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The pulmonary pattern is strengthened on the right and left. The roots of the lungs are reduced in structure, compacted, expanded (due to the vascular component). The diaphragm domes are smooth, clear, at the level of the 4th rib. The pleural sinuses are free. The shadow of the mediastinum is in the midline, the arcs are smoothed, the contours are clear and even. The boundaries of the mediastinal organs are not expanded. Pneumatosis intestinalis (this is an accumulation of gases, as far as I know).

Good afternoon. Interpretation of your x-ray:

1. Minor rotation - the child turned during the picture, so the halves of the chest turned out to be asymmetrical. The doctor’s note shows this – the child is behaving restlessly.
2. The pulmonary fields are pneumatized - normally they are airy. The term “pneumatization” means the presence of air in the alveoli (physiological norm).
3. Without visible focally infiltrative shadows – there are no pathological darkenings or spots.
4. The pulmonary pattern is strengthened on the right and left - an increase in the number of arteries and capillaries to improve the gas supply to the blood. In children, physiologically, this condition is often observed until the tidal volume of the lungs returns to normal during the process of growth. This picture also occurs with bronchitis (inflammation of the bronchi).
5. The roots of the lungs are reduced in structure, compacted, expanded due to the vascular component - an increase in the number of pulmonary vessels. The X-ray symptom indicates an increase in the arterial network. The reasons are a lack of oxygen in the body due to intense physical activity, chronic diseases.
6. The domes of the diaphragm are smooth, clear at the level of the 4th rib - physiological state and location.
7. Free pleural sinuses and a mediastinal shadow in the middle are normal.
8. Pneumatosis intestinalis is an accumulation of gases in the intestinal lumen. In children, it is observed physiologically during breaks between meals or during food shortages or intense physical activity.

Conclusion. The X-ray symptoms described above do not indicate the presence of any pathological conditions. Strengthening the pulmonary pattern and expanding the roots of the lungs due to the vascular component can be attributed to functional changes in the tissue due to the growth of the body, if heart disease and chronic respiratory infections are excluded.

What is pulmonary pneumatization?

What is pneumatization of lung tissue?

In the section Diseases, Medicines, to the question How to understand pneumatization of the lung tissue is preserved? the best answer given by the author Yona Myshaeva means everything is fine, the lung is filled with air

So screw it all

this means that the lung is filled with air, inflated. and performs its functions. for example, when wounded, it can become saturated with blood and bunch up, shrink into a lump, then the person will suffocate. even if the ribs move back and forth.

Chronic nonspecific pneumonia

Pneumonia is a group of exudative inflammatory processes in the lungs, different in etiology, pathogenesis and morphological characteristics, with a predominant lesion of their respiratory sections in the parenchyma. Young, able-bodied people are sick. It is most often caused by staphylococci and streptococci.

In acute parenchymal (lobar) pneumonia, predominantly localized infiltration of the walls of the alveoli is observed with filling of their lumen with neutrophilic or fibrinous contents. Continuous infiltration of the entire lung is rare; usually the process is limited to a part of the lobe or one or two segments.

Pathomorphological stages of the course are distinguished:

I. Stage of tide and hyperemia. Duration of the day. At this stage, the capillaries begin to expand and fill with blood, and serous fluid begins to accumulate in the alveoli.

II. Red liver stage. Duration of the day. Exudate in the alveoli acquires a red-brown color due to the release of red blood cells.

III. Stage of gray hepatization. Duration 7 – 9 days. Leukocytes predominate in the exudate.

IV. Resolution stage. Duration 7 – 15 days.

Clinically: pneumonia often occurs with symptoms of intoxication, characterized by an acute onset, with inflammatory changes in the peripheral blood, temperature reaction, chest pain, and cough.

1. X-ray diagnostics: X-rays are taken in 2 projections, this is an overview image of the chest organs and a lateral projection of the side of interest, as well as an X-ray tomogram for bronchial patency. The diagnosis is made on the basis of X-ray data - the presence of infiltrative changes in the lungs, detected on radiographs (fluorograms) in two projections. Timely and correct diagnosis of pneumonia depends on the therapist, radiologist and doctors of related specialties involved in the diagnostic process.

1. Physical examination, laboratory data: in the stage of high tide, percussion sound becomes dull, auscultation - weakening of breathing and crepitus at the height of inspiration, due to the unraveling of the walls of the alveoli. At the stages of hepatization, percussion sound becomes dull, auscultation - weakening of vesicular breathing, wheezing of various sizes. At the resolution stage, the percussion sound is restored, crackling rales appear again. Inflammatory changes are characteristic in the peripheral blood: neutrophilic leukocytosis, increased ESR.

X-ray signs of pneumonia: in the flushing stage - increased pulmonary pattern in the affected lobe due to hyperemia. The transparency of the pulmonary field may be reduced, the roots are not changed, and when the process is located in the lower lobe, the mobility of the dome of the diaphragm is reduced. In the hepatization stage, high-intensity darkening without clear contours will correspond to the affected lobe or segment. If the darkening is adjacent to the interlobar pleura, then its contours will be clear. The mediastinal shadow is usually located. At the resolution stage there will be a decrease in the intensity of the shadow, its fragmentation or a decrease in size of the shadow. The strengthening of the pulmonary pattern remains, the interlobar pleura can be emphasized.

On a series of radiographs: a general photograph of the chest organs in a direct projection, on a photograph of the chest organs in the right lateral projection there is - the darkening is localized in the right lung, corresponds to the 8th, 9th segment, has the shape of a pyramid, highly intense, homogeneous in structure, surrounding lung tissue not changed. On the median linear tomogram: the lower lobe bronchus on the right is patent. Diagnosis: pneumonia of the 8th, 9th segments on the right.

Time frame for complete resorption of pneumonia: 20 – 25 days.

Outcomes: recovery, prolonged pneumonia, abscess pneumonia.

Complications: exudative pleurisy, abscess.

Exudative pleurisy is an inflammatory disease of the pleura with effusion into the pleural cavity. It may be a primary lesion of the pleura or accompany pneumonia, tuberculosis, or tumors. Normally, the pleural cavity contains about ml of fluid; when it increases, it becomes visible on radiographs. During an ultrasound examination, the fluid becomes visible.

The clinical picture of exudative pleurisy will resemble pneumonia. Characterized by pain in the chest on the affected side, which decreases in the position on the affected side, high intoxication syndrome, lag of the affected part of the chest in the act of breathing, dullness of percussion sound and absence of normal vesicular breathing over the affected area of ​​the lung.

X-ray picture: intense, structurally homogeneous darkening in the lower parts of the lungs (due to gravity, fluid begins to accumulate in the deepest posterior paravertebral sinus) with a not very clear, concave upper contour - Demoiseau's line. With a large amount of fluid and high darkness, the mediastinum may shift to the healthy side. The mobility of the diaphragm is reduced.

On a plain X-ray of the chest organs in a direct projection there is: homogeneous, homogeneous in structure, highly intense darkening of the right lung to the level of the anterior plate of the 4th rib with a concave indistinct upper contour - Demoiseau's line. The right dome of the diaphragm is not visualized. The mediastinal shadow is shifted to the healthy side. The laterogram of the affected part of the chest shows a horizontal level of fluid in the form of a darkening band.

X-ray diagnostics: radiography of the chest organs is performed in 2 projections; in order to prove the presence of free effusion in the chest cavity, laterography must be performed. A series of images is taken: laterograms on the affected side during inhalation and exhalation, and an additional laterogram on the opposite side.

Differential diagnosis is made with pneumonia. In order to prove the presence of effusion, an X-ray of the affected part of the chest is taken in the later position, as a result of which the fluid spreads when the patient is positioned on the affected side and the fluid level becomes visible.

Chronic nonspecific pneumonia.

Chronic nonspecific pneumonia (radiological term) - is characterized by irreversible damage to all structures of the lung, due to recurrent purulent-destructive or productive nonspecific inflammation with the development of pneumosclerosis.

Etiology and pathogenesis: This inflammatory process is most often the result of acute or prolonged pneumonia that has not completely resolved. Protracted pneumonia is considered to be pneumonia that does not resolve within 3 months. Chronic pneumonia is considered repeated inflammation that occurs in the same place for 6 months. The causative agent is Haemophilus influenzae, Streptococcus pneumoniae, the disease is chronic, relapsing with periods of remission and exacerbation. The period of remission is characterized by a sparse clinical picture; during the period of exacerbation, symptoms of intoxication appear, a cough with viscous, poorly discharged, purulent sputum; with a long course of the disease, symptoms of respiratory failure and cyanosis increase.

X-ray diagnostics: X-ray of the chest organs in 2 projections, X-ray - tomogram for bronchial patency. In order to get an idea of ​​the state of the bronchial tree in chronic pneumonia, it is necessary to perform CT or bronchography.

X-ray picture: the images show inhomogeneous darkening due to a combination of areas of infiltration and sclerosis, coarse fibrous strands, compacted bronchial lumens. Large bronchi are passable, convoluted, in the lumen of which bronchial secretions accumulate, which can fester with the formation of bronchiectasis. The process can extend to a segment, part of a share, a whole share, in which case the affected part decreases in volume. Pneumatization of lung tissue decreases. The picture is complemented by deformation of the root of the lung due to fibrosis and pleural layers around the affected area.

On a plain X-ray of the chest organs in a direct projection: in the left lung there is a darkening in the upper parts, highly intense, heterogeneous in structure due to multiple areas of clearing of a round shape, due to decay and areas of compaction, due to fibrosis. Pneumatization of lung tissue is reduced.

Central lung cancer is a malignant tumor of epithelial origin from the bronchial endothelium of the 1st, 2nd, 3rd order. There are various forms of central lung cancer: endobronchial, when the tumor grows into the lumen of the bronchus, and exobronchial (peribronchial), when the tumor grows into tissue like a sleeve, compressing the bronchus and, finally, mixed.

Pathogenesis and clinical picture: the disease manifests itself not only as a tumor node on an x-ray, but also as secondary changes in the lung tissue as a result of bronchial compression and impaired ventilation. Degrees of ventilation impairment: hypoectasis, valvular emphysema, atelectasis. As a result of secondary changes in the lung tissue, an inflammatory process develops - pneumonitis. With hypoectasis, air patency is maintained, but hypoventilation phenomena are observed; with valve blockage of the bronchus, obstructive emphysema occurs. An increase in the size of the tumor node leads to a complete disruption of bronchial obstruction, while the air in the alveoli is absorbed and atelectasis occurs. As a result, atelectasis forms obstructive pneumonitis with or without abscess formation.

With a small size of the tumor node, patients are bothered by a cough, which at first is of a reflex nature, hemoptysis, chest pain, with an increase in the size of the node and obstruction of the bronchus by the tumor, ventilation disturbances appear, and in the clinic, along with hemoptysis and cough, chest pain increases , shortness of breath increases, symptoms of intoxication. The more pronounced the dyspnea is, the larger the bronchus is affected. Metastasizes to the lymph nodes of the mediastinum.

X-ray diagnostics: X-ray of the chest organs in 2 projections, X-ray - tomogram for bronchial patency. Patients are indicated for bronchoscopy with biopsy to confirm the diagnosis. In order to get an idea of ​​the condition of the bronchial tree and mediastinal lymph nodes, it is necessary to perform a CT scan. Treatment is surgical.

