insufficient functioning of the respiratory organs, while over time the elasticity and strength of lung tissue is impaired.

In adults, the cause of the disease can be hormonal in nature, when the ratio between estrogens and androgens is disrupted. Hormones are involved in the process of contraction of bronchioles. Therefore, if the balance is disturbed, they can stretch over time, but do not affect the functioning of the alveoli. Age-related changes should also be taken into account. In old age, the lungs do not have the same density, strength, and elasticity as at a young age.

Doctors identify causes that relate to increased pressure in the lungs. As a rule, it is because of this process that emphysema develops. Negative pressure can form in the lungs when the bronchial lumen is blocked, or during harmful work, which involves an increase in air pressure in the lungs, for example, among trumpet musicians.

Modern experts will never take into account one factor that could influence the development of pathology, since they believe that only a combination of several reasons can contribute to emphysema.

Features of the disease in children

According to statistics, among children, infants are more often susceptible to pathology; boys have a greater risk than girls in developing the disease. Several factors are considered to be the cause of pulmonary emphysema in newborns. One of them is associated with congenital characteristics, that is, the process of improper development of the organ and respiration occurs in the perinatal period. The second one talks about, but modern experts believe that this factor no longer relevant.

Numerous observations and studies have proven that common cause Pulmonary emphysema in children is due to insufficient development of tissues, the organ itself or a separate bronchus. Lung stretching is caused by a pathological process when, during breathing, the bronchi narrow and the alveoli slow down the flow of oxygen that is in the lungs.

Congenital emphysema has symptoms that any parent will undoubtedly notice:

• tachycardia;
• shortness of breath, which manifests itself quite clearly in childhood;
• there is a blue tint of the skin in the area of ​​the nose and lips;
• during an attack, the child may lose consciousness due to lack of air;
• breathing is accompanied by a distinct whistle.

In childhood, there are several forms of the disease: decompensated, subcompensated, compensated. The first appears in the first days of a baby’s life and is observed in premature babies. It is easy to recognize this form of the disease; the symptoms manifest themselves clearly. The second one is not talking about congenital pathology, but acquired.

Symptoms may appear several years after birth; they will be subtle at the initial stage.

The compensated form is considered the most dangerous, since it does not imply the presence of severe symptoms. Signs of the disease may be completely absent, which complicates the diagnostic process.

Children are shown surgical intervention with pulmonary emphysema. In case of decompensated form, it should be carried out urgently. Subcompensated and compensated imply elective surgery.

How to treat - drugs for emphysema

Therapy is usually prescribed not only by the therapist, but by the treating pulmonologist. Without his consultation, it is impossible to obtain an adequate treatment plan. All measures boil down to the patient following a special diet, giving up bad habits, oxygen therapy is prescribed, therapeutic physical training and massage are prescribed. The treatment package also includes taking special drugs that help eliminate the manifestations of the disease.

1. Inhibitors are prescribed, for example, Prolastin. It helps reduce the level of enzymes through protein content that destroy the connective fibers of organ tissue.
2. Antioxidants are prescribed to improve tissue nutrition and metabolism. They help slow down and eliminate the pathological process occurring in the alveoli. The representative is Vitamin E.
3. A prerequisite is the use of mucolytic drugs, such as Lazolvan or ACC. They thin out mucus, help faster, and reduce the production of free radicals.
4. Teopek is a bronchodilator inhibitor, often used for pulmonary emphysema. It leads to relaxation of the smooth muscles of the bronchi, reduces mucous edema and helps to expand the lumen in the organ.
5. Prednidazole is a glucocorticosteroid. Prescribed only if bronchodilator therapy is ineffective. It has a strong anti-inflammatory effect on the lungs and helps expand the lumen of the bronchi.
6. Atrovent is used in the form of inhalations. The drug is used together with saline solution in a nebulizer. Prevents bronchospasm, improves the breathing process.
7. Theophyllines are prescribed; these are long-acting medications that help eliminate pulmonary hypertension. They help the respiratory system not to get tired by influencing its muscles.

