Treatment of shortness of breath in diseases of the bronchopulmonary system using traditional methods Bronchial asthma A mild attack of breathlessness can be stopped by taking oral tablets of aminophylline, theophedrine or antasman, no-shpa, papaverine or halidor, 30-60 drops of solutan. Good

Treatment of shortness of breath in diseases of the bronchopulmonary system using non-traditional methods To treat patients with shortness of breath caused by bronchial asthma, traditional medicine suggests using various medicinal plants and infusions from them. Below are some

Diseases of the biliary system A febrile state can occur in patients with damage to the biliary system and liver (cholangitis, liver abscess, empyema of the gallbladder). Fever in these diseases can be the leading symptom, especially in

Diseases of the blood system Iron deficiency anemia Iron deficiency anemia is a disease associated with a lack of iron in the blood and bone marrow, as a result of which hemoglobin synthesis is disrupted and trophic disorders occur in tissues. EtiologyChronic

Diseases of the cardiovascular system Main symptoms for diseases of the cardiovascular system In diseases of the cardiovascular system, patients are concerned about weakness, fatigue, sleep and appetite disturbances, memory loss, shortness of breath, heart pain, sensation

Diseases of the cardiovascular system For coronary heart disease, including in patients who have had a myocardial infarction (for a month or more), massage in combination with acupressure is indicated. The massage is carried out in a sitting position (in the early stages) or lying on your back with

Diseases of the cardiovascular system Main symptoms of diseases of the cardiovascular system Dyspnea is a disturbance in the rhythm, frequency or depth of breathing, accompanied by a feeling of lack of air. Causes of shortness of breath in patients with diseases

Diseases of the blood system Iron deficiency anemia Iron deficiency anemia is a disease associated with a lack of iron in the blood and bone marrow, as a result of which hemoglobin synthesis is disrupted and trophic disorders occur in tissues. Etiology Chronic

Types of bronchopulmonary diseases

Bronchopulmonary diseases are a collective name for diseases caused by destabilization of the functioning of the bronchi and lungs. They can be chronic, acute, congenital or hereditary.

Types of bronchopulmonary diseases:

¦ acute bronchitis is a disease caused by inflammation of the bronchial mucosa.

¦ asbestosis is a disease caused by the accumulation of asbestos fibers in the tissues of the lungs.

Pneumonia is an inflammatory process in the tissues of the lung.

¦ bronchial asthma - acute illness, the dominant symptoms of which are periodic conditions or attacks of expiratory suffocation caused by bronchial hyperactivity.

Atelectasis is a pathology of the lung in which it does not fully expand. In some cases, atelectasis leads to collapse of the lung (complete or partial). Ultimately, this causes oxygen deficiency.

Main symptoms of bronchopulmonary diseases

The clinical picture is characterized by repeated (several times a year) inflammatory processes in the lungs. The severity of clinical manifestations depends on the volume and prevalence of pathological and inflammatory changes. The physical development of patients suffers little. Signs of intoxication may be expressed: malaise, pallor, “shadows” under the eyes, decreased appetite. Changes in the shape of the nails and terminal phalanges of the fingers rarely occur in children. With extensive lesions, flattening and barrel-shaped deformation of the chest, retraction in the sternum or keeled bulge may develop. An increase in body temperature is an unstable symptom that usually accompanies an exacerbation of the bronchopulmonary process.

The most persistent symptoms are cough, sputum production and persistent wheezing in the lungs.

* Cough is the main clinical sign. Outside of exacerbation, it can be rare, inconsistent, dry, appearing only in the morning. With extensive lesions, patients may cough up sputum, often of a mucous or mucopurulent nature. During an exacerbation, the cough, as a rule, becomes wet, “productive”, the sputum becomes mucus-purulent or purulent in nature, and its quantity increases.

* Wheezes are heard constantly, their localization corresponds to the affected areas, and moist, medium- and fine-bubble wheezing persists even during the period of remission. Along with wet wheezing, dry wheezing can also be heard. With exacerbation, the number of wheezes increases and they are heard outside the affected areas.

General principles treatment of bronchopulmonary diseases

bronchopulmonary disease prevention spirometry

In acute bronchitis, artificial ventilation may be required; in pneumonia, antibiotics cannot be avoided.

Particular attention in the treatment of bronchial asthma is paid to maintenance. The basic rule that must be followed when faced with these diseases is to begin treatment immediately! Otherwise, you may miss the initial stage of the disease, which can lead to disastrous consequences.

Treatment of diseases of this group is symptomatic, in particular, in the treatment of bronchitis, first of all, it is necessary to ensure that the sputum is completely eliminated. When treating bronchopulmonary diseases, there are general recommendations, for example, steam inhalations, plenty of hot drinks and others.

Also, each disease in this group has its own treatment characteristics. diseases in remission. After all, as you know, a disease is easier to prevent than to treat. It is this expression that is most applicable to bronchial asthma - it is easier to prevent an attack than to fight for a patient in a state of pulmonary obstruction.

Today, pulmonology has a sufficient range of treatment methods and medical supplies, which allow you to successfully fight bronchopulmonary diseases, the main thing is to seek help from a doctor in time.

The treatment of diseases of the respiratory system has achieved great success. This is due to the introduction into medical practice of various highly effective antibiotics, anti-inflammatory, antiallergic drugs, hormones, the development of new methods of combating respiratory failure and the improvement of surgical treatment methods. Currently, treatment is more effective than in the recent past, however, if the patient already had advanced changes at the first visit to the doctor, it is not always possible to achieve complete healing. For inflammatory diseases of the respiratory tract and lungs, especially those accompanied by high fever, general malaise, chest pain, cough, in addition to medications, other means are widely used to alleviate the condition of patients (cups, mustard plasters, warm alkaline drinks, etc.). All these remedies are prescribed by a doctor. Self-administration of so-called popular drugs by patients is usually not effective and often causes harm. There are many cases where patients, on their own initiative, took antitussives, at a time when copious mucus discharge was required to restore bronchial patency and, therefore, not suppress, but, on the contrary, stimulate the cough reflex. Uncontrolled reception antipyretics, anti-inflammatory drugs, antibiotics and sulfa drugs also usually end sadly: either the condition quickly deteriorates, or patients, mistakenly assessing the temporary disappearance of a painful manifestation of the disease as recovery, stop all treatment and after some time are forced to consult a doctor with an already advanced or chronic form diseases.