X-ray picture: the initial X-ray sign of central cancer is a darkening of a homogeneous structure with a fuzzy contour in the root area and in the basal zone, this is the shadow of the tumor. In the exobronchial form, there may be no shadow of a tumor. With increasing hypoventilation, small-spotted shadows appear, caused by the development of lobular atelectasis. With the formation of valvular emphysema, there is a significant increase in the transparency of the ventilated area, a low position of the dome of the diaphragm on the affected side, and a shift of the mediastinum to the healthy side are characteristic. Atelectasis will be characterized by lobar or segmental darkening with clear contours, high intensity, corresponding to the affected bronchus. Reduction of atelectasis leads to a decrease in the volume of a portion of the lung, as a result of which the reduced lobe or segment is displaced. The x-ray shows a displacement of the interlobar fissure and the root of the lung. Tomograms will determine the bronchial stump, conical or cone-shaped in the exobronchial form of cancer. In the endobronchial form, the stump will be defined as an “amputation” of the bronchus.

On a plain X-ray of the chest organs in a direct projection: the darkening is localized in the hilar zone of the left lung, tends to be spherical, has a homogeneous structure, fuzzy, uneven contours and high intensity. On a linear tomogram in the left lateral projection, the stump of the upper lobar bronchus with an undermined contour is determined as an “amputation” of the bronchus. A darkening adjacent to the affected bronchus is also visualized - (nuclear shadow of the tumor) spherical in shape with an uneven, fuzzy contour of high intensity, homogeneous in structure.

Conclusion: central cancer of the upper lobe bronchus on the left.

Emphysema: causes, symptoms and treatment

Pulmonary emphysema is a pathological condition associated with structural or functional changes in the lung tissue and characterized by excessive expansion of the air spaces (alveoli) at the junction of the smallest bronchi (terminal bronchioles) into them.

Emphysema: main causes and mechanisms of development

Based on the speed of development of emphysema, acute and chronic forms are distinguished.

Acute pulmonary emphysema usually disappears if the causes that caused it are eliminated.

It can be caused by:

• complete or partial shutdown of the entire lung or part of it, which leads to increased respiratory load on the working parts of the lungs with a compensatory increase in their pneumatization and, accordingly, an increase in volume;
• breathing with difficult (incomplete) exhalation (most often found in bronchial asthma, bronchitis, prolonged cough, tuberculosis, etc.);
• pneumothorax (entry of atmospheric air into the pleural cavity, leading to partial or complete collapse of the lung), pneumonia, etc.

Chronic pulmonary emphysema is characterized by persistent structural changes that have developed in the lungs as a result of prolonged exposure to factors that impair the elasticity of the alveoli.

Very often this is caused by smoking, chronic tracheobronchitis and asthmatoid bronchitis (with impaired bronchial obstruction), pulmonary tuberculosis, childhood infections (whooping cough, measles), pneumosclerosis, as well as occupational hazards (working in chemical production, playing wind instruments, from glassblowers, etc.).

Most often, chronic pulmonary emphysema occurs in men in older age groups, which is associated with their lifestyle and work.

With the progression of emphysema, not only a decrease in the elasticity of the lungs is observed, but also the appearance of inflammation around the smallest blood vessels in the walls of the alveoli, which leads to a gradual thinning of their walls and the merging of the smallest alveoli into larger ones. This leads to a decrease in the respiratory surface and the appearance of hypoxia - insufficient supply of oxygen to organs and tissues.

In the initial stages of the formation of pulmonary emphysema, compensatory mechanisms are activated - the number of red blood cells and hemoglobin in the blood increases, the work of the heart is activated, and ventilation of the lungs is enhanced. This allows the body to maintain gas exchange at a sufficient level, but over time these mechanisms are depleted (especially if exposure to adverse factors continues) and a serious complication develops - respiratory failure.

In severe pulmonary insufficiency, part of the blood in the lungs does not have time to be pumped to the left parts of the heart, and stagnation occurs in the pulmonary circulation, and subsequently in the veins of the systemic circulation. Thus, a pulmonary heart is formed and pulmonary heart failure occurs.

Emphysema: symptoms

The most common symptoms for patients with pulmonary emphysema are shortness of breath with difficulty exhaling and coughing. Patients try to alleviate their condition by changing the position of the body - it is usually sitting with the hands resting on a seat or bed - this helps to use the diaphragm and auxiliary muscles of the chest (intercostal muscles, muscles of the shoulder girdle) when breathing.

In this case, the skin of the face often has a reddish-bluish (cyanotic) tint, and the veins of the neck are swollen. During breathing, retractions of the intercostal spaces can be seen. Breathing is often hoarse and whistling, with prolonged exhalation.

At the initial stage of development of emphysema, shortness of breath and cough usually occur only with increased stress or overexertion. As the process progresses, shortness of breath appears with little physical effort, and then at rest.

With the development of pulmonary respiratory failure with symptoms of stagnation, patients develop swelling in the limbs and face, the liver increases in size, and fluid accumulates in the abdominal cavity - ascites.

At the initial stages of the development of emphysema, the prognosis is favorable, especially if the causes contributing to the development of emphysema are eliminated and intensive therapy is carried out for the disease leading to respiratory failure.

Emphysema: diagnosis and treatment

Usually, depending on the stage of development of the process and the cause of the disease, the following is added to general clinical studies:

• X-ray (computed tomography) of the chest organs;
• sputum examination;
• bronchoscopy with biopsy;
• spirography (study of external respiration function);
• ECG and echocardiography;
• Ultrasound of the abdominal organs (to exclude ascites).

Treatment is complex and most often includes:

• carrying out breathing exercises and exercise therapy, but with reasonable limitation of physical activity;
• procedures aimed at oxygenation (increased oxygen saturation) of the blood;
• smoking cessation, oxygen therapy, speleotherapy, barotherapy;
• in the presence of bronchopulmonary infection - a course of antibacterial therapy;
• to improve bronchial patency - bronchodilators;
• if an allergic component is detected, antihistamines are used, and in severe cases, corticosteroids;
• for poor sputum discharge - expectorants, herbal medicine, chymotrypsin inhalation;
• symptomatic therapy aimed at normalizing heart function and unloading it, preventing the development of pulmonary heart failure.

Emphysema: prevention

Prevention consists of preventing the development and timely treatment of diseases that cause emphysema and lead to pulmonary failure, primarily bronchitis.

It is necessary to avoid cooling, dampness, and crowding. Hardening the body (physical education, gymnastics) and improving living conditions are of great importance.

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Pneumofibrosis of the lungs - what is it and why is it dangerous?

Pneumofibrosis is a lung disease in which there is an overgrowth of connective tissue.

This pathology disrupts the structure of organs, reduces their ventilating function, leads to a decrease in lung volume, and also causes deformation of the bronchi. Complications or the presence of infection in the body can lead to death.

The ICD 10 code is included in section J80-J84.

Causes

The development of the disease is facilitated by certain conditions that lead to disruption of the pulmonary system. Therefore, the causes of the disease are very diverse.

Pneumofibrosis can be caused by:

• Tuberculosis;
• Pneumonia;
• Living in environmentally polluted areas;
• Obstructive bronchitis;
• Hereditary predisposition;
• Mechanical damage to the respiratory system;
• Stagnant processes in the respiratory system;
• Toxic effects of certain medications;
• Infectious diseases;
• Fungal diseases;
• Smoking;
• Mycoses;
• Sarcoidosis.

All these factors cause pneumofibrotic changes in the lungs.

Symptoms

Many patients do not suspect they have the disease because they do not know its symptoms. Therefore, it is important to know what consequences can occur in advanced stages of pulmonary fibrosis, and why it is dangerous. The patient experiences an overgrowth of connective tissue and respiratory failure.

It is important to consult a pulmonologist in a timely manner, since in the later stages of the disease it is quite difficult to correct or stop this process. The occurrence of complications can lead to death. Therefore, the patient must understand whether it is dangerous to neglect even minor symptoms and how to understand that medical attention is needed.

The main symptom is shortness of breath. At the initial stage, it appears only after physical exertion. Over time, shortness of breath is observed even at rest.

Symptoms of the disease also include:

• Cough with sputum and pus;
• When coughing, there is pain in the chest;
• Blue skin tone;
• There is increased fatigue;
• Body temperature may fluctuate throughout the day;
• When exhaling, wheezing is heard;
• Body weight drops sharply;
• The neck veins swell during coughing.

Classification

The disease is characterized by alternation of normal areas of lung tissue with connective tissue.

In this regard, the disease is divided into types:

1. Radical. The basal appearance is expressed in the presence of light compactions on the tissue, which can begin to develop if a person has had bronchitis or pneumonia. This pathology can develop even years after the illness.
2. Diffuse. The doctor diagnoses a diffuse type in a patient in the presence of multiple lesions, in which there are practically no healthy areas on the organs. If the disease has an advanced stage, there is a risk of abscesses. Relapses of such pulmonary fibrosis can occur throughout a person’s life. The diffuse type is also dangerous because, due to a decrease in lung volume, the respiratory function begins to quickly weaken.
3. Local. With this type, replacement with connective tissue is observed only in certain places. Therefore, in general, normal tissue remains firm and elastic, allowing a person to lead a quality life without much limitation.
4. Focal. Focal pneumofibrosis affects small parts in the form of separate areas.
5. Basal. This type can only be identified after an x-ray examination. The lesion is observed only at the base of the lungs. Most often, treatment is prescribed with folk remedies. Positive results are obtained from breathing exercises for this type of pulmonary fibrosis.
6. Limited. The limited appearance does not affect gas exchange processes and does not disrupt organ functions.
7. Linear. The linear appearance occurs due to the presence of inflammatory processes. The disease is provoked by pneumonia, bronchitis, tuberculosis and other diseases of the respiratory system.
8. Interstitial. The disease is provoked by inflammatory processes in capillaries and blood vessels. This type of pulmonary fibrosis is characterized by severe shortness of breath.
9. Postpneumonic. Postpneumonic fibrosis appears if a person has suffered from infectious diseases or pneumonia. As a result of inflammatory processes, fibrous tissue grows.
10. Heavy. Due to chronic processes that occur in the lungs, severe fibrosis is diagnosed. Inflammatory phenomena provoke the proliferation of connective tissue.
11. Moderate. Moderate indicates the presence of minor damage to lung tissue.
12. Apical. Apical fibrosis is localized at the top of the lung.

Post-radiation fibrosis is dangerous. He requires serious therapy. Therefore, it is important to diagnose the disease in time and begin treatment immediately.

Hyperpneumatosis occupies a special group. This is a complex pathological disease with a pathogenetic syndrome.

Diagnostics

Before determining how to treat the disease, the pulmonologist conducts a conversation with the patient, directs tests, and examines the chest, assessing its shape.

Using a phonendoscope, he listens to the work of the lungs to identify noises or wheezing.

Instrumental procedures will allow the doctor to determine whether the patient has pneumosclerosis or pneumoneurosis.

• Radiography;
• Computed tomography;
• Ventilation scintigraphy;
• Spirometry;
• Transbronchial biopsy;
• Bronchoscopy;
• Plethysmography.