In addition to a complex of medications, the use of massage, oxygen therapy, therapeutic exercises and diet, specialists can prescribe breathing exercises. It helps strengthen the respiratory muscles and restore the process of natural inhalation and exhalation, which was disrupted by emphysema.

Folk remedies

In combination with drug treatment, you can use the following advice: traditional medicine. Before using a specific recipe, you should consult with a therapist and pulmonologist; each plant has its own contraindications for use, and each person is individual in their response to herbal medicine.

Among the numerous traditional medicine treatments for emphysema, the following 3 recipes are popular.

1. An infusion of coltsfoot can help with complex therapy emphysema. It is necessary to collect the leaves of the plant and dry it; only ground components are used. They are taken per 1 tbsp. spoon of leaves 2 cups of boiling water. The duration of exposure to boiling water should be at least an hour. After the infusion, use 1 tbsp. spoon 6 times a day.
2. You can use a collection of herbs: sage, eucalyptus, raspberry leaves, thyme and elecampane root. The components are used in equal proportions, usually a measure of 1 tbsp is used. spoon, pour a glass of boiling water and infuse for 60 minutes. The decoction is great for coping with shortness of breath. Apply after straining ¼ cup per day, 4 times.
3. There is a simple recipe that does not cost money. Potato flowers are used. 1 teaspoon of the plant is poured into a glass of boiling water and infused for 2 hours. Use the decoction for shortness of breath, strain and drink 1/2 cup half an hour before meals, 3 times a day.

Life forecast - how long do people live with emphysema?

The life expectancy of a patient after therapeutic intervention can be influenced by many factors. There are no specific statistics that could indicate favorable or unfavorable development of emphysema after surgery or conservative treatment. The further development of the pathology and life of the patient depends on individual characteristics the body and the patient himself, to what extent he adheres to the specialist’s recommendations.

Separately, there is a forecast for morbidity among patients who have genetic form pathologies, because life expectancy is in this case depends on heredity.

After therapy, it is advisable to undergo a special examination, which helps determine the patient’s respiratory capabilities. It is carried out through a test that determines the volume of air exhaled by a person over a certain period of time, indexes the patient’s body weight, and diagnoses the presence of shortness of breath. Based on the results of the study, a professional can draw a picture of the further development of the disease and whether relapses are possible.

Much depends on the patient’s life and lifestyle. If the patient refuses to eliminate bad habits or change working conditions, this can adjust the doctors’ prognosis in a negative direction.

Patients in whom the pathology was detected in time and given adequate treatment can count on a favorable outcome. People who follow all the doctor’s recommendations during the postoperative or therapeutic period can also count on a positive outcome.

In children, the life prognosis depends on the form of the pathology and how early neonatologists or pediatricians were able to detect the disease and proceed to its treatment. If a child experiences frequent relapses of inflammatory processes in the respiratory system, for example, tracheitis, bronchitis, pneumonia, it is necessary to urgently consult a pulmonologist to examine the lungs in order to exclude the possibility of the formation of emphysema.

It is easier to prevent any illness than to treat it; every person needs to monitor their lifestyle. The presence of negative factors, bad habits, and heredity can cause the development of pathology. By eliminating the causes that influence the predisposition to the development of emphysema, the occurrence of pathology can be prevented.

According to WHO, up to 4% of the population, mainly older men, suffer from emphysema (emphysao - “to swell”), a pathological increase in lung volume. There are acute and chronic forms of pathology, as well as vicarious (focal, local) and diffuse emphysema. The disease occurs with disturbances in pulmonary ventilation and blood circulation in the respiratory organs. Let's take a closer look at why emphysema occurs, what it is and how to treat it.

What is pulmonary emphysema?

Emphysema (from the Greek emphysema - bloating) – pathological change lung tissue, characterized by its increased airiness due to expansion of the alveoli and destruction of the alveolar walls.