In causal treatment, the main place is given antibacterial agents: sulfa drugs and antibiotics. The extreme popularity of these medications among the population is fraught with considerable dangers. Ineffectiveness of application, adverse reactions, the protracted course of the disease and often the transition to a chronic form may also be a consequence of inept choice of the drug and its dosage. In accordance with strictly established biological laws, in order to suppress a particular pathogen of an infectious disease, a certain constant concentration of drugs in the blood and tissues of the body is required, taking into account the sensitivity of microorganisms to them and individual characteristics the patient's body. Only a doctor prescribes antibacterial drugs. Neglect of medical recommendations can lead to very serious complications. Often the population strives to purchase new antibiotics for treatment, including for diseases of the respiratory system. Advances in medicine and healthcare make it possible to constantly introduce new effective antibiotics into practice, not in order to replace previously proposed ones, but for a more rational medical choice. IN complex treatment For a number of patients with certain chronic diseases of the respiratory system, the use of hormonal drugs plays an important role. Independent use of hormones without a doctor’s prescription also sometimes leads to serious consequences. Strict medical supervision taking and stopping hormones is a prerequisite for their successful use. Inhalation of oxygen with the help of special devices or from oxygen pillows is widely prescribed in cases of significant disturbances in gas exchange in the lungs. Medical practice has been enriched with new means of combating respiratory failure. During suppurative processes in the lungs, weakened patients are given an infusion of blood, blood substitutes, protein-containing liquids and medicinal mixtures that correct the disturbed metabolic balance.

A cold can develop into a disease of the bronchi and lungs; autumn slush and cold contribute to this process. In the article we will look at the symptoms, treatment and prevention of bronchopulmonary diseases.

Inflammation of the bronchi, trachea and lungs rarely begins suddenly. This is facilitated by factors such as sore throat, colds, laryngitis, and sometimes inflammation of the nasopharynx and ear. If a source of infection is detected in the body, it is important to eliminate it, because microorganisms tend to spread.

Symptoms of the disease can begin acutely, with high fever, poor health, headaches, feelings of fatigue, and loss of strength. On examination, wheezing is heard and breathing becomes difficult.

For inflammation respiratory organs there is often an accumulation of mucus, which can accumulate and be removed with difficulty; this is dangerous, since mucus is an accumulation harmful microorganisms that cause the disease, it should be disposed of.

Coughing is a reflex that helps clear the bronchi and lungs of harmful mucus that accumulates during illness.

It is a mistake to “turn off” a cough with the help of antitussives; this can be done with a dry cough, but with a wet cough it will lead to negative consequences, since sputum will accumulate and the healing process will be delayed and cause complications.

Treatment of bronchopulmonary diseases is aimed at relieving the inflammatory process, destroying the pathogen, and cleansing the lungs of mucus. In medical institutions, antibacterial therapy, expectorants, warming procedures, inhalations, and special massage are used.

At home, treatment can be carried out using folk remedies that will help in treatment.

Cough remedies

Black radish juice and honey will help in removing phlegm. To prepare the juice you need a large fruit, rinse it, cut out the middle. Pour honey into the middle and leave for several hours; take 1 tsp of the juice that forms. three times a day.

Honey horseradish and lemon

The mixture of components is known for helping to cleanse the lungs of mucus that accumulates during the inflammatory process.

Oregano

The plant has expectorant properties. To prepare the decoction you need 1 tbsp. oregano and a liter of boiling water. Pour boiling water over the plant in a thermos and leave for 2 hours, take 50 ml 3 times a day.

Warming agents

It is very effective to use warming procedures when coughing, helping to relieve inflammation and remove phlegm. Of these procedures, compresses are the most effective.

Potato compress

The easiest way to boil potatoes in their jackets is to crush them and place them in plastic bag, place warm on the area between the shoulder blades and wrap with a warm scarf. Keep the compress for 1 hour. These compresses are best used before bed.

Rye flour compress

Mix flour, honey and vodka in a bowl to form a flat cake. Place the cake on the area between the shoulder blades, cover it with film, cotton wool and a towel, secure the compress with a scarf.

Compress with mustard

Boiled potatoes, ½ tsp. mix mustard, honey and place as a compress, put parchment paper and cotton wool on top, secure with a towel.

Inhalation can also be used to remove phlegm. They are effective with medicinal herbs, potatoes and soda because they remove phlegm.

Inhalation with medicinal herbs

Boil pine twigs in boiling water and inhale their steam for several minutes. After the procedure, go to bed.

Inhalation with soda and sea salt

Place 1 tbsp of sea salt and soda in a bowl of water. pour boiling water and inhale the steam for several minutes.

Inhalation with boiled potatoes, boil 1 potato in a liter of water, when the potatoes are cooked, mash them, do not drain the water, add 1 tbsp. soda and inhale the steam for several minutes.

Diseases of the upper respiratory tract and diseases of the ear, nose, throat, and oral cavity are dangerous to carry on your feet. You need to avoid hypothermia, eat more vitamin C and drink enough water.

Acute bronchitis

Acute bronchitis is a diffuse acute inflammation of the tracheobronchial tree.

Etiology

The disease is caused by viruses, bacteria, physical and chemical factors.