The procedures will also make it possible to identify whether pleurofibrosis is located on the right or left, to determine whether there are sclerotic changes or tumors in the tissues, to determine lung disease and what type of pneumofibrosis it is.

If diagnostics show that the lung fields are pneumatized, then it is necessary to carry out several procedures and select the appropriate medications. Using diagnostics, pleuropneumofibrosis can be identified.

Diagnostic measures will help identify pneumatosis in the patient, which is characterized by the presence of cysts. To do this, pneumatization is carried out, which will help decipher the data from an x-ray or tomogram in order to identify the amount of air in the lung fields.

If one or more cavities with fibrotic changes or capsules are identified in the patient’s lungs, the patient is diagnosed with post-tuberculous fibrosis.

After diagnosis, the doctor prescribes comprehensive treatment that will reduce the risk of relapse in the future. It is impossible to completely cure the disease.

Treatment

The doctor’s task is to select drugs that will eliminate the cause of the disease. Treatment is carried out until complete recovery, and not only when symptoms disappear.

1. To restore bronchial patency the following is prescribed:

• Bromhexine;
• Salbutomol.

1. To improve microcirculation - Trental.
2. Patients are advised to take antioxidants.
3. Anti-inflammatory, antibacterial and hormonal drugs are prescribed in courses.

• Give up bad habits;
• Take a course of oxygen therapy;
• Normalize sleep and rest patterns;
• Do breathing exercises regularly.

In advanced cases, there may be a question about surgical intervention.

ethnoscience

1. Infusion of birch leaves. Pour 50 g of leaves with water and cook for 10 minutes. Then infuse the composition and drink 70 grams per day.
2. Thyme decoction. Pour 500 g of boiling water over a spoonful of the plant and leave the broth in a thermos for 6-7 hours. Drink 100 grams per day for no more than 4 weeks.
3. Flax decoction. Pour a glass of boiling water over a spoonful of seeds and leave covered for 20 minutes. Drink 100 grams of decoction before bed.

Adequate selection of medications, adherence to preventive measures and the use of alternative treatment methods will help stop the development of pathological processes. The patient’s task is to strictly follow all the doctor’s recommendations.

Pneumosclerosis

Pneumosclerosis is a pathological replacement of pulmonary connective tissue, as a consequence of inflammatory or dystrophic processes in the lungs, accompanied by impaired elasticity and gas exchange in the affected areas. Local changes are asymptomatic, diffuse changes are accompanied by progressive shortness of breath, cough, chest pain, and fatigue. To identify and evaluate lesions, radiography and computer/multislice CT of the lungs, spirography, and lung biopsy with morphological verification of the diagnosis are used. In the treatment of pneumosclerosis, corticosteroids, cytostatics, antifibrotic drugs, oxygen therapy, and breathing exercises are used; If necessary, the question of lung transplantation is raised.

Pneumosclerosis

Pneumosclerosis is a pathological process characterized by the replacement of pulmonary parenchyma with non-functioning connective tissue. Pneumofibrosis usually develops as a result of inflammatory or dystrophic processes in the lungs. The proliferation of connective tissue in the lungs causes deformation of the bronchi, sharp compaction and wrinkling of the lung tissue. The lungs become airless and decrease in size. Pneumosclerosis can develop at any age; this lung pathology is more often observed in men over 50 years of age. Since sclerotic changes in the lung tissue are irreversible, the disease has a steadily progressive course and can lead to profound disability and even death of the patient.

Classification of pneumosclerosis

Based on the severity of replacement of the pulmonary parenchyma with connective tissue, the following are distinguished:

• pneumofibrosis - severe limited changes in the lung parenchyma, alternating with airy lung tissue;
• pneumosclerosis (actually pneumosclerosis) – compaction and replacement of the lung parenchyma with connective tissue;
• pneumocirrhosis is an extreme case of pneumosclerosis, characterized by complete replacement of the alveoli, vessels and bronchi with connective tissue, compaction of the pleura, and displacement of the mediastinal organs to the affected side.

According to the prevalence in the lungs, pneumosclerosis can be limited (local, focal) and diffuse. Limited pneumosclerosis can be small- and large-focal. Limited pneumosclerosis macroscopically represents an area of ​​compacted pulmonary parenchyma with a decrease in the volume of this part of the lung. A special form of focal pneumosclerosis is carnification (postpneumonic sclerosis, in which, at the site of inflammation, the lung tissue resembles raw meat in appearance and consistency). Microscopic examination in the lung can reveal sclerotic suppurative foci, fibroatelectasis, fibrinous exudate, etc.

Diffuse pneumosclerosis affects the entire lung, and sometimes both lungs. The lung tissue is compacted, the volume of the lungs is reduced, and their normal structure is lost. Limited pneumosclerosis does not have a significant effect on the gas exchange function and elasticity of the lungs. With diffuse damage to the lungs by pneumosclerosis, a picture of a rigid lung and decreased ventilation is observed.

Based on the predominant damage to certain lung structures, alveolar, interstitial, perivascular, perilobular and peribronchial pneumosclerosis are distinguished. According to etiological factors, post-necrotic, discirculatory pneumosclerosis, as well as sclerosis of the lung tissue, which developed as a result of inflammatory and dystrophic processes, are distinguished.

Causes and mechanism of development of pneumosclerosis

Typically, pneumosclerosis accompanies or serves as an outcome of certain lung diseases:

The development of pneumosclerosis can be caused by insufficient volume and effectiveness of anti-inflammatory therapy for these diseases.

Also, pneumosclerosis can develop as a result of hemodynamic disturbances in the pulmonary circulation system (as a result of mitral stenosis, left ventricular heart failure, pulmonary embolism), as a result of ionizing radiation, taking toxic pneumotropic drugs, in patients with reduced immune reactivity.

Postpneumonic pneumosclerosis develops as a result of incomplete resolution of inflammation in the lungs, leading to the growth of connective scar tissue and obliteration of the alveolar lumen. Especially often, pneumosclerosis occurs after staphylococcal pneumonia, accompanied by the formation of necrosis of the pulmonary parenchyma and the formation of an abscess, the healing of which is accompanied by the proliferation of fibrous tissue. Post-tuberculosis pneumosclerosis is characterized by the proliferation of connective tissue in the lungs and the development of peri-scar emphysema.

Chronic bronchitis and bronchiolitis cause the development of diffuse peribronchial and perilobular pneumosclerosis. With long-term pleurisy, the superficial layers of the lung are involved in the inflammatory process, compression of the parenchyma by exudate occurs and pleurogenic pneumosclerosis develops. Fibrosing alveolitis and radiation damage cause the development of diffuse pneumosclerosis with the formation of a “honeycomb lung”. In cases of cardiac left ventricular failure and mitral valve stenosis, the liquid part of the blood leaks into the lung tissue with the further development of cardiogenic pneumosclerosis.

The mechanisms of development and forms of pneumosclerosis are determined by its causes. However, common to all etiological forms of pneumosclerosis are disturbances in the ventilation function of the lungs, the drainage ability of the bronchi, and the circulation of blood and lymph in the lungs. Disruption of the structure and destruction of the alveoli leads to the replacement of the morphofunctional structures of the pulmonary parenchyma with connective tissue. Impaired lymph and blood circulation that accompany bronchopulmonary and vascular pathology also contribute to the occurrence of pneumosclerosis.

Symptoms of pneumosclerosis

Limited pneumosclerosis usually does not bother patients; sometimes there is a slight cough with scanty sputum. When examined on the affected side, a depression of the chest may be detected.

Diffuse pneumosclerosis is symptomatically manifested by shortness of breath - at first during physical activity, and then at rest. Skin with a cyanotic tint due to decreased ventilation of the alveolar tissue of the lungs. A characteristic sign of respiratory failure in pneumosclerosis is the symptom of Hippocrates' fingers (in the form of drumsticks). Diffuse pneumosclerosis is accompanied by symptoms of chronic bronchitis. Patients are bothered by a cough - at first rare, then obsessive with the release of purulent sputum. The course of pneumosclerosis is aggravated by the underlying disease: bronchiectasis, chronic pneumonia. Aching chest pain, weakness, weight loss, and increased fatigue are possible.

Signs of lung cirrhosis often appear: gross deformation of the chest, atrophy of the intercostal muscles, displacement of the heart, large vessels and trachea towards the affected side. In diffuse forms of pneumosclerosis, hypertension of the pulmonary circulation and symptoms of cor pulmonale develop. The severity of pneumosclerosis is determined by the volume of affected lung tissue.

Morphological changes in the alveoli, bronchi and blood vessels during pneumosclerosis lead to disturbances in the ventilation function of the lungs, arterial hypoxemia, reduction of the vascular bed and are complicated by the development of cor pulmonale, chronic respiratory failure, and the addition of inflammatory lung diseases. Pulmonary emphysema is a constant companion to pneumosclerosis.

Diagnosis of pneumosclerosis

Physical findings in pneumosclerosis depend on the location of pathological changes. Above the affected area or diffusely, sharply weakened breathing, wet and dry rales, and dull percussion sound are heard.

Pulmonary x-ray can reliably detect pneumosclerosis. Using radiography, changes in the lung tissue during asymptomatic pneumosclerosis are detected, their prevalence, nature and severity. To detail the condition of areas affected by pneumosclerosis, bronchography, CT of the lungs and MRI are performed.

X-ray signs of pneumosclerosis are varied, since they reflect not only sclerotic changes in the lungs, but also the picture of concomitant diseases: pulmonary emphysema, chronic bronchitis, bronchiectasis. Radiographs reveal a decrease in the size of the affected part of the lung, strengthening, reticulation and looping of the pulmonary pattern along the branches of the bronchi due to deformation of their walls, sclerosis and infiltration of peribronchial tissue. Often the lung fields of the lower sections take on the appearance of a porous sponge (“honeycomb lung”). Bronchograms show convergence or deviation of the bronchi, their narrowing and deformation, small bronchi are not identified.

Bronchoscopy often reveals bronchiectasis, signs of chronic bronchitis. Analysis of the cellular composition of bronchial washings allows us to clarify the etiology and degree of activity of pathological processes in the bronchi. When examining the function of external respiration (spirometry, peak flowmetry), a decrease in the vital capacity of the lungs and an indicator of bronchial patency (Tiffno index) are revealed. Blood changes in pneumosclerosis are nonspecific.

Treatment of pneumosclerosis

Treatment of pneumosclerosis is carried out by a pulmonologist or therapist. An acute inflammatory process in the lungs or the development of complications may be an indication for inpatient treatment in the pulmonology department. In the treatment of pneumosclerosis, the main emphasis is on eliminating the etiological factor.

Limited forms of pneumosclerosis that do not manifest themselves clinically do not require active therapy. If pneumosclerosis occurs with exacerbations of the inflammatory process (frequent pneumonia and bronchitis), antimicrobial, expectorant, mucolytic, bronchodilator agents are prescribed, and therapeutic bronchoscopy is performed to improve the drainage of the bronchial tree (bronchoalveolar lavage). For symptoms of heart failure, cardiac glycosides and potassium preparations are used; in the presence of an allergic component and diffuse pneumosclerosis, glucocorticoids are used.