Emphysema is pathological condition, often developing in a variety of bronchopulmonary processes and having extremely great importance in pulmonology. The risk of developing the disease in some categories is higher than in other people:

• Congenital forms of pulmonary emphysema associated with whey protein deficiency are more often detected in residents of Northern Europe.
• Men get sick more often. Emphysema is detected at autopsy in 60% of men and 30% of women.
• U smoking people the risk of developing emphysema is 15 times higher. Passive smoking also dangerous.

Without treatment, changes in the lungs due to emphysema can lead to loss of ability to work and disability.

Causes leading to the development of emphysema

The likelihood of developing emphysema increases if the following factors are present:

• congenital deficiency of α-1 antitrypsin, leading to the destruction of alveolar tissue of the lungs by proteolytic enzymes;
• inhalation of tobacco smoke, toxic substances and pollutants;
• microcirculation disorders in lung tissues;
• bronchial asthma and chronic obstructive pulmonary diseases;
• inflammatory processes in the respiratory bronchi and alveoli;
• features of professional activity associated with a constant increase in air pressure in the bronchi and alveolar tissue.

Under the influence of these factors, damage to the elastic tissue of the lungs occurs, reduction and loss of its ability to fill and collapse.

Emphysema can be considered as an occupationally caused pathology. It is often diagnosed in individuals who inhale various aerosols. The etiological factor may be pneumonectomy (removal of one lung) or trauma. In children, the reason may lie in frequent inflammatory diseases lung tissue (pneumonia).

The mechanism of lung damage in emphysema:

1. Stretching of bronchioles and alveoli - their size doubles.
2. Smooth muscles are stretched, and the walls of blood vessels become thinner. The capillaries become empty and the nutrition in the acinus is disrupted.
3. Elastic fibers degenerate. In this case, the walls between the alveoli are destroyed and cavities are formed.
4. The area in which gas exchange occurs between air and blood decreases. The body experiences oxygen deficiency.
5. The enlarged areas compress healthy lung tissue, further impairing the ventilation function of the lungs. Shortness of breath and other symptoms of emphysema appear.
6. To compensate and improve the respiratory function of the lungs, the respiratory muscles are actively involved.
7. The load on the pulmonary circulation increases - the vessels of the lungs become overfilled with blood. This causes disturbances in the functioning of the right side of the heart.

Types of disease

The following types of emphysema are distinguished:

1. Alveolar - caused by an increase in the volume of the alveoli;
2. Interstitial - develops as a result of the penetration of air particles into the interlobular connective tissue - interstitium;
3. Idiopathic or primary emphysema occurs without previous respiratory diseases;
4. Obstructive or secondary emphysema is a complication of chronic obstructive bronchitis.

According to the nature of the flow:

• Spicy. It can be caused by significant physical activity, an attack of bronchial asthma, or the entry of a foreign object into the bronchial network. There is swelling of the lung and overstretching of the alveoli. The condition of acute emphysema is reversible, but requires emergency treatment.
• Chronic emphysema. Changes in the lungs occur gradually; at an early stage, it is possible to achieve complete cure. Without treatment it leads to disability.

According to anatomical features, they are distinguished:

• Panacinar (vesicular, hypertrophic) form. Diagnosed in patients with severe emphysema. There is no inflammation, there is respiratory failure.
• Centrilobular form. Due to the expansion of the lumen of the bronchi and alveoli, an inflammatory process develops, and mucus is released in large quantities.
• Periacinar (parasepital, distal, perilobular) form. Develops with tuberculosis. It may result in a complication - rupture of the affected area of ​​the lung (pneumothorax).
• Peri-scar form. It is characterized by minor symptoms and appears near fibrotic foci and scars in the lungs.
• Interstitial (subcutaneous) form. Due to the rupture of the alveoli, air bubbles form under the skin.
• Bullous (bubble) form. Bullae (bubbles) with a diameter of 0.5-20 cm are formed near the pleura or throughout the parenchyma. They arise at the site of damaged alveoli. They can rupture, become infected, and put pressure on surrounding tissues. Bullous emphysema usually develops as a result of loss of tissue elasticity. Treatment of emphysema begins with eliminating the causes that provoke the disease.