Cooling, tobacco smoking, alcohol consumption, chronic focal infection in the casopharyngeal region, impaired nasal breathing, and chest deformation predispose to the disease.

Pathogenesis

The damaging agent penetrates the trachea and bronchi with inhaled air, hematogenously or lymphogenously. Acute inflammation may be accompanied by a violation of bronchial patency due to an edematous-inflammatory or bronchospastic mechanism. Characterized by swelling and hyperemia of the mucous membrane; on the walls of the bronchi and in their lumen - mucous, mucopurulent or purulent secretion; degenerative changes in the ciliated epithelium.

In severe forms, the inflammatory process affects not only the mucous membrane, but also the deep tissues of the bronchial wall.

Clinical picture

Bronchitis of infectious etiology often begins against the background of acute rhinitis and laryngitis. With a mild course of the disease, rawness in the chest, a dry, less often wet cough, a feeling of weakness, and weakness occur. There are no physical signs or dry rales are heard over the lungs against the background of hard breathing. Body temperature is subfebrile or normal. The composition of peripheral blood does not change. In moderate cases, general malaise and weakness are significantly pronounced, a strong dry cough with difficulty breathing and shortness of breath, and pain in the lower parts of the chest are characteristic. The cough gradually becomes wet, the sputum becomes mucopurulent in nature. On auscultation, hard breathing, dry and moist fine bubbling rales are heard. The body temperature remains low-grade for several days. There are no pronounced changes in the composition of peripheral blood. A severe course of the disease is observed when bronchioles are affected (bronchiolitis). The onset of the disease is acute. Fever (38–39 °C), severe shortness of breath (up to 40 respiratory movements per minute), shallow breathing. The face is puffy, cyanotic. Painful cough with scanty mucous sputum. Percussion sound with a boxy tint, weakened or harsh breathing, abundant fine wheezing. Symptoms of obstructive emphysema increase. Leukocytosis and increased ESR are noted. X-ray reveals an increase in the pulmonary pattern in the lower sections and in the region of the roots of the lungs.

Bed rest, plenty of warm drink with honey, raspberries, linden blossom, heated alkaline mineral water. Acetylsalicylic acid, ascorbic acid, multivitamins. Mustard plasters, cups on the chest.

For severe dry cough, codeine (0.015 g) with sodium bicarbonate (0.3 g) is prescribed 2-3 times a day. Take expectorants (thermopsis infusion, 3% potassium iodide solution, bromhexine). Inhalations of expectorants, mucolytics, and antihistamines are indicated. If symptomatic therapy is ineffective for 2–3 days, as well as moderate and severe disease, antibiotics are prescribed in the same doses as for pneumonia.

Prevention

Elimination of the possible etiological factor of acute bronchitis (dust, gas contamination of work areas, hypothermia, smoking, alcohol abuse, chronic and focal infection in the respiratory tract), as well as measures aimed at increasing the body's resistance to infection (hardening, vitamin food).

Pneumonia

Pneumonia is an acute inflammatory process in the lungs, caused primarily or secondarily by nonspecific pathogenic or conditionally pathogenic microflora with a breakthrough of immune defense mechanisms and accompanied by damage to the respiratory parenchyma and interstitial tissue with the obligatory accumulation of exudate containing neutrophils in the alveoli.

Classification

I. By etiology (indicating the causative agent):

1) bacterial;

2) mycoplasma;

3) viral;

4) fungal;

5) mixed.

II. By pathogenesis:

1) primary;

2) secondary.

III. According to the presence of complications:

1) uncomplicated;

2) complicated (pleurisy, abscess, bacterial toxic shock, myocarditis, etc.).

The division of pneumonia into focal and parenchymal is valid only for the inflammatory process in the lungs caused by pneumococcus. It is advisable to reflect the protracted course of pneumonia only if the etiology of the disease is pneumococcal or if there is an association of microorganisms in the lesion. In other forms of pneumonia (staphylococcal, Friedlander's, mycoplasma, etc.), resolution of the inflammatory process in the lungs often lasts more than 4 weeks. Secondary pneumonia is called pneumonia, the development of which followed a disease, the pathogenesis of which is directly or indirectly related to the bronchopulmonary system (atelectatic, post-traumatic, aspiration) or occurs against the background of an immunodeficiency state (AIDS, immunosuppressive therapy).

The identification of so-called atypical pneumonias caused by intracellular pathogens (mycoplasma, legionella, chlamydia) deserves special attention. Their peculiarity is the predominance of symptoms of general intoxication, which overshadow pulmonary manifestations, and the absence of infiltrative changes on a chest x-ray in the first days of the disease (interstitial type). The course of such pneumonia is unpredictable: they can be asymptomatic or severe, with the development of life-threatening complications. According to localization, pneumonia is divided into unilateral and bilateral, upper, middle or lower lobar (or in the corresponding segments), as well as hilar or central (Fig. 1-13). It is also advisable to reflect the severity of acute pneumonia (Table 6).

Etiology

The most common causative agents of pneumonia are pneumococci (30 to 40%), viruses (about 10%) and mycoplasma (15–20%). To date, in almost half of patients the cause of the disease remains unknown.

Pathogenesis

Main factors:

1) the introduction of infection into the lung tissue, often by bronchogenic, less often by hematogenous or lymphogenous routes;

2) decreased function of the local bronchopulmonary defense system;

3) development of inflammation in the alveoli under the influence of infection and its spread through the interalveolar pores to other parts of the lungs;

4) development of sensitization to infectious agents, formation of immune complexes, their interaction with complement, release of inflammatory mediators;

5) increased platelet aggregation, disturbances in the microcirculation system;

6) activation of lipid peroxidation, release of free radicals that destabilize lysosomes and damage the lungs;

7) neurotrophic disorders of the bronchi and lungs. Clinical picture

Clinical manifestations of acute pneumonia, in addition to the general symptoms of this disease, have distinctive features due to the etiology of the inflammatory process in the lungs. When analyzing anamnestic data, emphasis is placed on the presence of a prodromal period of the disease, rigidity and pleural pain, similar diseases in family members and colleagues, and the onset of an inflammatory process in the lungs.