Good results for pneumosclerosis are achieved by using a physical therapy complex, chest massage, oxygen therapy and physiotherapy. Limited pneumosclerosis, fibrosis and cirrhosis, destruction and suppuration of lung tissue require surgical treatment (resection of the affected part of the lung). A new technique in the treatment of pneumosclerosis is the use of stem cells, which make it possible to restore the normal structure of the lungs and their gas exchange function. In case of gross diffuse changes, the only treatment method is lung transplantation.

Forecast and prevention of pneumosclerosis

Further prognosis for pneumosclerosis depends on the progression of changes in the lungs and the rate of development of respiratory and heart failure. The worst cases of pneumosclerosis are possible as a result of the formation of a “honeycomb lung” and the addition of a secondary infection. With the formation of a “honeycomb lung,” respiratory failure becomes more severe, pressure in the pulmonary artery increases, and cor pulmonale develops. The development of a secondary infection, mycotic or tuberculous processes against the background of pneumosclerosis often leads to death.

Measures to prevent pneumosclerosis include the prevention of respiratory diseases, timely treatment of colds, infections, bronchitis, pneumonia, and pulmonary tuberculosis. It is also necessary to take precautions when interacting with pneumotoxic substances or taking pneumotoxic drugs. In hazardous industries associated with the inhalation of gases and dust, it is necessary to use respirators, install exhaust ventilation in mines and in the workplaces of glass cutters, grinders, etc. If signs of pneumosclerosis are detected in an employee, it is necessary to transfer to another place of work that does not involve contact with pneumotoxic substances. The condition of patients with pneumosclerosis is improved by stopping smoking, hardening, and light physical exercise.

Pneumofibrosis of the lungs is a pathological proliferation of connective tissue under the influence of inflammation or a degenerative process. This condition leads to the threat of respiratory dysfunction and deterioration of organ ventilation. Find the answer Are you having a problem? Enter “Symptom” or “Name of the disease” into the form, press Enter and you will find out all the treatment for this problem or disease.

The site provides reference information. Adequate diagnosis and treatment of the disease is possible under the supervision of a conscientious doctor. Any drugs have contraindications. Consultation with a specialist is required, as well as detailed study of the instructions! Here you can make an appointment with a doctor.

General information

Pneumofibrosis of the lungs - what is it? This is the process of formation of connective tissue in the lungs, which replaces normal lung tissue. The formation of an excess amount of connective tissue is a consequence of sluggish, protracted inflammatory processes in the lung tissue and bronchi. We can say that pulmonary fibrosis is a secondary process and completes these diseases. It develops in areas that have not been resolved for a long time pneumonia, in the tissue around the bronchi and blood vessels, around the lymphatic vessels, the walls of the alveoli and septa. The ICD-10 code is J84.1 (interstitial lung diseases with mention of fibrosis). Also, pneumofibrosis can occur for no apparent reason and rapidly progress - this is a synonym for Hamman-Rich syndrome).
The stroma (framework) of the lungs is made up of connective tissue, which is located around the arteries, bronchi, and in the interalveolar septa. The structure of connective tissue contains collagen and elastin fibers. Elastin and collagen fibers intertwine in the walls of the alveoli and around the bronchi, and it is their interweaving that gives the lungs elastic properties - the ability to expand when inhaling and return to its original position when exhaling. The strength of the lung framework is associated with collagen.

With pulmonary fibrosis, an increased amount of connective tissue is formed due to collagen, as a result of which the elasticity of the lung tissue is lost, the function of gas exchange is significantly reduced, since collagen is deposited in the walls of the alveoli, and respiratory failure progresses. The extent of fibrosis (local or diffuse) determines the degree of respiratory and gas exchange impairment, the course of the disease and its prognosis.

Various forms of diseases

Basal pulmonary fibrosis is characterized by damage to the base of the lungs (basal sections). The diagnosis is made after an x-ray. Medicines are prescribed to stop the inflammatory process. In other cases, supportive manipulations are recommended: herbal treatment and breathing exercises.
The hilar form - the disease covers the root of the lung; the impetus for its onset can be a history of bronchitis or pneumonia. Characteristic of primary tuberculosis, leading to lung deformation.

Focal pneumofibrosis - affects individual areas of tissue, leading to a decrease in its volume and compaction. Respiratory and ventilation functions are not impaired. Under a microscope, this is a reduction in the area of ​​the lung and compaction of its parenchyma.

Local form - with this form, the lung tissue loses its functions and is replaced by connective tissue in a single area of ​​the organ. Diffuse pulmonary fibrosis is one of the severe forms of the disease, which affects the tissue of an entire organ, and sometimes both lungs.

The volume of the affected surface is greatly reduced due to compaction and deformation of tissues, and ventilation is impaired.

Linear form - appears as a consequence of complications after tuberculosis or pneumonia. Interstitial pneumofibrosis - with this form the patient suffers from shortness of breath, the disease develops as a result of inflammatory phenomena in the pulmonary blood vessels.

Severe form - the disease progresses as a result of chronic inflammatory pulmonary diseases. Smoking is the cause of the development of the disease at a young age. Cigarette smoke causes stagnation of mucus in the bronchi.

Pathogenesis

Lung connective tissue cells synthesize protein elastin And collagen. Elastin has the ability to stretch and return to its original position. Collagen forms strong fibrils and gives rigidity to the lung framework. The connective tissue produces both enzymes (proteinases) that destroy these proteins and proteinase inhibitors that inhibit the destruction process.

The proteinase-inhibitor system is normally in balance, but during inflammatory processes it is disrupted. During inflammation, the production of the enzyme a1-AT, which destroys elastase, as a result of which its activity increases. Elastase causes disorganization of connective tissue - it destroys elastic and collagen fibers of the alveolar walls. In place of the destroyed alveoli, cavities form. A combined bacterial-viral infection is itself accompanied by high production of elastase. Immune reactions that are triggered in the body during inflammation also activate the production of elastase.

On the other hand, during inflammatory processes, the activity of fibroblasts, which produce type 1 collagen, increases, which is accompanied by increased fibrosis and proliferation of connective tissue in the interstitium of the organ. When connective tissue spreads into the alveoli, intra-alveolar fibrosis occurs, then the connective tissue grows around the arteries and bronchi.

When vessels are involved in the pathological process, they develop sclerosis, the capillary bed becomes empty and develops hypoxia lung tissue. Under its conditions, the function of fibroblasts in relation to the production of collagen is even more activated, which contributes to more rapid development pneumofibrosis. Therefore, hypoxia is the main condition for the replacement of normal lung tissue with connective tissue. Vascular involvement complicates blood circulation in the pulmonary circle. There is a load on the right side of the heart and hypertrophy of the right ventricle (pulmonary heart), which over time leads to cardiac decompensation.

Pathogenesis idiopathic fibrosing alveolitis not clear. Presumably, collagen breakdown in interstitial tissue decreases, but its synthesis increases, in which fibroblasts and alveolar macrophages participate. In this case, it is important to reduce the production of an inhibitory factor, which inhibits collagen synthesis under normal conditions. Some authors consider Hamman-Rich syndrome to be an autoimmune disease, since there is overproduction of immunoglobulins of various classes. The resulting antigen-antibody complexes are deposited in the walls of the blood vessels of the lungs. Under the influence of the CEC, the lung tissue is damaged, it becomes denser, the interalveolar septa thicken, and the alveoli and capillaries are filled with fibrous tissue.

How to treat the disease

Before prescribing therapy, an examination is carried out to establish a diagnosis. The main diagnostic method is radiography. Additionally, bronchoscopy, assessment of respiratory function, and general laboratory tests are performed. This body of research also reveals the underlying cause of pulmonary fibrosis.

There is no effective therapy against pulmonary fibrosis yet.

Pneumofibrosis without symptoms is not always treated with medications.

If the disease has not entered the acute phase, treatment is carried out at home. The main task of therapeutic measures is to eliminate the cause of the disease. When the cause is the ingress of dust particles or other harmful substances, then, first of all, stop contact with the provocateur of the disease. Excitement and stress are contraindicated for the patient.

If the cause is an infection, antibacterial drugs are indicated depending on the pathogen. Maintenance therapy is also prescribed.

Breathing exercises are useful and help improve the functionality of the breathing apparatus.

In advanced forms, surgical treatment is possible. After a course of therapy, the patient is registered with a pulmonologist for a year or more.

Treatment with folk remedies

Often, with pneumofibrosis, they resort to traditional medicine. In mild forms, this type of treatment becomes the main one. They use herbal decoctions and teas, compresses for rapid removal of phlegm, lotions and warming.

Pine buds have long been used for lung diseases. This valuable product contains many essential oils that have a beneficial effect on the respiratory tract - they help eliminate mucus, destroy pathogenic microbes, and activate the secretory ability of the epithelium.

For the decoction, take 10 g of kidneys, add a glass of water, and heat in a water bath for half an hour, leave for another 15 minutes. Then the broth is filtered and drunk warm 3 times daily at a dose of 1 tablespoon.

Classification

With the flow:

• Progressive.
• Not progressive.

According to the prevalence of the process:

• Local.
• Diffuse.

Depending on the damage to individual lung structures (this is determined by computed tomography), the following types of pneumofibrosis are distinguished:

• Interstitial.
• Perivascular (spread of connective tissue around blood vessels).
• Alveolar (intra-alveolar - connective tissue replaces the alveoli).
• Peribronchial (distribution of connective tissue around the bronchi).
• Perilobular (growth along the interlobular septa).

Local pneumofibrosis is also limited. In the local variant, the pathological process of fibroformation covers one area (locus) of the lung tissue. This part of the lung becomes denser, which is very clearly visible on x-rays - the pathological process has clear boundaries.

Local fibrosis is the outcome of macrofocal pneumonia, but can also be detected in chronic bronchiolitis. Most often, local pulmonary fibrosis does not affect respiratory function and is asymptomatic.

Diffuse pulmonary fibrosis is characterized by the appearance of large areas of replacement with connective tissue, which diffusely covers almost all of the lung tissue. Areas may also form in the lungs emphysema. Since the spread of the process occurs faster than in the local version, the structure of the lungs is significantly deformed and the volume of the lungs decreases, pronounced disturbances in respiratory function are noted.

Complete ventilation of the lungs is significantly reduced and diffuse pulmonary fibrosis relatively quickly leads to the development of respiratory failure. The situation becomes more serious if both lungs are affected and the pleura is involved in the pathological process (pleuropneumofibrosis). This form of pulmonary fibrosis occurs in occupational diseases associated with inhalation of dust from silicon dioxide and metals (in particular, beryllium).

There have been cases of the development of diffuse pneumofibrosis in children with bronchopulmonary dysplasia, which develops in newborns during the treatment of respiratory disorders with artificial ventilation using high concentrations of oxygen. Diffuse pulmonary fibrosis is the outcome of exogenous allergic alveolitis that occurs when inhaling allergens. This may be material containing fungi (actinomycetes, penicillium, aspergillus), bird protein from parrots and pigeons, antigens of insects and fish (for those working with fishmeal).

Hilar pulmonary fibrosis is a lesion of the lungs in the area where the anatomical connection of the lung with the mediastinal organs is located. Radical fibrosis is a consequence of previous pneumonia And bronchitis. It can form for a long time after illness. In sarcoidosis, in most cases fibrosis develops in the upper lobes, as well as hilar fibrosis.