Symptoms of emphysema

The symptoms of emphysema are numerous. Most of them are not specific and can be observed with other pathologies of the respiratory system. Subjective signs of emphysema include:

• nonproductive cough;
• expiratory shortness of breath;
• the appearance of dry wheezing;
• feeling of lack of air;
• weight loss
• a person experiences severe and sudden pain in one of the halves of the chest or behind the sternum;
• Tachycardia is observed when the rhythm of the heart muscle is disrupted due to lack of air.

Patients with pulmonary emphysema mainly complain of shortness of breath and cough. Shortness of breath, gradually increasing, reflects the degree of respiratory failure. At first it occurs only during physical stress, then it appears while walking, especially in cold, damp weather, and sharply intensifies after coughing attacks - the patient cannot “catch his breath.” Shortness of breath with emphysema is inconsistent, changeable (“it doesn’t happen from day to day”) - stronger today, weaker tomorrow.

A characteristic sign of pulmonary emphysema is loss of body weight. This is due to fatigue of the respiratory muscles that work in full force to facilitate exhalation. A marked decrease in body weight is an unfavorable sign of the development of the disease.

Noteworthy is the bluish color of the skin and mucous membranes, as well as the characteristic change in the fingers like drumsticks.

In people with chronic long-term emphysema of the lung are developing external signs diseases:

• short neck;
• anteroposteriorly expanded (barrel-shaped) chest;
• the supraclavicular fossae protrude;
• on inhalation, the intercostal spaces are retracted due to tension in the respiratory muscles;
• the abdomen is somewhat saggy as a result of the prolapse of the diaphragm.

Complications

A lack of oxygen in the blood and an unproductive increase in lung volume affect the entire body, but above all, the heart and nervous system.

1. The increased load on the heart is also a compensation reaction - the body’s desire to pump more blood due to tissue hypoxia.
2. Possible occurrence of arrhythmias, acquired heart defects, coronary disease– a symptom complex known as common name"cardiopulmonary failure."
3. In the extreme stages of the disease, lack of oxygen causes damage nerve cells in the brain, which is manifested by decreased intelligence, sleep disturbances, and mental pathologies.

Diagnosis of the disease

At the first symptoms or suspicion of emphysema patient's lung examined by a pulmonologist or therapist. Determine the presence of emphysema on early stages difficult. Often, patients consult a doctor when the process is already advanced.

Diagnostics includes:

• blood test to diagnose emphysema
• detailed patient interview;
• examination of the skin and chest;
• percussion and auscultation of the lungs;
• determination of the boundaries of the heart;
• spirometry;
• plain radiography;
• CT or MRI;
• assessment gas composition blood.

X-ray examination of the chest organs is of great importance for the diagnosis of pulmonary emphysema. At the same time, dilated cavities are detected in various parts of the lungs. In addition, an increase in lung volume is determined, indirect evidence of which is the low location of the dome of the diaphragm and its flattening. Computed tomography also allows you to diagnose cavities in the lungs, as well as their increased airiness.

How to treat emphysema

There are no specific treatment programs for pulmonary emphysema, and those carried out do not differ significantly from those recommended in the group of patients with chronic obstructive respiratory diseases.

In the treatment program for patients with pulmonary emphysema, general measures that improve the quality of life of patients should come first.

Treatment of pulmonary emphysema has the following objectives:

• elimination of the main symptoms of the disease;
• improvement of heart function;
• improving bronchial patency;
• ensuring normal blood oxygen saturation.

For relax acute conditions use drug therapy:

1. Eufillin to relieve an attack of shortness of breath. The drug is administered intravenously and relieves shortness of breath within a few minutes.
2. Prednisolone as a strong anti-inflammatory agent.
3. For mild or moderate respiratory failure, oxygen inhalation is used. However, here it is necessary to carefully select the oxygen concentration, because this can be both beneficial and harmful.

