Empiama pleura: symptoms and treatment

Empiama Plevra - the cluster of purulent exudate in the cavity of the pleura with the secondary compression of the lightweight fabric in the pleurisy. What are the symptoms of this disease? How treatment is carried out? Answers to these questions you will find in the article.

Content

Symptoms of empyama

All forms of acute empya pleura have common symptoms: cough with sputum, shortness of breath, chest pain, body temperature rise, as well as signs of intoxication­Name. According to modern ideas, an empieme clinic pleura ukla­It smelts into the picture of severe systemic response syndrome to inflammation, which, with untimely medical events, can give rise to the development of sepsis and polyorgan deficiency.

With closed empy, cough is accompanied by a small amount of sputum. Prolonged and frequent cough attacks with a significant amount of sputum, as a rule, indicate­Chimes of bronchiploral fistula. Especially a large amount of sputum pain­they are separated in position­nii on a healthy side­Gda create conditions for improving pus outflow.

With total empiece­ME patients due to sharp pain and shortness of breath can not lie and take on­Poliusida. With false emphas, pain syndrome is expressed weaker. Without taking you­the needed position, patients are more common on the affected side of the chest­Noah cells that limit­Her breathing ex­smoke, and with this reduces pain.

Most patients have shortness of breath in peace, cyanosis of lips and hands, testifying to pronounced respiratory failure, oxygen­nier starvation and acidosis. Pulse is usually raised to 110-120 per 1 min. Tempe­body wound, as a rule, high and sometimes, especially with rotary and non-clositary anaerobic infections, has a hectician character. Click­Netical picture is similar to sepsis (repeated crops are needed when infection is identified). With a positive result, you can confidently­Stew talk about sepsis. The lack of a temperature reaction is usually evidence of the organism's astivality, but does not exclude sepsis.

In the study of the chest notes the lag of affected by­Fishing with breath. Intercostal intervals are expanded and smoothed due to the pressure of the exudate and relaxation of intercostal muscles. When comparing two skin folds taken on symmetrical places of both polo­Breastfish, it can be noted that on the sore side, the skin fold is somewhat thicker, and the study is more painful.

When forming sub-reconnect phlegmon, soft tissues of the chest wall in the region of the starting breakthrough of a pus from the pleura become a raft­Palpation is painful; The subsequent fluctuation appears.

For the accumulation of the exudate in the pleural cavity, it is characterized by weakening or no voice trembling and respiratory noise. Percussively you­Pot in the pleural cavity can be determined when the content in it is not­it is 250-300 ml of exudate. If the contents of the pleural cavity is only exudate, the upper boundary of stupidity corresponds to the line of Ellis-Damuazo-Sokolov. The accumulation of a large number of pusa leads to a shit­mediastinum in a healthy side and squeezing healthy lung. By­This bottom of the spine on the healthy side is determined by the triangular form of a plot of shortening of a percussion sound (the triangle of Grochko Rahafussa). Liquid pushes and partially collaboats cortical lung departments.

With the accumulated empya, the accumulation of pus sometimes perform­Share hard.

In the povepoint, they reveal a stupid percussion sound over a plot with an upper horizontal boundary corresponding to the accumulation of pus, and tympanic sound over the air accumulation area. With auscultation of op­Relieve the weakening or almost complete absence of respiratory noise and reinforced bronchophony in the zone of the exudate. In the presence of bron-hopile fistula and well-drained through the bronchus cavity­enhanced bronchial breathing (amphoric) due to­Nanz, which is created in a large cavity when air passes through bronchial fistula.

There is a high leukocytosis in the blood (over 10,000), a sharp shift of the leukocyte formula to the left, an increase in SE. Often observed anemia.

The development of an empieme of the pleura is accompanied by a violation of the functions of gray­Dove-vascular system, breathing, liver, kidneys and endocrine glands. These violations can develop sharply or gradually. Especially severe disorders occur during breakthrough to the pleural cavity of the abscess easily­GO, having a wide message with aerial paths. Arise­In this case, the popenemotorax is accompanied by severe disorders that can be characterized as shock.

Large disorders are detected in protein and water-salt exchanging.

Often changing the immunoreactivity of the body. Freshland­Jumps of humoral and cellular immunity, as with every serious purulent process.

Along with the symptoms, characteristic of all the Empathy of the pleura,­it has its own features. Emphamas characterized­ride soreness and shortening of the percussion sound only in­LASTICS MANUAL MUCHES. At apical empy, there is often swelling­ki and the prescription region, plexitis phenomena, Bernard-Gorn syndrome. With basal pleurisite pains are localized at the bottom of the chest­ki, hypochondrium, top of the belly. The pain often radiates in the blade, shoulder and other parts of the body depending on which nerve is involved in­Power process.

Treatment of empieth

Regardless etiology And the forms of acute empy of the pleura during treatment must be ensured:

At
Free emphas of pleuras are used by constant washing of pleural
cavities through two tubes (pleural lava). Antiseptic­whisk liquid
administered through the rearview tube (seventh-eighth intercostal), and
sucking - through the upper-eyed (installed in the second intercostal).
2-3 days after improving liquid suction­Water through both
Tubes and achieve full lung flashes. Under­Lico bronchial fistula This method is contraindicated due to the possibility of fluid getting into the bronchial.

Wider
Toracotomy with resection of ribs, reserving pleural polo­I
The subsequent drainage is shown only if there are large
sequesters and bunches of curved blood. In suspected
not­how many sections of the delimited empy are shown video photocopy
For careful removal of fibrin, destruction
Divorcing Schwart, washing of pleural cavity
Antibacterial­Preparations and subsequent drainage.
Similar to Procea­The fool is held in the presence of large sequesters and
clutches in the pleural cavity, if necessary
Easy decortications. Thoracotomy is shown if not
Video photocoscopic equipment. With no­Vius effect from the specified
events when it becomes obvious that the light, stamped
pleural scars (sin), straighten not­Perhaps shown
Early lung decortication (thoracotomy with removal­Changed
visceral pleura, sucks or polar), which leads to­Strom
Fragrance and obliteration of the Polish cavity.