Table 6 Severity of acute pneumonia

Pneumococcal pneumonia. Pneumococcal pneumonia occurs in two morphological forms: lobar and focal.

Croupous pneumonia is manifested by a sudden onset (the patient names the day and hour), stunning chills with an increase in body temperature to febrile levels, cough (initially dry and then with viscous rusty sputum), severe shortness of breath, and chest pain. On examination - herpes on the lips, chin, in the area of ​​the wings of the nose, shortness of breath, lag in chest breathing on the affected side. In the left lung, small pleural overlays remain in the parietal and interlobar fissures; the vascular pattern in both lungs is normal.

In the initial phase - a dull tympanic sound over the lesion, hard breathing with prolonged exhalation, initial (mild) crepitus, sometimes in a limited area - dry and moist rales. In the thickening phase, there is a sharp increase in vocal tremors, the appearance of bronchophony, breathing cannot be heard, crepitus disappears, and often there is a pleural friction noise. In the resolution phase, vocal trembling normalizes, bronchophony disappears, crepetato redux appears (abundant, sonorous over a long distance), sonorous fine-bubble rales, bronchial breathing is gradually replaced by vesicular breathing. When examining the cardiovascular system - rapid pulse, in severe cases - weak filling, arrhythmia, decreased blood pressure, muffled heart sounds.

Rice. 1. Bilateral bronchopneumonia. Focal shadows in both lungs

Rice. 2. Bilateral confluent pseudolabar pneumonia. The confluent lesions have spread to the segments of the upper lobe on the right and the lower lobe on the left, their shadow is heterogeneous due to the presence of swollen areas

Rice. 3. Widespread bilateral focal pneumonia with a tendency of foci of inflammation to merge, the lower lobe of the right lung is swollen

Rice. 4. Pneumonia has resolved, an enhanced vascular pattern remains, in the lower lobe on the right there is discoid atelectasis

Rice. 5. Segmental pneumonia (uniform darkening in the VI segment) (lateral projection)

Rice. 6. Mid-lobe syndrome (lateral projection)

Rice. 7. The focus of pneumonia in the VI segment on the right has a rounded shape, a reaction of the costal pleura is noted, the structure of the right root can be traced (direct projection)

Rice. 8. Resolved pneumonia, an enhanced vascular pattern remains at the site of inflammation (direct projection)

Rice. 9. Pneumonia of IV, V, X segments of the right lung (direct projection)

Rice. 10. Phase of resolving pneumonia with increased vascular-interstitial pattern and disc-shaped atelectasis (direct projection)

Rice. 11. Bilateral polysegmental pneumonia

Rice. 12. In the left lung, pneumonia was complicated by effusion pleurisy, in the right lung, at the site of resolved pneumonia, a vascular-interstitial pattern is expressed

Rice. 13. In the left lung, small pleural overlays remain in the parietal and interlobar fissures, the vascular pattern in both lungs is normal

Laboratory data of lobar pneumonia:

1) general blood test: neutrophilic leukocytosis, shift to the left to myelocytes, toxic granularity of neutrophils, lymphopenia, eosinopenia, increased ESR;

2) biochemical analysis: increased levels of alpha-2 and gamma globulins, LDH (especially LDHZ);

3) general urine analysis: protein, sometimes microhematuria;

4) study of blood gas composition: decrease in p02 (hypoxemia);

5) coagulogram study: DIC syndrome (moderate).

Instrumental studies of lobar pneumonia. X-ray examination: during the high tide stage, the pulmonary pattern of the affected segments intensifies, the transparency of the pulmonary field in these areas is normal or slightly reduced. In the compaction stage there is intense darkening of the lung segments affected by inflammation. In the resolution stage, the size and intensity of the inflammatory infiltration decreases, the root of the lung can be expanded for a long time. Spirography: decreased vital capacity, increased modulus. ECG: decrease in T waves and ST interval in many leads, appearance of a high P wave in leads II, III.

Clinical signs of focal pneumonia are characterized by a gradual onset after a previous acute viral infection of the upper respiratory tract or tracheobronchitis. Cough with mucopurulent sputum, weakness, sweating, sometimes shortness of breath, chest pain when breathing, increased body temperature. On percussion of the lungs in the case of large-focal or confluent pneumonia - shortening of the percussion sound, expansion of the root of the lungs on the affected side; on auscultation - hard breathing with prolonged exhalation, fine bubbling rales, crepitus in a limited area, dry rales.

Laboratory data of focal pneumonia:

1) OAC: moderate leukocytosis, sometimes leukopenia, band shift, increased ESR;

2) BAK: increase in the level of alpha-2- and gamma-globulins, sialic acids, fibrin, seromucoid, the appearance of PSA. Instrumental studies of focal pneumonia. X-ray of the lungs: foci of inflammatory infiltration in the 1st-2nd, sometimes 3-5th segments, most often in the right lung. Large and confluent foci of inflammation appear as uneven, spotty and ill-defined darkening.

Staphylococcal pneumonia. Staphylococcal pneumonia as an independent nosological entity occurs only when the infection is bronchogenic, usually after a viral infection. With the hematogenous route of infection, staphylococcal lung damage becomes an integral part of the picture of a more severe disease - sepsis.

The clinical symptoms of staphylococcal pneumonia are characterized by a particularly severe course with signs of severe intoxication (cough with scanty sputum of the “raspberry jelly” type, severe general weakness, often confused consciousness).

The physical picture is characterized by a discrepancy between the volume of the lesion and the severity of the patient's condition.

