Pneumothorax – what it is, causes, symptomsand treatment of pneumothorax of the lungs

Pneumothorax of the lungs – the appearance in the pleural cavity accumulations
of air. This is fraught with serious consequences, the lungs cannot
function normally, respiratory function is impaired. it
condition in our days is becoming more common. Occurs in patients
at the age of 20 – 40 years.

The injured person needs to start as soon as possible.
provide emergency care, as pneumothorax can be completed
fatal. In more detail, what is this disease,
what causes and symptoms, as well as first aid for pneumothorax and
effective treatment – further in the article.

Pneumothorax: what is it?

Пневмоторакс

Pneumothorax is an excessive accumulation of air between
pleural sheets leading to a short or
prolonged respiratory failure and
cardiovascular failure.

When pneumothorax air can penetrate between the sheets
visceral and parietal pleura through any defect on
surface of the lung or chest. Penetrating the cavity
pleura air causes an increase in intrapleural pressure (in
normal, it is lower than atmospheric) and leads to the fall of part or
whole lung (partial or complete collapse of the lung).

Больной пневмотораксом испытывает резкую боль в груди,
дышит часто и поверхностно, с одышкой. Feels “lack of
air. There is pallor or cyanosis of the skin, in
particular person.

  • In the international classification of diseases ICD 10 pneumothorax
    located: J93.

Disease classification

Pneumothorax is of two fundamentally different types in
depending on the origin and communication with the external environment:

  1. open when gas or air enters the pleural cavity from
    the external environment through the defects of the chest – injured, while there are
    depressurization of the respiratory system. In case of development
    open pneumothorax it changes and this leads to the fact that
    the lung subsides and no longer fulfills its function. Gas exchange in
    it stops and oxygen does not enter the blood;
  2. Закрытый – нет контакта с окружающей средой. Further
    an increase in the amount of air does not occur and theoretically given
    the species may resolve spontaneously (is the easiest
    form).

By type of distribution:

  • unilateral. About its development speak in the event that
    only one lung subsides;
  • bilateral. The victim falls right and left lobe
    lungs it состояние чрезвычайно опасное для жизни человека,
    therefore, he needs to start providing urgent care as soon as possible.
    help.

Also emit:

  • Traumatic пневмоторакс возникает в результате
    penetrating chest injury or lung damage
    (for example, fragments of broken ribs).
  • spontaneous pneumothorax that occurs without any
    a previous disease, or a disease that is latent;
  • A tense pneumothorax is a condition where it is walking.
    air entering the pleural cavity but not possible
    exit, there is a gas filling cavity. There is a full
    collapse of the lung and air does not get into it even with deep
    inhale.
  • secondary – arising as a complication of pulmonary or extrapulmonary
    pathology,
  • artificial or iatrogenic – doctors create if necessary
    certain manipulations. Сюда можно отнести: биопсия плевры,
    insertion of a catheter into the central veins.

By the volume of air that entered the cavity between the sheets
pleura, recognize the following types of pneumothorax:

  • partial (partial or limited) – lung collapse
    incomplete;
  • total (full) – there was a complete collapse of the lung.

By the presence of complications:

  • Complicated (pleurisy, bleeding, mediastinal and
    subcutaneous emphysema).
  • Uncomplicated.

The reasons

Etiological factors that can lead to development
pneumothorax, divided into three groups:

  • Diseases of the respiratory system.
  • Injuries.
  • Medical manipulations.

The causes of spontaneous pneumothorax of the lung can be
(arranged in decreasing frequency):

  • Буллёзная болезнь lungs
  • Pathology of the respiratory tract (chronic obstructive disease
    легких, муковисцидоз, астматический статус).
  • Infectious diseases
    (пневмоцистная пневмония, туберкулёз лёгких).
  • Interstitial lung disease (sarcoidosis, idiopathic
    пневмосклероз, гранулёматоз Вегенера, лимфангиолейомиоматоз,
    tuberous sclerosis).
  • Connective tissue diseases (rheumatoid
    артрит, анкилозирующий спондилит, полимиозит, дерматомиозит,
    склеродермия, синдром Марфана).
  • Злокачественные новообразования (саркома, рак
    light).
  • Грудной эндометриоз.
Traumatic The cause is injury:

  • Open – cut, stab, gunshot;
  • closed – received during a fight, a fall from a great height.
Spontaneous The main cause of spontaneous pneumothorax is pulmonary rupture.
blistering with bullous disease. Mechanism of occurrence
emphysematous lung tissue extensions (bulls) are still not
studied.
Iatrogenic It is a complication of some medical procedures:
installation of subclavian catheter, pleural puncture, blockade
intercostal nerve cardiopulmonary resuscitation (barotrauma).
 Valve  Valve тип болезни, как один из самых опасных,
shows such signs:

  • sudden onset of shortness of breath,
  • blue face
  • severe weakness of the whole organism.

The person unconsciously begins to feel fear, symptoms occur
hypertension.

Symptoms пневмоторакса легких

The main manifestations of pneumothorax are due to sudden
the emergence and gradual accumulation of air in the pleural cavity
and compression of the lung, as well as displacement of the mediastinum organs.