For all patients with emphysema, physical programs are indicated, especially chest massage, breathing exercises and teaching the patient kinesitherapy.

Is hospitalization necessary to treat emphysema? In most cases, patients with emphysema are treated at home. It is enough to take medications according to the schedule, adhere to a diet and follow the doctor’s recommendations.

Indications for hospitalization:

• sharp increase in symptoms (shortness of breath at rest, severe weakness)
• the appearance of new signs of illness (cyanosis, hemoptysis)
• ineffectiveness of the prescribed treatment (symptoms do not decrease, peak flow measurements worsen)
• severe concomitant diseases
• newly developed arrhythmias; difficulties in establishing a diagnosis.

Emphysema has a favorable prognosis if the following conditions are met:

• Prevention of pulmonary infections;
• Quitting bad habits (smoking);
• Providing balanced nutrition;
• Living in a clean air environment;
• Sensitivity to medications from the group of bronchodilators.

Breathing exercises

When treating emphysema, it is recommended to regularly carry out various breathing exercises in order to improve the exchange of oxygen in the lung cavity. The patient should do this for 10-15 minutes. inhale the air deeply, then try to hold it as long as possible while exhaling with gradual exhalation. This procedure It is recommended to carry out daily, at least 3 - 4 r. per day, in small sessions.

Massage for emphysema

Massage helps remove mucus and dilate the bronchi. Classic, segmental and acupressure. It is believed that acupressure has the most pronounced bronchodilator effect. The purpose of massage:

• prevent further development of the process;
• normalize respiratory function;
• reduce (eliminate) tissue hypoxia, cough;
• improve local ventilation, metabolism and sleep of the patient.

Exercise therapy

With emphysema, the respiratory muscles are in constant tone, so they quickly get tired. To prevent muscle overstrain, physical therapy has a good effect.

Oxygen inhalations

A long procedure (up to 18 hours in a row) of breathing through an oxygen mask. In severe cases, oxygen-helium mixtures are used.

Surgical treatment of emphysema

Surgical treatment for emphysema is not often required. It is necessary when the lesions are significant and drug treatment does not reduce the symptoms of the disease. Indications for surgery:

• Multiple bullae (more than a third of the chest area);
• Severe shortness of breath;
• Complications of the disease: oncological process, bloody sputum, infection.
• Frequent hospitalizations;
• Transition of the disease to a severe form.

A contraindication to surgery may be severe exhaustion, old age, chest deformation, asthma, pneumonia, in severe form.

Nutrition

Compliance with rational food intake in the treatment of emphysema plays a fairly important role. It is recommended to eat as many fresh fruits and vegetables as possible, which contain a large number of vitamins and microelements beneficial to the body. Patients need to adhere to the consumption of low-calorie foods so as not to provoke a significant burden on the functioning of the respiratory system.

The daily calorie intake should not exceed more than 800 - 1000 kcal.

Fried and fried foods should be excluded from your daily diet. fatty foods nutrition that negatively affects the functioning of internal organs and systems. It is recommended to increase the volume of fluid consumed to 1-1.5 liters. in a day.

In any case, you cannot treat the disease yourself. If you suspect that you or your relative have emphysema, you should immediately contact a specialist for timely diagnosis and initiation of treatment.

Life prognosis with emphysema

A complete cure for emphysema is impossible. A feature of the disease is its constant progression, even during treatment. If you seek medical help in a timely manner and follow therapeutic measures The disease can be somewhat slowed down, the quality of life can be improved, and disability can be delayed. When emphysema develops against the background of a congenital defect of the enzyme system, the prognosis is usually unfavorable.

Even if the patient is given the most unfavorable prognosis due to the severity of the disease, he will still be able to live at least 12 months from the date of diagnosis.