Clinical and radiological staphylococcal pneumonia occurs in two variants: staphylococcal destruction of the lungs and staphylococcal infiltration. In the vast majority of cases, staphylococcal destruction of the lungs occurs. An X-ray examination of the lungs against the background of inhomogeneous infiltration of the lungs reveals dry cavities of destruction with thin walls (staphylococcal bullae). During dynamic X-ray examination of the lungs, cavities quickly appear and quickly disappear. With staphylococcal infiltration, severe intoxication and long-lasting darkening in the lungs during X-ray examination are noted (up to 4–6 weeks).

Friedlander's pneumonia. Friedlander's pneumonia is caused by Klebsiella and occurs in very weakened patients. The disease develops gradually, with a long prodromal period characterized by fever, dull cough and general malaise. After 3–4 days, multiple decay cavities with liquid contents appear in the infiltration zone.

Legionella pneumonia. Legionnaires' disease (legionella pneumonia). It occurs as an epidemic outbreak in people who have constant contact with the ground, living or working in air-conditioned rooms.

The disease manifests itself acutely, with high body temperature, skin and diarrheal syndromes, arthromegaly, focal infiltrates are detected with a persistent tendency to suppuration and the formation of empyema.

Laboratory data for Legionella pneumonia. A blood test reveals leukocytosis with neutrophilia, a sharp increase in ESR to 50–69 mm/h and alanine minotransferase (ALT). Treatment with erythromycin gives a “terminating” effect.

Mycoplasma pneumonia. The clinical picture is characterized by febrile fever, a painful dry cough, turning into a wet one, with the separation of scanty mucopurulent sputum, and body aches.

Physical symptoms are very scarce. On auscultation, harsh breathing and local dry or moist, sonorous fine-bubble rales are heard. X-ray examination reveals peribronchial and perivascular infiltration. Blood tests reveal a significant increase in ESR with a normal leukocyte count. Improvement in well-being is noted when tetracycline antibiotics are prescribed.

For preliminary etiological diagnosis of acute pneumonia, one can rely on data from the epidemiological situation in the district, region and neighboring regions. Gram staining of sputum is important for early diagnostic diagnosis. The diagnosis is confirmed by examining sputum according to Mulder with determination of flora and its sensitivity to antibiotics. The method of enzyme immunoassay of histological sections or prints from the site of inflammation makes it possible to identify the etiological factor of acute pneumonia with a high degree of reliability.

Indications for hospitalization

Patients with lobar pneumonia, with severe intoxication syndrome, in the presence of complications and severe concomitant diseases, as well as in unsatisfactory living conditions and remote places of residence are subject to inpatient treatment.

Treatment of pneumonia should begin as early as possible, be as causal as possible and adequate to the patient’s condition and the presence of concomitant diseases. Good patient care (a bright, well-ventilated room, a bed with a hard surface) is of great importance. The patient's position should be comfortable, with an elevated headboard. Throughout the day, the patient should often change position in bed, sit down, turn from side to side to facilitate breathing and discharge sputum. To limit the possibility of reinfection, the wards are regularly exposed to ultraviolet irradiation. The diet of patients should be complete and contain a sufficient amount of vitamins. In the first days, limited nutrition is recommended: broths, compotes, fruits. Then the diet is expanded to include other easily digestible foods containing sufficient amounts of proteins, fats, carbohydrates, microelements, and vitamins. Smoking and alcohol are prohibited. In the absence of signs of heart failure, drinking plenty of fluids up to 2.5–3 liters is recommended.

The choice of antibiotic therapy would be easier if it were possible to immediately determine the nature of the pathogen. Taking into account that the main causative agents of acute primary pneumonia are viruses, pneumococci, mycoplasma and legionella, its therapy begins with penicillin (daily dose - 3.0–6.0 million units intramuscularly) or its semisynthetic preparations (ampicillin 4.0– 6.0 g). When treating a patient on an outpatient basis, preference is given to 2nd generation oral cephalosporins (cefaclor, cefuroxime sodium), which are active against most gram-positive and gram-negative bacilli.

Empirical antibacterial therapy for community-acquired pneumonia (European Respiratory Society recommendations):

1) mild “pneumococcal pneumonia”. Amoxicillin 1.0 g orally every 8 hours for 8 days. Procaine-penicillin 1.2 million units intramuscularly every 12 hours for 8 days;

2) mild atypical pneumonia. Macrolides orally for 2 weeks;

3) severe pneumonia, probably of pneumococcal etiology. Penicillin C (benzyl penicillin) 2 million units intravenously every 4 hours;

4) severe pneumonia of unknown etiology. III generation cephalosporins + erythromycin (rifampicin);

5) aspiration “anaerobic” pneumonia. Clindamycin 600 mg intravenously every 6 hours. Amoxicillin + clavulanate (coamokisklav) 2.0 g intravenously every 8 hours.

Antibacterial therapy is considered effective if there is a decrease in intoxication symptoms within 2–3 days. The lack of effect from the therapy within the specified period suggests the presence of an inflammatory process in the lungs caused by gram-negative flora or an association of pathogens. The main principle of therapy in geriatrics should be the use of broad-spectrum antibiotics with minimal side effects. At the same time, antibacterial drugs, due to their long-term elimination from the body of an elderly person, are prescribed in average therapeutic doses. The use of expectorants is mandatory in the treatment of patients with acute pneumonia. Among the drugs of the first group, the most effective are bromhexine (8 mg 4 times a day), thermopsis, marshmallow, and mucosolvin. In case of broncho-obstructive syndrome, preference is given to expectorants with a cholneblocking effect (solutan, atrovent, broncholitin). For dry, non-productive cough, non-narcotic antitussive drugs are prescribed (glaucine 0.05 g, libexin 0.1 g per day). In order to stimulate nonspecific immunobiological processes, aloe extract, FiBS (1 ml once a day for a month), autohemotherapy, methyluracil (1 g 3 times a day for 10–14 days) are used. Slow resolution of the inflammatory process in the lungs should serve as an indication for the prescription of anabolic hormones (sublingual nerabol 5 mg 2 times a day for 4–8 weeks, retabolil 1 mg 1 time every 7–10 days, 4–6 injections).