Stands out separately idiopathic fibrosing alveolitis(ELISA) or Hamman-Rich disease. It is a rapidly progressive form of diffuse pulmonary fibrosis, the cause of which is unknown. The disease is severe with constantly increasing respiratory failure. Idiopathic fibrosing alveolitis is the most unfavorable prognostic lung disease, manifesting itself at different ages, with men getting sick more often. Inflammatory damage to the lung tissue and alveoli develops, which leads to disorganization of the lung parenchyma, interstitial fibrosis and cystic formations in the lungs. ELISA can occur in healthy lung tissue, and against the background of chronic broncho-obstructive pathology.

Clinical picture of pulmonary fibrosis

Early diagnosis is difficult due to unclear and poorly expressed symptoms in the early stages of pulmonary fibrosis. Often the patient goes to the hospital with a pronounced and advanced form of the disease. Right ventricular hypertrophy developing against the background of the disease is expressed by:

• In loss of consciousness;
• Swelling;
• Fainting.

If the disease is accompanied by pneumonia, then the patient’s condition is severe, with symptoms similar to the flu.

Characterized by:

• Headaches;
• High temperature;
• Weakness;
• Aches in the muscles;
• Sore throat;
• Dry cough;
• Shortness of breath.

In advanced cases, the patient’s fingers take on a specific shape - the phalanges thicken, and the fingers resemble a club in shape. Pneumofibrosis affects different parts of the lungs, so the clinical picture depends on the location of the lesion. There are different forms of the disease: basal and hilar pneumofibrosis.

Focal, local and diffuse forms differ in the area of ​​lung tissue involved in the process.

The course of the disease is specific depending on the cause of the pathology. There are linear, interstitial and stringy forms.

Causes

First of all, various diseases of the bronchopulmonary system lead to pulmonary fibrosis:

• Pneumonia. Its protracted course is naturally resolved by the formation of post-pneumonic pneumofibrosis, which is observed in 10-20% of patients. With pneumonia caused by Legionella pneumophila, a long course is always observed, foci of infiltration that do not resolve for a long time and a high incidence of post-pneumonic pneumofibrosis. Staphylococcal pneumonia usually occurs with destructive changes in the lungs; there is a slow resolution of the disease, resulting in local pneumofibrosis.
• Occupational dust diseases that are associated with inhalation of dust and gases. They flow like diffuse pneumonitis and progressive alveolitis with a mandatory outcome in fibrosis. Occupational diseases include silicosis, silicates And metalloconiosis. The fibrogenicity of coal dust varies. Dust with a silicon dioxide content of more than 10% is considered highly fibrogenic and upon contact with it, silicosis, silicosilicosis and anthracosilicosis occur. This group of diseases is characterized by a progressive fibrotic process. When exposed to weakly fibrogenic dust (silicon dioxide in it is less than 10%), silicates, carboconiosis, pneumoconiosis of grinders, metalloconiosis from radiopaque dust, and from dust from electric welding of iron products develop. These diseases are characterized by moderate pneumofibrosis, a benign course with slow progression. They are often complicated by chronic bronchitis, which determines the severity of the disease.
• At pneumoconiosis of miners interstitial fibrosis and local emphysematous areas are combined. During the course of the disease, the prerequisites for productive sclerotic changes are formed, characterized by the development of pneumofibrosis in the acini and lobules of the lung. The reason for the rapid development of connective tissue is a violation of the lymphodynamics of the lungs, since dust particles are excreted lymphogenously through the lymphatic vessels of the acinus. Under conditions of prolonged exposure to dust, removal becomes difficult.
• Chronic obstructive pulmonary disease, which is characterized by inflammatory changes in the bronchial wall with the development of peribronchial fibrosis. In bronchial asthma, subepithelial fibrosis develops.
• Allergic lung diseases. A synonym is exogenous allergic alveolitis. The disease occurs when inhaling dust containing antigens. Damage to the alveoli and surrounding tissue is typical, resulting in fibrosis. An occupational disease develops in persons who have constant contact with dyes, resins, fungicides, polyurethane, chromium, cobalt and arsenic, engaged in rubber production, mushroom cultivation, and compost processing. In addition, one of the most common causes of allergic alveolitis is keeping a house with flying birds (pigeons, budgies) and living in damp rooms with mold. People prone to allergic diseases are at risk. Pneumonitis(alveolitis) has different course options: from recovery to severe development of fibrosis (“honeycomb” lung) with gross damage to the pulmonary architecture.
• Cystic fibrosis. Inflammation in the walls of the bronchi causes fibrotic changes in the wall itself and peribronchial fibrosis. These processes, in turn, contribute to the development of bronchiolitis obliterans with expansion of the alveoli and alveolar ducts.
• Pulmonary sarcoidosis. This is a systemic disease, which is characterized by the formation of granulomas in the lung tissue and intrathoracic lymph nodes. In the lungs, against the background of pneumofibrosis and emphysema, dissemination of foci is determined. As the disease progresses, conglomerates of lesions cover the entire lung tissue, and pulmonary fibrosis and emphysema also intensify. At this stage of the process, the patient develops severe respiratory failure.
• Conditions after lung surgery always end in the formation of pneumofibrosis.
• Tuberculosis. The long course of tuberculosis is accompanied by pneumofibrosis, emphysema and bronchiectasis.
• Mechanical damage to the lung.

Other causes of pulmonary fibrosis include:

• Chronic active hepatitis.
• Scleroderma, systemic lupus erythematosus, rheumatoid arthritis, ankylosing spondylitis.
• Diabetes.
• Radiation exposure. Pneumofibrosis is considered as a complication of radiation therapy lymphogranulomatosis, breast cancer, pleural mesothelioma. Radiation therapy to lymphatic drainage areas is also often accompanied by the development of pneumofibrosis.
• Chronically ongoing infectious processes. The chronic course of cytomegalovirus infection is very characterized by the development of pneumofibrosis.
• Toxic effects of medications. Amiodarone is a drug with proven pulmonary toxicity. When taking amiodarone, as well as cytostatics and nitrofurans, fibrosing alveolitis (allergic alveolitis) may develop. Reception Pierced complicated by pulmonary fibrosis, which leads to respiratory failure. The formation of fibrotic masses in the alveoli is observed when taking sulfonamides, penicillins, gold salts and narcotic drugs. Ergotamine causes pleural fibrosis.
• Although the cause of idiopathic interstitial fibrosis is unknown, there are risk factors that contribute to the development of the disease: smoking, respiratory tract infections, exposure to external factors (metal, wood, stone, plant dust, contact with birds, working with herbicides and fungicides, contact with aerosols and dyes hairdressers) and genetic predisposition.

Treatment with folk remedies

With pulmonary fibrosis, excellent folk recipes, time-reliable, which have been used for a long time by our grandmothers and great-grandmothers, can come to the rescue. Folk remedies are in no way inferior to medicines, but their composition is considered more useful.

Let's talk about some medicines:

1. Grind the oman roots and rose hips in separate cups. Take 1 tbsp. Take a spoonful of these plants and pour them into a metal container. Pour 600 ml of water. Place on low heat, and after boiling, cook for another 15 minutes. We filter the finished broth and pour it into a thermos, put it in a dark place to infuse for several hours. Then we drink the decoction, like tea, 150 ml 2-3 times a day, for 2 months (just don’t skip using it!). In case of low acidity, you need to drink this medicine 15 minutes before meals, and in case of high acidity, half an hour after meals. You can add a little honey to the broth and drink it chilled. The decoction increases energy levels, so it is good to drink before exercise. At the same time, oman and rose hips regenerate lung tissue well, cleanse the lungs of phlegm, and prevent the occurrence of inflammatory processes and infections in the mucous membrane of the respiratory tract.
2. The following recipe will require 2 tbsp. spoons of anise seeds. Pour them into a metal bowl, add 250 ml of water, and place on low heat. From the moment it boils, remove from the stove. Take the cooled broth 0.5 cups 2 times a day. You can also add anise seeds to milk along with cayenne pepper, and to sweeten the taste, you can add a little honey. Drink in small sips at night. You can make a liqueur with anise seeds: take 50 grams of seeds, pour them with 500 ml of strong white wine or low-quality cognac. Stir everything well and place in a dark place to infuse for 2 weeks. Then we drink 100 grams after meals.
3. Rosemary and essential oils based on it have an excellent therapeutic effect against pulmonary fibrosis. This plant and its oils are good at cleansing the lungs of toxins and excess phlegm. A medicine based on rosemary is a strong antioxidant that prevents the development of lung cancer, because in the last stage of pulmonary fibrosis a malignant tumor can form. Rosemary helps improve air circulation in the lungs and relaxes all bronchial passages, which improves the condition of the respiratory system. To prepare such a wonderful medicine you need: cut the rosemary into small pieces, pour it with water and honey 1:1. Put it all in the oven and simmer for about 120 minutes. Cool and refrigerate. Use this composition 1 tbsp. Spoon morning and evening. You can make a liqueur from rosemary, which has an amazing effect in the treatment of pulmonary fibrosis: take 50 grams of finely chopped plant, fill it with 500 ml of red wine, add 3 - 4 tbsp. spoons of sugar, put on low heat, after boiling, immediately remove from heat. Place the composition in a dark place for 48 hours. Store the strained drink in the refrigerator. Use 1 tbsp. Spoon, 60 minutes after eating.

After one course of treatment with some folk remedy, your breathing will improve, and you can do various breathing exercises.

Before using any folk remedy, it is advisable to consult with your doctor to avoid irreparable complications.

Symptoms

Symptoms depend on the underlying disease against which pulmonary fibrosis arose, but the main complaints of patients with pulmonary fibrosis of any origin are: dyspnea during exercise and at rest, weakness, increased fatigue. As shortness of breath progresses over time, it becomes the dominant symptom. Patients may also be bothered by a cough without sputum, chest pain, and sometimes hemoptysis due to the associated vasculitis. The temperature rises with exacerbation of the underlying disease. Weight loss is not typical.

With silicosis, the symptoms are scant: cough, shortness of breath, sputum production. For chronic bronchitis and bronchiectasis - cough with sputum. Auscultation of patients reveals weakened breathing, dry wheezing, reminiscent of “crackling cellophane” in the lower parts of the lungs.

Over time, with the development of cor pulmonale, patients develop puffiness of the face and swelling of the veins of the neck. In severe cases of heart failure, swelling of the legs and accumulation of fluid in the cavities appear: hydrothorax(in the pleural cavity), hydropericardium(in the pericardial cavity) and ascites(in the abdominal cavity).

Hamman-Rich syndrome has an acute onset, with cough, fever (associated with bacterial pneumonia) and increasing shortness of breath. In this case, the cough is unproductive (little sputum is produced), the patient is bothered by tightness in the chest and pain in the chest. It grows very quickly respiratory failure, cyanosis, is developing pulmonary hypertension And chronic cor pulmonale. Steadily progressing shortness of breath limits the patient's movements, he cannot take a deep breath and loses the ability to care for himself. Weight loss progresses and joint pain appears.

In the second variant of the course of idiopathic fibrosing alveolitis, which is more common, there is a gradual onset and slowly progressive shortness of breath (first with exertion, and then at rest).