Common symptoms in adults:

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  • it is difficult for the patient to breathe, he has a superficial frequent
    breath;
  • cold, sticky sweat;
  • an attack of dry cough;
  • integuments get bluish tint;
  • cardiopalmus; sharp chest pain;
  • fear; weakness;
  • decrease in blood pressure;
  • subcutaneous emphysema;
  • the victim takes a forced position – sitting or
    half-sitting

фото легких при пневмотораксе

The severity of symptoms of pneumothorax depends on the cause
diseases and degree of compression of the lung.

Types of pneumothorax Symptoms
Spontaneous
  • chest pain caused by the defect
  • sudden shortness of breath.

The intensity of pain syndromes differs from minor
to very strong. Many patients describe the pain initially as
acute, and after as dull or dull

Valve
  • The patient is in an excited state
  • complains of severe chest pain.
  • Pain can be piercing or dagger
    character,
  • pain give in the scapula, shoulder, abdominal cavity.
  • Immediately develop weakness, cyanosis, shortness of breath, quite
    вероятен обморок.

Lack of timely assistance often leads to development
complications that threaten the life of the patient.

Complications

Complications пневмоторакса происходят часто, по статистике —
half of all cases. These include:

  • empyema of the pleura – purulent pleurisy, pyothorax;
  • intrapleural bleeding due to pulmonary tear
    tissue, serofibrinous pneumopleuritis with the formation of “rigid”
    lung ,.

When valvular pneumothorax does not exclude the formation of subcutaneous
emphysema – accumulations of a small amount of air under the skin in
subcutaneous fat.

A long-term pneumothorax often ends up replacing
connective lung tissue, wrinkling of the lung, loss
elasticity, the development of pulmonary and heart failure,
by death.

Diagnostics

Already upon examination of the patient characteristic signs are revealed.
pneumothorax:

  • patient takes forced sitting or half-sitting
    position;
  • the skin is covered with cold sweat, shortness of breath, cyanosis;
  • expansion of intercostal spaces and chest,
    restriction of chest excursion on the affected side;
  • снижение артериального давления, тахикардия, смещение
    boundaries of the heart in a healthy way.

From instrumental survey methods “gold standard”
является рентгенография грудной клетки в сидячем
standing or standing. For the diagnosis of pneumothorax with a small
the amount of air used x-ray or radiography
on the exhale.

The final diagnosis is based on the results of radiographs or
tomography, on the basis of which pneumothorax differentiate with
following diseases:

  • Asphyxia;
  • pleurisy;
  • emphysema;
  • aortic aneurysm;
  • myocardial infarction;
  • diaphragmatic hernia.

First aid

Pneumothorax in valve or open form is one of
emergency conditions that are necessary immediately
call an ambulance Then be sure to produce the following
actions:

  • stop the process of filling the air of the pleural cavity
    the victim;
  • stop bleeding.

First emergency aid for any type of pneumothorax
It is not only the use of drug therapy, but also
observance of a certain mode.

Patients with pneumothorax are hospitalized in the surgical
hospital (if possible in specialized
отделения пульмонологии). Medical assistance consists of
conducting puncture of the pleural cavity, air evacuation and
recovery in the cavity of the pleura of negative pressure.

Treatment of pneumothorax

Treatment of pneumothorax начинают проводить ещё в скорой помощи.
Doctors conduct:

  • oxygen therapy;
  • pain relief (this is an important moment in the treatment,
    painkillers are necessary for the patient at the stage of recession
    lung, and during its expansion);
  • remove the cough reflex;
  • spend pleural puncture.

Depending on the type of disease, the treatment will be as follows:

  1. Небольшой закрытый ограниченный пневмоторакс – чаще всего
    does not require treatment.  It spontaneously resolves through
    several days without causing serious disorders;
  2. при закрытом – проводят аспирацию попавшего воздуха при
    help puncture system;
  3. при открытом – сначала переводят его в закрытый, ушивая
    hole. Then the air is sucked through the puncture
    system;
  4. при клапанном – переводят его в открытый вид с помощью
    thick needle and then treated surgically;
  5. при рецидивирующем – хирургическое удаление его причины.
    Patients over the age of 50 years with a relapsing course
    pneumothorax is preferable to use not simple pleural
    puncture and setting drainage tube and holding active
    аспирации of air.

Treatment and rehabilitation last from 1-2 weeks to several
months, it all depends on the reason.

Rehabilitation after pneumothorax

  1. After leaving the hospital, the patient undergoing pneumothorax of the lungs,
    must for 3-4 weeks refrain from any physical
    loads.
  2. Forbidden to fly on an airplane for 2 weeks after
    treatment.
  3. Do not do skydiving, diving – all this
    causes pressure drops.
  4. It is strictly forbidden to smoke, you should definitely quit
    dangerous habit.
  5. Врачи также советуют пройти обследование на туберкулез,
    CNDF

В 20 % случаев у пациентов наблюдается рецидив pathology,
especially if it is caused by a primary disease. Considered dangerous
is a human condition when the pleural cavity is filled
air from two sides. This usually entails a sharp violation.
breathing and death.

The bilateral form of pneumothorax is characterized by favorable
outcome only in 50% of cases.

Forecast

Any pneumothorax of the lungs requires immediate hospitalization.
пациента в хирургический стационар для хирургического treatment. Than
previously a patient diagnosed with symptoms of the disease,
will be sent to the hospital, the greater the chance of successful
treatment.

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