Physiotherapeutic methods of treatment occupy an important place in the treatment of patients with acute pneumonia. Non-hardware physiotherapy is indicated for home treatment. It includes jars, mustard plasters. With the help of hardware physiotherapy, UHF is applied to the area of ​​the pneumonic focus during the period of bacterial aggression; during the period of resorption, microwave therapy (microwave therapy) is used. To eliminate residual changes in the lungs, thermal therapeutic agents (paraffin, ozokerite, mud) are used. Electrophoresis of medicinal substances is used during all periods of the inflammatory process to eliminate individual symptoms of the disease or to resolve a pneumonic focus. Calcium, magnesium, heparin, aloe, iodine, lidase ions have a good therapeutic effect. Therapeutic exercises are performed for patients with subfebrile or normal body temperature in the absence of symptoms of decompensation from the heart and lungs. In this case, preference is given to exercises that help increase the respiratory mobility of the chest and stretch the pleural adhesions.

It is advisable to dwell on the following conditions in the pneumonia clinic that require emergency treatment: infectious-toxic shock, collapse, pulmonary edema and acute respiratory failure. During the height of infectious-toxic shock, antibacterial therapy is carried out according to an abbreviated program, and daily doses of antibacterial drugs should be reduced by at least 2 times, and in some cases they even have to be stopped for a short time. The patient is prescribed prednisolone 60–90 mg intravenously every 3–4 hours in combination with the sympathomimetic dopamine. A limitation to infusion detoxification therapy is the increased permeability of the vascular wall. Preference is given to high molecular weight plasma substitutes or albumin solutions. Small doses of heparin are used (10–15 thousand units 2 times a day) and constant oxygen therapy. Treatment of pulmonary edema in patients with acute pneumonia depends on the mechanism of its development. For hemodynamic edema, peripheral vasodilators are used - nitrates (nitroglycerin under the tongue, 2-3 tablets every 5-10 minutes, or nitroglycerin preparations intravenously, Lasix 60-80 mg is used intravenously in a bolus). For toxic pulmonary edema, glucocorticoids (prednisolone 60–90 mg intravenously every 3–4 hours) and antihistamines are used. Diuretics are used in small doses. The appearance of precursors of acute right ventricular failure, thrombocytopenia and hyperfibrinogenemia requires the administration of heparin (up to 40–60 thousand units per day), the appointment of antiplatelet agents (dipyridamole 0.025 g 3 times a day), xanthinol nictinate 0.15 g 3 times a day), non-steroidal anti-inflammatory drugs (indomethacin 0.025 g 3 times a day, acetylsalicylic acid 0.25-0.5 g per day).

Recovery criteria: elimination of clinical and radiological symptoms of pneumonia, restoration of bronchial patency, disappearance of changes in the blood.

Medical and labor examination. For uncomplicated pneumonia, the period of temporary disability ranges from 21 to 31 days. In a complicated course, they can reach 2–3 months.

Prevention

Prevention of acute pneumonia consists of sanitizing foci of chronic infection, hardening the body, and avoiding hypothermia. People most susceptible to pneumonia are children and the elderly, smokers, those suffering from chronic diseases of the heart, lungs, kidneys, gastrointestinal tract, those with immunodeficiency, and those who are constantly in contact with birds and rodents.

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Diseases of the bronchopulmonary system

Diseases of the bronchopulmonary system

Diseases of the bronchopulmonary system account for about 40–50 percent of all diseases of modern humans. The main one is considered to be bronchial asthma, accounting for a quarter of the total number of diseases of the bronchi and lungs. The rest include inflammatory diseases: pneumonia, bronchitis, chronic obstructive pulmonary disease and others. Most often, people from 20 to 40 years old suffer from diseases of the bronchopulmonary system.

It is very important to monitor the condition of the respiratory system and promptly treat diseases of the bronchopulmonary system, even if it is an ordinary cold. This is evidenced by the high frequency of occurrence of these diseases and the number deaths. The most significant factors that provoke the occurrence of diseases of the bronchopulmonary system are:

• Low standard of living.
• Profession.
• Smoking.

Types of diseases of the bronchi and lungs

Bronchial asthma is caused by an allergic factor and is hereditary disease. It begins in childhood and persists throughout life with periodic exacerbations and dulling of symptoms. This disease can be treated throughout life, an integrated approach is used, and is very often used in treatment hormonal drugs. The disease, bronchial asthma, significantly worsens the patient’s quality of life, makes him dependent on a large number of medications and reduces his ability to work.

TO inflammatory diseases include bronchitis and pneumonia.

Inflammation of the bronchial mucosa is called bronchitis. With viral and bacterial infection can occur in an acute form, chronic bronchitis is more often associated with fine particles, for example, dust. Statistics show that every third person who comes in with a cough or asthma attacks is diagnosed with bronchitis. About 10% of the population suffers from this disease - chronic bronchitis. One of the main reasons is smoking. There are almost 40 percent of people addicted to this habit in Russia, most of them are men. Main danger diseases - changes in the structure of the bronchus and its protective functions. This disease is also classified as an occupational disease; painters, miners, and quarry workers are susceptible to it. The disease bronchitis cannot be left to chance; timely measures must be taken to prevent complications.