For the duration of the patient's existence after diagnosis of the disease in to a large extent the following factors influence:

1. General condition of the patient's body.
2. The appearance and development of systemic diseases such as bronchial asthma, chronic bronchitis, tuberculosis.
3. How the patient lives plays a big role. Does he lead an active lifestyle or does he have little mobility? He follows the system rational nutrition or eats food haphazardly.
4. The age of the patient plays an important role: young people live longer after diagnosis than older people with the same severity of the disease.
5. If the disease has genetic roots, then the prognosis of life expectancy with emphysema is determined by heredity.

Despite the fact that irreversible processes occur with pulmonary emphysema, the quality of life of patients can be improved by constantly using inhaled drugs.

Prevention

1. Anti-tobacco programs aimed at preventing children and adolescents from smoking, as well as stopping smoking in people of any age, are of great preventive importance.
2. It is also necessary to treat lung diseases in time so that they do not become chronic.
3. Observation by a pulmonologist of patients with chronic diseases respiratory organs, administering vaccines to the population, etc.

Pulmonary emphysema (from the Greek emphisao - “I swell”) is a disease in which irreversible changes occur in the partitions between the alveoli and the terminal branches of the bronchi expand. Voids are formed in the lung tissue - specific spaces that are filled with air. The lungs themselves inflate and increase in volume. Alveoli are pulmonary vesicles that are intertwined with a network of capillary vessels. Absorbed through their thin wall essential element, which is necessary for human life - oxygen. The lungs contain about 700 million. The bronchi are the element of the pulmonary system through which the air flow passes. The main bronchus gives rise to two smaller ones, which, in turn, form four, but smaller in diameter. This division gradually ceases, ending in bronchioles, alveolar ducts and alveoli. This final section is called the acinus or structural unit of the lungs. It is here that destructive changes occur, which turn the organ into a useless swollen “bag” that does not perform its functions.

Without proper treatment, emphysema leads to disability.

It is worth noting that increased airiness of the lungs in some cases is physiological state, for example, during intense physical activity or prolonged exposure to cold.

The risks of developing emphysema in people are different, for example, people are more susceptible to:

• people with such a bad habit as smoking. The risk of developing this pathology increases by as much as fifteen times;
• The male sex is more susceptible to the formation of emphysema. The ratio is 1:3;
• high risks of developing the disease in residents of northern Europe, due to a congenital deficiency of a specific whey protein.

Provoking factors

The following may serve as provoking factors and main reasons for the development of the disease:

• infectious diseases of the respiratory tract. Sputum formed during purulent bronchitis or (pneumonia) prevents some of the air from escaping. The walls of the alveoli are thus significantly overstretched. In addition, our cells immune system that fight infection (lymphocytes, macrophages) are capable of producing enzymes that partially destroy not only microbial but also alveolar structures;
• alpha-1 antitrypsin deficiency. Normally, it is needed to neutralize enzymes that destroy the walls of the alveoli. It is a congenital pathology;
• abnormalities in the development of pulmonary structures;
• professionally caused hazards. Long work wind musician, glassblower leads to a weakening of the smooth muscles of the bronchi and impaired blood supply. When exhaling, not the entire volume of air is expelled from the alveoli; they are deformed, expanded, and cavities are formed;
• chronic obstructive pulmonary diseases - bronchial asthma eventually lead to pulmonary emphysema;
• contaminated air. The most dangerous are inhalation of cadmium, sulfur oxide and nitrogen. They are distinguished by transport and thermal power plants;
• age-related changes. Lung diseases throughout life, poor circulation, increased sensitivity to toxic substances are a favorable environment for the development of emphysema;
• hit foreign body(seeds, buttons, etc.) into the lumen of the bronchi can contribute to the development acute form emphysema.

Changes in lung tissue

Under the influence of these factors, lung tissue undergoes the following changes:

• the size of the alveoli and bronchioles increases two or more times;
• stretching of the smooth muscles of the bronchi occurs, thinning of the walls of blood vessels, their desolation and disruption of nutrition in the structural unit of the lungs - the acinus;
• the walls of the alveoli are destroyed with the formation of cavities;
• gas exchange is disrupted, and in this case the body is in a state ( oxygen starvation);
• the respiratory muscles are activated to compensate for the condition;
• over time, due to the load on the right parts of the heart, from which the vessels supplying the lungs emerge, another serious pathology- chronic pulmonary heart disease.