Patients are concerned about a nonproductive cough, weight loss, and fatigue. In the later stages, thickening of the nail phalanges of the hands is observed - “drumsticks”. The age at which the disease occurs is 60-70 years.

Breathing exercises

Excellent helpers for pulmonary fibrosis are breathing exercises that help improve the functioning of the respiratory organs, strengthen the entire body due to the supply of oxygen to collapsed areas of the lungs.

There are many good methodical exercises to strengthen the respiratory system, for example, the Buteyko and Strelnikova methods. But you don’t need to stick to only these methods; you can do easier breathing exercises, for example, inflating balloons. And for greater effect from such exercises, it is better to carry them out in the fresh air or in a well-ventilated area.

Here are some great exercises:

• Take a deep breath, hold your breath for a while and slowly exhale;
• While inhaling, slowly raise your arms up, exhale sharply and slowly lower your arms with the sound “ha”;
• Inflate balloons several times a day for about 1-2 minutes;
• A good exercise is to blow through a tube lowered into water for about 2-3 minutes;
• Standing, feet shoulder-width apart, slowly lean forward, at the same time spread your arms to the sides, while bending, inhale with your stomach pulled in;
• The next exercise should be performed lying on your back (can be on the floor), exhale through your mouth, slightly pressing your hands on the diaphragm.

In conjunction with the described breathing exercises, you can do other gymnastics that help better ventilation of the lungs, for example, if pulmonary fibrosis is associated with bronchitis or pneumonia.

But remember one rule - you should not do too difficult gymnastics in an acute form of the disease, first wait for the body to recover a little, and then, if it improves, start doing gymnastics.

Tests and diagnostics

• Screening method - fluorography.
• X-rays provide more accurate diagnostic signs. Hamman-Rich syndrome characterized by the following radiological signs that initially appear in the lower and middle parts of the lungs: strengthening and deformation of the pulmonary pattern, decreased transparency of the lungs due to a large number of strands running along the bronchi and vessels from the root of the lung to the periphery, swelling of the lung tissue along the periphery. A cellular pattern is characteristic due to connective tissue growth around the acini. As the disease progresses, the pleura thickens (parietal, interlobar, diaphragmatic) and the upper sections are involved in the process. Fuzzy focal merging shadows appear in the lungs, and the mobility of the diaphragm decreases. In advanced cases, cavities up to 1-3 cm appear on the periphery of the lungs and the formation of a “honeycomb” lung.
• High resolution computed tomography. This is a highly sensitive method that determines the severity of fibrosis, its prevalence and changes in dynamics. The technique of thin sections and reconstruction of the lung in space makes it possible to see the process in volume. The picture of idiopathic fibrosis in the early stages is represented by changes in the form of “ground glass”. Then basal changes are formed on both sides according to the “honeycomb lung” type, which gives rise to cysts measuring 3-10 mm with thick walls.
• Tomography And bronchography bronchiectasis is found in the lower parts of the lungs.
• Body plethysmography (a study of the elasticity of lung tissue) reveals a “hard” lung.
• Study of external respiration function - changes of a restrictive type, decrease in lung volumes (decrease in vital capacity).
• A study of blood gas composition shows a decrease in the diffusion capacity of the lungs.
• Hypoxemia(partial oxygen tension decreases to less than 60 mm Hg) increases with exercise, and develops at its height hypercapnia(the level of carbon dioxide increases, its pressure becomes more than 45 mm Hg. Art.)
• Cytological and histological examination of lung tissue biopsy.

What is pneumofibrosis

Pneumofibrosis is a consequence of inflammatory and/or dystrophic processes in the lungs, in which the lung tissue is replaced by connective tissue. In this case, the formation of a “honeycomb lung” is noted with the formation of cavities and cysts in the lung itself. Fibrosis is a “holey” lesion of the lung tissue.

Pneumofibrosis belongs to the general group of pneumosclerotic pulmonary pathology along with pneumosclerosis and cirrhosis of the lungs. Such conditions differ from each other in that of all, pneumofibrosis is characterized by the slowest rate of proliferation of connective tissue.
For reference. More often, pneumofibrosis develops in males.

Consequences and complications

The consequences of pulmonary fibrosis are quite serious and the main ones are:

• Progressive respiratory failure.
• Lung cancer, which often develops against the background of idiopathic fibrosis.
• Secondary pulmonary hypertension, which develops already in the first years of the disease, but proceeds unnoticed by the patient. As it progresses, shortness of breath increases, which depends on the level of increase in pressure in the pulmonary artery.
• Pulmonary bleeding, pneumothorax And pneumomediastinum- consequences of rupture of fibrous cavities and cysts that form in the lungs in the late stages of idiopathic fibrosis.

Prognosis and prevention for the disease

Depends on the area of ​​the surface involved in the process and the rate of replacement of lung tissue with connective tissue. In the presence of secondary infections and tuberculosis processes, the likelihood of death increases sharply. Preventive measures include:

• Treatment of all colds on time, using the correct technique;
• Compliance with precautionary measures in hazardous industries;
• Hardening;
• Maintaining a healthy lifestyle: quitting smoking;
• Physical exercise.

Pneumofibrosis does not depend on gender, but often occurs in men over 50 years of age.

The progression of the disease leads to disability and death, which is why timely diagnosis and qualified treatment are so important.

Forecast

The prognosis for idiopathic fibrosing alveolitis is unfavorable - survival rate is worse than for malignant tumors. Increasing fibrosis in the natural course of fibrosing alveolitis with the presence of a “honeycomb lung” significantly worsens the patient’s condition. Life expectancy ranges from 2 to 6 years: in acute cases - 2 years, in subacute cases - 2-4 years. With adequate treatment, it is possible to improve the quality of life and its duration. A drug Esbriet increases median survival to 6.9 years.

In cases of secondary pulmonary fibrosis, the prognosis depends on the underlying disease, the extent and rate of progression of fibrosis, as well as the presence of complications ( bronchiectasis, emphysema, respiratory failure). The prognosis also depends on the type of formation of pulmonary fibrosis. It can form as cords or as a honeycomb lung when the alveoli are affected.

Severe fibrosis in any part of the interstitium of the lungs, as well as atelectatic fibrosis(after pneumonia or as a result of bronchial closure) belong to favorable types. These types of pulmonary fibrosis do not affect the ventilation and diffusion function of the lungs, and therefore do not lead to severe respiratory failure. If we consider acinar fibrosis and “honeycomb lung”, in which the entire acinus and alveoli are affected (diffusion of gases occurs in them), then they lead to severe respiratory failure. These types of fibrosis are considered unfavorable in terms of prognosis and life expectancy. “Honeycomb lung” is the most unfavorable prognostic sign, especially in the presence of large “honeycombs” or alternating small and large ones located in the lower parts of the lungs.

Fibrosis in silicatosis and carboconiosis progresses slowly, so the prognosis for life is favorable. Silicosis also has a favorable prognosis, but if it becomes complicated tuberculosis and spontaneous pneumothorax, the course of the disease and the prognosis are unfavorable.

Complex treatment of pathology

How to treat pulmonary fibrosis? It is impossible to completely get rid of the disease. His treatment is aimed at:

• To stop the process,
• Prevention of asphyxia,
• Preservation of the normal state of healthy tissues.

Specific therapy is prescribed by a pulmonologist. In acute cases of the disease and the presence of inflammatory processes, hospital treatment is necessary.

The main direction of medical action is to eliminate the cause of the pathology.

In the absence of obvious clinical manifestations, specific therapy is not required.

For inflammation, the following are prescribed:

• Expectorants;
• Mucolytics;
• Antibiotics.

Episodes of heart failure require the use of:

• Potassium preparations;
• Cardiac glycosides.

To eliminate allergic reactions, glucocorticoids are needed. In case of suppuration and destruction of lung tissue, surgical intervention is required to resect the affected area. Physical methods of conservative treatment:

• Chest massage;
• Physiotherapy;
• Walks in the open air.

The latest innovation in the field of pulmonology is the use of stem cells in fibrotic lung diseases. Using this method, gas exchange and the structure of the respiratory organs are improved.

In advanced stages, lung transplantation is indicated to save the patient's life.

Dietary nutrition is used in treatment. The diet is aimed at accelerating repair in the lungs and reducing protein loss in sputum. High content foods shown:

• Calcium;
• Copper;
• Potassium salts;
• Vitamins A and B9.

List of sources

• Gavrisyuk V.K., Dzyublik A.Ya., Monogarova N.E. Idiopathic fibrosing alveolitis // News of medicine and pharmacy. 2008. No. 256. from 22-24.
• Interstitial lung diseases: a practical guide / Ed. ON THE. Mukhina. M.: Litterra, 2007.
• Sakharchuk I.I., Ilnitsky R.I. Inflammatory diseases of the lungs and pleura. Kyiv; "Book Plus". 2006 – 295 p.
• Aisanov Z.R., Kokosov A.N., Ovcharenko S.I., Khmelkova N.G., Tsoi A.N., Chuchalin A.G., Shmelev E.I. Chronic lung diseases. Federal program. RMJ, 2001; No. 1: p. 9 – 33.
• Ivanova A. S. Fibrosing processes / A. S. Ivanova, E. A. Yuryeva, V. V. Dlin. M.: Overlay, 2008. 196 p.

Diagnostics

The most important method for diagnosing pulmonary fibrosis is an x-ray of the lungs. With its help, it is possible to determine the first symptoms of the disease, pathological changes, and concomitant diseases.

Also, using X-ray diagnostics, pneumofibrosis is differentiated from lung cancer.

The main radiological signs of pulmonary fibrosis will be:

• Strengthening the pattern of the lungs.
• Deformation of the pulmonary pattern.
• Expansion of vascular shadows.
• “Pulmonary shadows” with sharp, uneven contours, which are lesions.
• Shadows similar to lines with a random direction, the formation of cells, which indicates the neglect of the process.

The next mandatory diagnostic method will be to assess the function of external respiration, vital capacity of the lungs and functional vital capacity.

The third necessary study will be a bronchoscopy to recognize the form of the disease and exclude an oncological process. Magnetic resonance imaging and computed tomography may be prescribed as additional diagnostic measures.

To diagnose lung diseases, you need to look for a qualified pulmonologist. Of course, a general practitioner or therapist can also make general recommendations. However, a specialist in lung diseases, such as a pulmonologist, is preferable in complex cases.

How to treat

Diagnostic tests are carried out by a pulmonologist. He appoints:

• X-rays of light. The main symptom of the disease is a pronounced pattern and change in the lung. In the picture you can see the vessels and the shadows extending from them. At an advanced stage of the disease, shadows in the form of honeycombs and tissue scarring will be visible.
• Study of the functioning of external respiration. Lung capacity is checked. Its low rate indicates a disorder in the organ and the development of pulmonary diseases.
• Laboratory. Used to exclude other diseases, such as tuberculosis.
• Study of the bronchi. A part of the lungs is taken and examined using a camera. This test will show what stage the disease is at and how far it has spread.

Recent and chronic lung diseases of the patient must be ascertained. The doctor makes an oral interview with the patient and studies his medical record.

The disease can be confused with cancer

Therefore, it is very important to conduct a comprehensive examination of the body.