Pneumonia is pneumonia. Very often the leading cause of death in children younger age. A fairly common and common disease, on average about three million people suffer from it every year, while every fourth disease acquires severe forms and consequences, even threatening human life. Reduced immunity, infection in the lungs, risk factors, lung pathologies - these reasons give rise to the development of the disease - pneumonia. Complications may include pleurisy, abscess or gangrene of the lung, endocarditis and others. Treatment of pneumonia should begin at the earliest stages, under the supervision of a doctor in a hospital. It must be comprehensive with subsequent rehabilitation of the patient.

The Argo catalog contains a large number of general strengthening drugs and means to maintain the health of the immune system, bronchopulmonary system and the whole body, which significantly accelerate the recovery of a sick person, ensure his further recovery, and allow him to quickly return to health. normal life and breathe deeply

Section: Diseases of the bronchopulmonary system

Section: Diseases of the bronchopulmonary system

Section: Diseases of the bronchopulmonary system

Section: Diseases of the bronchopulmonary system

Section: Diseases of the bronchopulmonary system

Section: Diseases of the bronchopulmonary system

Section: Diseases of the bronchopulmonary system

Section: Diseases of the bronchopulmonary system

Section: Diseases of the bronchopulmonary system

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Spicy and chronic diseases respiratory tract infections are one of the most common and socially significant in the world; all groups of the population are affected to one degree or another: children, the elderly and able-bodied citizens.

In Russia, with its long and cold winters, this problem is of particular importance, since it is during the cold season that there is a noticeable exacerbation of chronic bronchopulmonary diseases and a surge in acute respiratory infections.

According to statistics, about 5-7% of the adult population of the Earth suffer from acute bronchitis(in 90-95% of cases this is viral infection, caused by rhinosyncytial virus, rhinovirus, adenovirus), 17% of Russians are diagnosed with bronchial asthma, and 15% are diagnosed with chronic obstructive pulmonary disease (COPD). The situation with the incidence of influenza and other acute respiratory viral infections is even more disappointing. Thus, according to WHO, today every third person on the planet suffers from acute respiratory diseases. In Russia, annually from 27 to 41 million patients are diagnosed with influenza and other acute respiratory viral infections. Children are especially susceptible to these diseases. Every year, from 27.3 to 41.2 million Russian children consult doctors about ARVI and influenza, the share of which in the overall structure of childhood morbidity is more than 82%. The most dangerous of ARVIs, of course, is influenza - a contagious acute infectious disease characterized by specific intoxication and catarrh of the upper respiratory tract. Influenza pathogens belong to the orthomyxovirus family and include 3 types of influenza viruses: A, B, C (depending on their antigenic characteristics). Influenza A viruses are the most common cause of epidemics and pandemics. Outbreaks of influenza (A and B) occur annually during the winter months and last about 6-8 weeks.

Lyudmila Korneva, PhD, chief pulmonologist of the North-Western District of Moscow, explains the extremely high prevalence of respiratory tract diseases by well-known environmental problems, the emergence of new mutating strains of viruses and bacteria and, finally, the lack of adequate immunoprophylaxis and immunorehabilitation. In addition, the unmotivated, without proper indications, use of antibacterial drugs, which leads to chronicity of the disease and increased resistance of pathogens to antibacterial drugs, also contributes to the increase in the incidence of respiratory diseases.

Most respiratory diseases are associated with the development of inflammation in the respiratory organs and are characterized by the appearance of symptoms such as cough, intoxication, sputum, shortness of breath, and sometimes respiratory failure. A cough, especially a prolonged and painful one, is the most common reason for a patient to see a doctor. By nature it is divided into unproductive and productive, and by duration and course - into acute and chronic. According to the European Respiratory Society, out of 18,277 people aged 20-48 years from 16 countries, 30% complained of cough at night, 10% of productive cough, and 10% of non-productive cough.

When diagnosing a cough, an important indicator is productivity, i.e. the presence of sputum. Numerous scientific studies have shown that the ability to freely separate sputum depends on its rheological properties– viscosity, adhesion and elasticity. Therefore, the main emphasis in the treatment of conditions accompanied by viscous sputum is on the use of bronchosecretolytic drugs, known as mucolytics.
Mucolytics thin and promote the removal of sputum, restoring the normal state of the mucous membrane of the respiratory tract. There are three groups of mucolytic drugs: carbocysteine ​​and its derivatives, ambroxol and its derivatives, N-acetylcysteine ​​and its derivatives. The most balanced complex action Among these drugs is ambroxol, which affects all components of disorders of the discharge of bronchial secretions.

Lazolvan®– original drug ambroxol. Important properties of Lazolvan® are: reducing the viscosity of sputum; stimulation of the production of surfactant - a protective protein that lines the mucous membrane of the bronchial tree; depolymerization of acidic mucopolysaccharides; restoration of the function of the ciliated epithelium of the bronchi; increasing the concentration of antibacterial drugs in lung tissue and bronchial secretions.

In addition to the mucolytic effect, Lazolvan® has a secretomotor (direct effect on mucociliary clearance), antitussive, antiprotease and indirect antiviral action. Lazolvan® increases the synthesis of interleukin-12, which stimulates antiviral defense. The antioxidant effect of Lazolvan® has been proven, which consists in reducing the concentration of oxygen radicals. A significant advantage of Lazolvan® is its synergistic effect with antibiotics. This allows Lazolvan® to be used together with antibiotics in cases where the use of the latter is necessary.

According to Lyudmila Korneva, Lazolvan® is widely used both in pulmonological practice and in ENT pathologies. It is prescribed for various respiratory diseases, incl. bronchitis, pneumonia, bronchiectasis.

Lazolvan® is available in the form of tablets, syrup and solution for inhalation. “Tablet forms can be recommended to all patients,” notes Lyudmila Korneva. “However, many children have great difficulty swallowing pills or simply refuse to do so. Besides, not every adult likes to take pills. In these cases, Lazolvan® is prescribed in syrup form. It is very important that Lazolvan® is also available in the form of a solution, which is used both orally and as inhalation nebulizer therapy, which is an effective innovative form of treatment for bronchopulmonary diseases.”