Types of emphysema

According to the flow there are:

• spicy. Occurs during an attack of bronchial asthma or a foreign body. Characterized by the reversibility of the condition during emergency care;
• chronic. Noted gradual development, on initial stages a cure is possible.

By prevalence it happens:

• focal. Develops locally postoperative scars, tuberculosis and post-inflammatory foci. Long time a person may not even suspect that he has this form of the disease;
• diffuse. A significantly larger part of the lungs is affected; in advanced cases, there is only one treatment option - an organ transplant.

By origin:

• primary form. It is an independent pathology, more often associated with congenital characteristics. It can be diagnosed immediately after birth and at any year of life. The disease progresses rapidly and is poorly treatable;
• secondary. It is gradually led to by obstructive diseases of the pulmonary system. Air cavities can occupy an entire lobe of the lungs.

According to anatomical features:

• blistering (bullous). Instead of the affected alveoli, blisters form, reaching large sizes, prone to suppuration, compression of adjacent structures and sometimes rupture;
• vesicular (hypertrophic, panacinar). Appears when severe course affecting an entire lobe, there is no healthy tissue between the damaged acini. Manifested by severe respiratory failure;
• paraseptal (perilobular, periacinar, distal). The areas near the pleura are affected ( serosa, enveloping the lungs on one side, and internal organs on the other hand), occurs with tuberculosis;
• centrilobular. The central part of the structural unit of the lungs, the acinus, is affected. An inflammatory focus forms in this area with periodic mucus secretion. Viable lung tissue is preserved between the damaged areas;
• peri-scar. Occurs at the site of post-inflammatory changes. For example, at the site of fibrous tissue formation after pneumonia;
• subcutaneous (interstitial). When the alveoli rupture, air bubbles through tissue crevices can reach the scalp and neck and remain under it.

How to suspect the onset of emphysema?

If any of the following symptoms develop, consult a specialist immediately.

If you have:

• exacerbations of underlying diseases (chronic obstructive pulmonary disease, bronchial asthma, etc.) have become noticeably more frequent;
• they take longer and are much more severe;
• the treatment for these diseases that helped you no longer has a positive effect;
• the severity of shortness of breath increased;
• The ability to work and the ability to perform physical activity decreased noticeably.

7 typical signs of a person with emphysema

With a long-term disease, a person with emphysema can be easily recognized at first glance:

• the neck becomes short;
• the chest looks like a “barrel”;
• supraclavicular fossae protruded;
• when trying to inhale, the intercostal spaces become retracted due to active work auxiliary respiratory muscles, in particular intercostal muscles;
• the stomach sags due to the lowering of the diaphragm - the respiratory muscle;
• bluish skin;
• the terminal phalanges of the fingers are similar to " Drumsticks”, and nails - on “watch glasses”.

In addition, symptoms of pulmonary emphysema include:

• shortness of breath that occurs on exhalation. For a long time may go unnoticed, but it progresses and becomes more pronounced by the age of 60 - 65 years. Unlike shortness of breath with, it does not worsen when lying down;
• swelling of the neck veins due to increased intrathoracic pressure. It is especially noticeable when coughing, which also accompanies this pathological process;
• pronounced work of auxiliary muscles that help patients breathe - intercostal, scalene, pectoral and abdominal muscles;
• weight loss due to pronounced work of the respiratory muscles.

When joining a chronic pulmonary heart swelling of various localizations occurs (feet, legs, thighs, scrotum, abdomen, face), liver enlargement, increased shortness of breath, severe cyanosis (blueness) of the skin.

Diagnosis of emphysema

If symptoms similar to pulmonary emphysema occur, you should consult a general practitioner or pulmonologist.

Percussion

Using percussion (tapping), a specialist can determine:

• “box” sound over emphysematous areas of lung tissue;
• limited mobility and drooping of the lower edge of the lungs.