Since the process of proliferation of connective tissue is irreversible, treatment is considered ineffective. It is aimed, first of all, at eliminating the concomitant disease. That is why it is important to study the exact causes of the pathology. Incorrect treatment is a consequence of an incorrect diagnosis.

If the main factor is pneumonia, then a course of treatment with antibiotics is prescribed in combination with other medications and physical therapy. Inflammation must be treated until it disappears completely. After therapy, the patient is observed by a doctor for another year.

In the absence of pulmonary insufficiency, treatment with ions and ultrasound can be performed. If the organ does not have enough air, oxygen therapy is prescribed. Cardiac medications are required to prevent heart attacks.

At a severe stage, pleural drainage may be prescribed. If fibrosis progresses rapidly, surgery will likely be required. The patient is prescribed a special diet, limited physical activity and complete rest.

An important point in rehabilitation is a set of breathing exercises. They maintain the normal functioning of the lungs and ensure the supply of oxygen to weakened segments of the organ

Prevention includes careful handling of toxic substances. It is mandatory to wear special masks

If fibrosis has already been detected, it is necessary to transfer the patient to another job with a healthier climate. Incomplete or self-treatment of inflammatory lung diseases is not allowed. Timely qualified assistance in the event of any pathology is the best form of prevention.

How dangerous is the disease?

First of all, with pulmonary fibrosis, there is a deterioration in the functioning of the lungs and heart. The disease can cause deficiency and impair the patient's quality of life. If it is not detected early, it will lead to a high probability of death.

At an advanced stage, pulmonary failure develops, the organ becomes like a sponge with honeycombs. The patient's condition worsens, it becomes difficult for him to breathe, the chest is deformed and a secondary infection develops. The resulting chronic failure is incurable; medications and exercises can only temporarily normalize breathing.

Against the background, the cor pulmonale develops, that is, the myocardium thickens and the organ section on the right side expands. For some time, it compensates for respiratory failure by forcefully circulating oxygen through the blood. But this is a temporary phenomenon. Then the muscle gets tired and myocardial infarction may occur.

In the background, there is a rapid heartbeat, disturbed cardiac rhythm and periodic pain in the chest.

Patients with this diagnosis cannot live a full life and, as a rule, are disabled. Cor pulmonale cannot be treated.

Another common complication is a general weakening of the immune system and the body’s susceptibility to viral infections. Since the patient’s blood circulation is already impaired, this contributes to constant infection. Patients often suffer from high fever, persistent cough, wheezing, and ARVI and other viral diseases.

Thus, the disease is incurable. Everything that can be done is to stop the proliferation of connective tissue, alleviate the patient’s condition and prevent the development of complications.

Possible complications

Progressive pulmonary fibrosis can provoke serious complications. This is mainly due to inflammatory processes and the risk of pathogenic microflora joining. One of the undesirable consequences of fibrosis is lung abscess. This condition is characterized by purulent melting of organ tissue and a high probability of death. The prognosis is also questionable for pulmonary fibrosis caused by tuberculosis.

Tuberculosis is a complication of pulmonary fibrosis

Diagnostic methods

With this disease, diagnosis is of great importance, because it helps the specialist decide whether there is a need for surgical treatment. This largely depends on what the causes of the disease are and whether therapy with folk remedies is possible. It is important to remember that:

• the disease is detected based on symptoms and detailed medical examination;
• when there is the slightest suspicion of pulmonary fibrosis, the patient should be referred to a pulmonologist;
• The main diagnostic method for this disease is x-ray. It will help to identify the sclerotic nature of tissue changes and distinguish the underlying disease from malignant processes in the pulmonary area;
• if there is such a need, the pulmonologist can prescribe a conventional and computed tomography, as well as a more detailed x-ray, in order to know exactly what the causes of the process are.

Prognosis for pathology

This disease is always a consequence of the main ailment, and therefore the prognosis in the presented situation depends on the severity and complications of the initial pathology. With minimal damage to the lung tissue, a sharp decrease in lung parameters is observed. This provokes respiratory failure and increased pressure in the pulmonary artery. Death is possible and occurs due to a new infection or active tuberculosis process.

The disease has a destructive effect on the structure and function of lung tissue. As the pathology develops, it provokes a change in the shape of the bronchi, a decrease in their volume and wrinkling. All age groups are equally susceptible to the disease. However, pneumofibrosis most often manifests itself in males.

Considering the danger of the disease and the high risk of complications, care should be taken not only in diagnosis, but also in treatment. It is important to consult a specialist and not self-medicate. In this case, we can talk about 100% recovery of the body.

Nature created the tissues in the human body in rational, limited ways.

When various pathologies arise, they can change their shapes and volumes.

This phenomenon is observed in the disease: pulmonary fibrosis.

Treatment with folk remedies is possible only after examination by a doctor, as prescribed.

When pulmonary fibrosis occurs, abnormal growth of connective substances occurs in the lung tissues. Such an ailment does not form on its own, but is the cause of an existing one. It is not distributed by gender; it affects both men and women.

It is important to contact the clinic in time to avoid dangerous consequences in the form of violations:

• elastic
• dystrophic
• decreases gas exchange in the respiratory organs
• deformation

According to the conditions of vital functions, a person breathes, but if he is sick, he constantly lacks air, which causes deformation of the respiratory tract and its main instrument -.

But for the appearance of pneumofibrosis, a provocation is needed, this can be an acquired infection or mechanical damage.

When diseases are poorly treated in cases where they were not correctly identified by the attending physician or the patient self-medicated inappropriately, two types of pathology may occur:

• local with compacted segments of lung tissue and mild pathological
• diffuse in the form of a more severe form, with disruption of the normal pulmonary structure with a decrease in volume, an increase in compaction

During local pneumofibrosis, gas exchange in the lungs does not decrease significantly, and changes in mechanical properties and elasticity also do not occur.

A completely different process occurs with a diffuse disease; in this case, adequate pulmonary ventilation is significantly reduced.

But the varieties of the disease are not limited to this; in nature the following are also observed:

• linear, with the appearance of scars
• basal, damaging the lungs in the lower part
• basal, speak for themselves, arise in the roots

• x-ray
• estimating the value using the Tiffno index
• bronchological methods

Thanks to x-rays, it is possible to identify the presence of the first signs and appearance of the disease at the first stage, and determine concomitant pathologies.

The X-ray machine will show:

• enhanced pulmonary pattern with its deformation contours
• expansion of vascular shadows
• affected areas
• violations in the directions of various branches

Using the index and its abnormal decrease, changes in external respiration and the nature of lung damage are determined.

Studying the bronchi makes it possible to evaluate foci of pneumofibrosis and determine its type.

Causes and symptoms of development

The disease occurs against the background of infectious and inflammatory diseases or as a result of exposure to harmful substances, fungi and allergic reagents. It is often a complication of viral lung diseases.

Many of our readers actively use the Monastic Collection of Father George to treat coughs and improve their condition with bronchitis, pneumonia, bronchial asthma, and tuberculosis. It contains 16 medicinal plants that are extremely effective in the treatment of chronic COUGH, bronchitis and cough caused by smoking.

The most common causes of hilar pneumofibrosis:

The most common cause is hypoxia of the lung tissue. It promotes the activation of a special type of cells - fibroblasts, which, in turn, produce collagen. This substance is connective tissue that will begin to replace the pulmonary tissue.

As a result of exposure to toxic substances or an infectious disease, areas of lung tissue die and connective tissue is formed in its place.

Also, the cause of pneumofibrosis can be improper therapy or improper treatment of the disease. This is especially true for self-administration of medications. Toxic medications can have the wrong effect and trigger the development of the disease.

Symptoms of the disease are:

In the local form of hilar pneumofibrosis, the symptoms are mild and can be confused with other pathologies, for example, with inflammation or bronchitis. Difficulty in making a diagnosis is created by the presence of infectious diseases, for example, it may not be noticed in tuberculosis.

Classification of the disease, its symptoms

In medical practice, local and diffuse types of pneumofibrosis are encountered. A local type of disease is characterized by compaction of a separate fragment of the lung. There are no obvious disturbances in gas exchange processes. Diffuse pulmonary fibrosis leads to the fact that they lose their original structure and shape, their density increases, and ventilation is impaired.

According to medical sources, pneumofibrosis is divided into hilar and linear. The linear form of the disease is a consequence of previous tuberculosis or infections.

Science does not know where hilar pneumofibrosis comes from. It makes itself felt after the patient has had bronchitis or pneumonia. Pneumofibrosis rarely occurs as an independent disease. Its appearance is preceded by a number of provoking factors, which include:

• infections;
• obstructive diseases;
• systematic inhalation of toxic vapors;
• hereditary factor;
• sarcoidosis;
• addiction to smoking;
• mycoses;
• beryllium disease;
• interstitial pulmonary edema;
• gastrointestinal reflux;
• taking antitumor drugs.

Depending on the period of time after which the patient consults a doctor, he is diagnosed with a progressive or non-progressive stage of pulmonary fibrosis. The non-progressive form of the disease is characterized by the absence of pronounced symptoms.

In this case, treatment of pneumofibrosis with folk remedies is allowed. The progressive form is dangerous due to complications. Relapses of the disease can bother a person throughout his life. It should be remembered that a disease such as pulmonary fibrosis is more typical for men.

Why is pulmonary fibrosis dangerous? Pneumofibrosis is an insidious disease. Tissue proliferation leads to shrinkage of the lungs and respiratory failure. Pulmonary artery pressure increases. This process cannot be stopped or corrected. Death occurs as a result of complications.

Signs of pulmonary fibrosis appear if the connective tissue has grown in both lungs. The first and main symptom of the disease is shortness of breath. At the first stage, it bothers a person after physical activity, later when he is at rest.

Other symptoms of pulmonary fibrosis include:

• cough accompanied by sputum and pus;
• the skin takes on a bluish tint;
• chest pain, worse when coughing;
• prostration;
• body temperature is unstable;
• sudden weight loss;
• swelling of the neck veins;
• wheezing and squeaking in the lungs, especially when exhaling.

At the same time, concomitant signs of the disease that provoked pulmonary fibrosis appear in the picture of the disease.

Many patients diagnosed with pulmonary fibrosis fear that it is cancer. Despite the similarity of the clinical picture, pulmonary fibrosis is not an oncological disease.

Symptoms of diffuse pulmonary fibrosis

If there is a local type of disease, then it practically does not manifest itself at all. And this has its own danger, because it can be detected on a random x-ray or fluorography. This means the development of complications is high. While the symptoms of diffuse pulmonary fibrosis are expressed as follows:

• shortness of breath, which will worsen over time
• a dry cough appears, and the harder a person tries to breathe, the more intense the attack
• there is a constant feeling of weakness, apathy
• if there is damage to the basal areas, then the nail phalanges of the fingers will begin to gradually thicken
• in case of advanced disease, during breathing the patient experiences a discomfort sensation in the right side of the ribs,
• cork-like friction
• temperature may rise
• There are pain sensations in the chest that “come in waves”
• in the absence of adequate measures, dry turns into wet, and bloody inclusions will begin to be observed

Depending on which part of the lung the lesion develops, symptoms may vary slightly. A pulmonologist makes an accurate diagnosis.

other methods

Traditional healers and their healing methods are a great assistant to therapists, but only as an addition to the main treatment.