Below is the frequency of taking Lazolvan® syrup (Table 1) and solution (Table 2).

It should be noted that inhalation therapy, based on the delivery of various drugs directly into the respiratory tract, is today recognized as the most optimal way to treat respiratory pathologies accompanied by the formation of sputum. Among the main advantages inhalation therapy- faster absorption of drugs, an increase in the active surface of the drug, its deposition in the submucosal layer of the bronchi (rich in blood and lymphatic vessels), the creation of high concentrations of drugs directly at the site of the lesion. And since the active substance, entering directly into the respiratory tract, creates locally high concentrations when using lower doses, systemic side effects, reactions from the gastrointestinal tract (GIT) and the likelihood of drug interactions.

It should be noted that the method of inhalation nebulizer therapy, which is an effective innovative form of treatment for bronchopulmonary diseases, is now increasingly used and nebulizers occupy a strong place among medical equipment both in hospitals and at home. A nebulizer is a special device consisting of an aerosol sprayer and a compressor. Using a nebulizer, a liquid solution of a drug is converted into a stable aerosol form in the form of a dispersed “cloud” for inhalation into the respiratory tract for therapeutic purposes.
Nebulizer therapy ensures rapid penetration of the drug into the respiratory tract, increases efficiency and significantly reduces treatment time; in addition, it is distinguished by ease of use. This method treatment is indicated for patients of all ages, but is especially preferable for frequently and long-term ill children.

The success of nebulizer therapy depends on several factors, primarily on the choice of a basic drug that can effectively combat cough.

It has been proven that nebulizer therapy using Lazolvan® allows achieving maximum effect in the optimal time frame, but excellent results can only be obtained if patients are trained in all the rules for its implementation and comply with them. Therefore, nebulizer therapy should be preceded by special classes in which the doctor must teach the patient proper breathing during the procedure, optimal seating and some mandatory rules, including disinfection of the device.

Correct breathing– one of the most important components of successful inhalation. To ensure this, compliance is required following conditions:
- sit with your back firmly resting on the back of the chair, your back should be straight;
- shoulders are relaxed and lowered, the body is relaxed, not tense;
- clothing components (belts, tight elastic bands, fasteners, etc.) do not squeeze the stomach;
- the mouthpiece is held deep in the mouth, tightly grasped with teeth and lips. The tongue is under the mouthpiece without covering its opening;
- during breathing, the abdominal muscles actively work, the abdominal walls move freely and participate in the act of breathing;
- inhalation is done through the mouth to the count of “one-two-three” (for young children, to the count of “one-two”) slowly, calmly, deeply;
- during inhalation, the stomach protrudes forward as much as possible;
- at the height of inhalation, the breath is held for the count of “one-two-three-four” (in young children, for the count of “one-two-three”);
- exhale through the mouth or nose to the count of “one-two-three-four-five-six” slowly, calmly, as far as possible;
- during exhalation, the stomach is pulled inward as much as possible.

When performing inhalation, clothing should not restrict the neck and make breathing difficult. It should be borne in mind that a strong forward tilt of the torso during the procedure also makes breathing difficult.

In addition to the above, there are several more important rules, the implementation of which ensures effective and safe treatment using a nebulizer:
- for inhalations you should use only those solutions that are produced specifically for these purposes and are sold in pharmacies;
- you must wash your hands thoroughly with soap before each inhalation;
- for the treatment of children under 5 years old, it is necessary to use sterile saline solution, disposable needles and syringes;
- medications should be diluted and mixed immediately before each inhalation;
- the solution remaining after inhalation must be removed from the nebulizer after each inhalation;
- the nebulizer should be sterilized according to the manufacturer’s instructions, after which the device is dried in disassembled form at room temperature.

When carrying out treatment, you must fully concentrate on the procedure and not be distracted by extraneous stimuli - music, TV, books and conversations.

The effectiveness of inhalation with Lazolvan® also depends on whether or not kinesitherapy (breathing exercises) was performed, which consists of removing sputum diluted by the drug from the lungs. Therefore, in order to ensure drainage of the bronchial tree, the doctor must prescribe special breathing exercises in combination with physical therapy, sound exercises, and breathing with controlled exhalation resistance.

In cases where bronchitis is chronic, dosed walking, running, swimming, exercise equipment, skiing, skating, and team sports are recommended along with long-term administration of Lazolvan®. Physical exercise contribute to improving the mobility of the chest and diaphragm, eliminating tension in the respiratory muscles and regulating their overall work, forming the correct breathing pattern, improving the drainage function of the bronchi and bronchial patency, increasing the extensibility of the lungs, optimizing gas exchange, correction respiratory failure.

A drug pharmaceutical companyBoehringer Ingelheim Lazolvan® is familiar firsthand to many Russian patients and doctors, who call it the “Gold Standard” of mucolytic therapy. This fall he replaced appearance, which improved its perception by consumers. Now Lazolvan® is sold in bright, attractive packaging, which provides significantly greater awareness and ease of perception for consumers. The white background with the image of two stripes (blue and red) was replaced by a rich blue with a silhouette of a person. The change affected all 4 forms of release of Lazolvan® - adult and children's syrups, tablets and solution for oral administration and inhalation. Moreover, for the first time on the packaging baby syrup a bright and multi-colored inscription “Children’s” appeared, which allows you to accurately select the required form of the drug. For ease of use and dosing, it is recommended to use the measuring cup that comes with each package of syrups.

Lazolvan® is a reference mucolytic with long-proven effectiveness and safety. Strict compliance with all requirements for its use will ensure reliable results, and the new colorful packaging will provide additional comfort for patients.