Auscultation

During auscultation (listening with a phonendoscope):

• increased exhalation;
• decreased breathing;
• dry or moist wheezing when it occurs;
• muffling of heart sounds due to hyperairiness of the lung tissue, which absorbs sound;
• increased heart rate (). In conditions of oxygen starvation, the heart tries to correct the situation;
• an increase in the frequency of respiratory movements, indicating respiratory failure.

Laboratory and instrumental diagnostics

From laboratory tests and instrumental research methods can be used:

• plain radiography of the chest organs. It is a very important method for diagnosing emphysema. There will be areas of increased transparency, an increase in the volume of the lungs, a low location of the diaphragm, drooping of the lower edges of the lungs;
• computed tomography. The disadvantage is the high radiation exposure. But it allows you to examine the lung tissue layer by layer and identify airy areas, even of small sizes, bullae, their volume and location, areas of fused alveoli, changes in the roots of the lungs;
• magnetic resonance imaging. Allows you to determine areas of compression of the lung tissue, circulatory disorders, even in small vessels, the presence of pleural fluid;
• spirography. It is performed using a spirograph, which takes into account the amount of air exhaled and inhaled. With emphysema, an increase in residual volume, total lung capacity, a decrease in vital capacity and pulmonary ventilation are determined. Indicators are reduced by 25 - 30%;
• peak flowmetry. Determined using a device that allows you to determine maximum speed exhale. It will be reduced by 20%;
• . There is an increase in red blood cells, hemoglobin, hematocrit (the ratio of blood plasma to red blood cells), a decrease in the erythrocyte sedimentation rate below 2 mm/h;

When determining the blood gas composition, a decrease in oxygen in the arterial blood below 60 mm Hg is noted, increased level carbon dioxide above 50 mm.

Treatment of emphysema. When should you have surgery?

There is no specific treatment. Attempts at treatment with human alpha-1-antitrypsin have not found widespread use. Quitting smoking is important. Medicines used include acetylcysteine ​​preparations (ACC, Asist, Asibrox). They are able to counteract free radicals formed during emphysema. Recently, preference has been given to long-acting theophyllines. These drugs act simultaneously to improve blood circulation in the lungs and correct ventilation disorders. In people who smoke, sensitivity to the drug is reduced, and in people of the older age group, on the contrary, it is increased. In addition, they may experience heart rhythm disturbances when using this medicine. Also, drugs such as:

• Salmeterol;
• Formoterol;
• Fenoterol;
• Ipratropium bromide.

More often a combination of these is used. The indication for prescribing glucocorticoids (Prednisolone) is the rapid progression of the disease, the ineffectiveness of other groups of drugs. This drug has a negative effect on the muscles (myopathic effect). More than 25% of people do not respond to hormone therapy. With the development of osteoporosis (destruction of the bone structure), which is a manifestation of pulmonary emphysema, it is recommended vitamin preparations, especially D3. Physical methods are also shown:

• chest massage;
• breathing exercises;
• kinesitherapy - treatment with movement.

Surgical treatment is carried out for:

• multiple bullae;
• severe form of the disease;
• with the development of complications;

Emphysema. Forecast for life

At congenital forms Unfortunately, the prognosis for the disease is unfavorable. The disease progresses rapidly and responds poorly to treatment. In other cases: when mild degree More than 80% of patients live with emphysema within 5 years, with moderate - about 70%, and with severe - less than 50%. The most common and dangerous complication leading to fatalities- pneumothorax (penetration of air into pleural cavity). Occurs especially often in bullous and subpleural forms of the disease. In addition, emphysema can be complicated by pneumonia when the bacterial flora is activated, and right ventricular heart failure.

Conclusion

The diagnosis of “pulmonary emphysema” is not a death sentence. At timely diagnosis and adequate treatment, the duration and efficiency of life increases significantly. A favorable outcome depends on:

• quitting smoking;
• infection prevention;