The specialist himself will prescribe, if the diagnosis reveals pulmonary fibrosis, herbal treatment, and they will help improve breathing, ease shortness of breath, and strengthen the immune system.

Among the medicinal indoor plants is the popular aloe vera. Its leaves contain a lot of vitamins and microelements. Tinctures, mixtures and rubbings are made on its basis.

In combination with the use of medications, having received medical approval, and only scars after tuberculoma remain on the lungs, the condition of pulmonary fibrosis will improve if you include in the nutritious diet (3 times a day, 25 grams) a mixture consisting of the following ingredients:

• domestic lamb or any animal fat – 100 gr.
• walnut – 100 gr.
• honey – 100 gr.
• aloe leaves – 100 gr.

It is very easy to make a homogeneous mass; all solid elements are twisted in a meat grinder. Melt the internal fat and honey over low heat, do not bring to a boil and mix thoroughly.

The prepared tincture cleanses the respiratory tract well:

• you will need red wine -1 glass
• honey – 2 tbsp. l.
• aloe leaves – 6 large leaves

The leaves are chopped, added to wine, mixed with honey. All received products are stored in a cold place, used before eating, but no more than three times a day and no more than 1 tablespoon.

Eucalyptus is used as an antiseptic. It has many therapeutic effects for various pulmonary diseases, heart ailments, and nervous breakdowns.

It is very easy to make a medicinal potion with its leaves. You need to take boiling water and put the crushed stuff there, you can use it immediately after 20 minutes. To enhance the effect, add honey to the solution.

Application does not require time restrictions, but to avoid accumulative formations, it is better to change the herbs after a month of use.

The use of common pikulnik and creeping thyme also has a beneficial effect on the body and respiratory tract. The manufacturing method is identical to eucalyptus; the herbs are simply brewed like tea.

A decoction of oat grains is considered a therapeutic method for pulmonary pathology. It is also consumed before meals. To do this, pour the cereal (1 glass) with water (1 liter) at night, and before breakfast the solution is heated to a boil and continued to be heated until the water is reduced by half. You can drink the strained broth warm.

There are many tips to alleviate the plight of a sick person, but the surest one is turning to a professional.

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A diagnosis of pulmonary fibrosis has been made - what is this disease? This is what is called the replacement of lung tissue with connective tissue. Pathology develops due to inflammatory or dystrophic processes. As a result, the structure of the affected areas is disrupted, and this leads to a deterioration in the main gas exchange function of the lungs.

Pneumofibrosis can only be partially called an independent disease. Most often this is a consequence of pathological changes occurring in the respiratory system. One of the most common reasons for the displacement of pulmonary connective tissue is oxygen starvation of the respiratory organ. It occurs due to deterioration of pulmonary ventilation, drainage of the bronchial tree, lymph and blood circulation.

Pneumofibrosis is included in the subgroup of pneumosclerotic anomalies. These also include pneumosclerosis and pulmonary cirrhosis. All three pathologies are very similar. They differ from each other in that with sclerosis and cirrhosis, the connective tissue grows more quickly than with pneumofibrosis.

There are two main variants of this disease:

• local (that is, limited, focal) pneumofibrosis;
• diffuse (extensive) pneumofibrosis.

With the local variant of the disease, the pathological process develops in one focus, rarely spreading beyond its boundaries. Although the lung volume decreases somewhat, its gas exchange function is not impaired. Diffuse pulmonary fibrosis covers large areas of the lungs. At the same time, their structure changes more radically. Becoming dense, they significantly decrease in volume, and this change significantly impairs ventilation of the lungs.

Local pulmonary fibrosis often does not manifest itself at all, and it does not even occur to a person that he is sick. Therefore, this variant of the disease is usually detected by chance, during an examination for a completely different reason. Another thing is diffuse pneumofibrosis. Its main symptoms are:

• shortness of breath, which becomes more severe over time;
• attacks of dry cough, aggravated by rapid breathing;
• the appearance of a whistling sound when inhaling;
• aching pain in the chest area;
• blue discoloration of the skin;
• noticeable weight loss;
• general malaise, weakness, fatigue.

If the basal sections of a person’s lungs are affected, this pathology is indicated by “Hippocrates’ fingers”; due to their thickened tips, they become like drumsticks. A late stage of the development of the disease is indicated by a symptom such as squeaking when inhaling, reminiscent of the sound that a cork makes when it rubs against glass. If you notice one or more of the listed symptoms, you should contact your local physician and get examined. If pulmonary fibrosis is detected, the doctor will prescribe adequate treatment and give recommendations for improving lifestyle.

Treatment of pneumofibrosis

Therapy for pulmonary fibrosis consists primarily of eliminating the primary disease that initiated the proliferation of connective tissue. For example, broad-spectrum antibacterial agents are actively used to treat pneumonia. To enhance the effect, glucocorticoids and expectorants (Bromhexine) are prescribed along with antibiotics.

In case of heart failure, which developed against the background of pleuropneumofibrosis or was the root cause of the pathology, cardiac glycoside preparations (Strophanthin, Korglikon) are used. All medications (including folk remedies) should be used only as prescribed by a doctor and under his constant supervision to avoid the development of allergic reactions or other serious complications.

As a rule, in the treatment of pleuropneumofibrosis and other diseases without signs of pulmonary insufficiency, physiotherapy is prescribed - for example, iontophoresis and ultrasound with the use of drugs. Oxygen therapy has a beneficial effect, as it can saturate the lungs with the necessary oxygen. In addition, for successful treatment, the patient should attend physical therapy classes, which help improve blood circulation and muscle tone.

Vitamin therapy, diet and strengthening the immune system in general help the body fight the disease and contribute to the successful treatment of pathology at any stage. Pneumofibrosis, like other pulmonary diseases, must be treated until complete recovery in order to avoid relapses. In addition, a patient who has suffered pneumonia or pulmonary fibrosis must be registered at the clinic for one year after recovery to monitor and prevent complications.

Traditional methods

Alternative medicine recipes are widely used in the treatment of pulmonary diseases. It should be noted that folk remedies are effective only in relieving some symptoms and alleviating the patient’s condition. Some popular recipes:

1. A crushed mixture consisting of 200 g of white mistletoe, 200 g of elecampane, 100 g of hawthorn and rosehip each, 50 g of ephedra two-spikelet, is poured with a glass of water and simmered over low heat for 5 minutes, then the broth is infused for one hour. The product should be taken 100 ml during the day.
2. Crushed birch leaves and thyme are mixed in equal proportions, poured with water, boiled for 5-7 minutes, then infused.
3. 1 tablespoon of crushed rose hips and elecampane roots is poured with water in a ratio of 1:3, boiled for 15 minutes, then cooled. The infusion should be taken daily, the course of treatment is 2 months.
4. 1 tablespoon of flax seed is poured into a glass of boiling water, the composition is infused for half an hour. Use the resulting decoction once a day before bedtime.
5. Beat the leaves of fresh cabbage or burdock so that the juice comes out. Place the plants on the chest, wrap them in cellophane and leave them overnight.

Breathing exercises

For the treatment of pulmonary diseases, breathing exercises are of particular importance. It is aimed at improving gas exchange and strengthening the muscles of the diaphragm, helping to restore free breathing

Some effective exercises:

1. A classic dynamic exercise to improve diaphragmatic breathing through resistance: slowly exhale air through a straw inserted into a glass of water. The procedure should be repeated for 10-15 minutes.
2. Lying on your back, exhale deeply on a count of 1-2-3, while pulling in your stomach. On the count of 4, you need to inhale, protruding your stomach as much as possible, and then cough dully, contracting your abdominal muscles.

How does the disease manifest itself?

Symptoms for this pathology are few. The most frequently identified clinical signs are:

• shortness of breath at rest or during exercise;
• cough;
• pale skin;
• weight loss;
• weakness;
• malaise;
• fatigue;
• mild chest pain;
• wheezing;
• decreased performance.

As pulmonary fibrosis progresses to cirrhosis or sclerosis, symptoms of heart failure, edema, and palpitations may appear. Most often, patients complain of shortness of breath. At first it bothers you during exertion (during running, work or fast walking), and then appears at rest. It is combined with a cough. The latter is most often dry. Sometimes there is separation of viscous sputum.

The appearance of blood streaks in it indicates the development of complications. Basal pneumofibrosis is characterized by damage to those parts of the organ that are located at the base. The local form occurs most easily, since only a small area of ​​tissue suffers. Gas exchange is not disrupted.

Linear pulmonary fibrosis is a consequence of pneumonia and inflammation of the bronchi.

It does not develop immediately, but after several months or even years.

Diagnosis and treatment

A chest x-ray can fully identify the type of disease, its extent and location. Thanks to this study, the doctor also gets the opportunity to differentiate pulmonary fibrosis from tumors developing in the lungs.

Bronchoscopy allows you to determine whether the patient needs surgical treatment. In addition, to eliminate medical errors, the capabilities of computed tomography are increasingly used in medicine today.

Patients with a local variant of the disease that is asymptomatic are usually not prescribed treatment. But if the illness is a consequence of inflammatory diseases they have suffered and is periodically complicated by exacerbations of the infectious process, a course of treatment is necessary. It includes bronchoscopic procedures to improve the drainage of the bronchial tree, antibiotics, anti-inflammatory and antitussive drugs.

If diffuse pulmonary fibrosis is caused by negative environmental influences, first of all it is necessary to eliminate its root cause. At the same time, a course of treatment is prescribed aimed at eliminating or reducing pulmonary insufficiency. Areas of destructive, suppurating tissue are surgically removed.

Drug therapy includes glucocorticosteroids in combination with Penicillamine, which has a powerful anti-inflammatory effect, potassium, vitamins B6 and E. The course of treatment also includes drugs that enhance tissue regeneration and metabolism, strengthening blood vessels. For heart failure, cardiac glycosides are prescribed.

The patient's condition is significantly improved by oxygen treatment (oxygen therapy), physiotherapeutic procedures, massage of the chest area, and physical therapy. A promising method for treating pulmonary fibrosis using stem cells, which helps restore the gas exchange function of the lungs.

In order to prevent this disease, it is important to promptly identify and effectively treat the diseases that lead to its development.

People who come into contact with chemicals that are toxic to the respiratory system, or who work in conditions harmful to the lungs, must strictly follow safety regulations.

Experienced pulmonologists know who develops pulmonary fibrosis, what it is and how to treat this pathological condition. Fibrosis is the process of replacing functional lung tissue with connective tissue. This causes respiratory dysfunction, leading to the development of respiratory failure.

Treatment of pulmonary fibrosis

How to treat pulmonary fibrosis? There is no specific treatment for fibrosis and its reverse development does not occur. However, attempts are being made to influence it. Its development can be stopped if pneumofibrosis is the outcome of inflammatory or autoimmune diseases of the bronchopulmonary system, which occur with periodic exacerbations.

In acute interstitial pneumonia during the inflammatory reaction (alveolitis - the equivalent on CT is “ground glass”), corticosteroids are prescribed. Most patients with idiopathic pulmonary hemosiderosis also show a positive response to treatment with glucocorticosteroids - this is manifested by a decrease in the frequency of exacerbations and the rate of development of fibrosis.

For idiopathic pulmonary fibrosis, low doses of prednisolone and cyclophosphamide are also prescribed. However, there is no definitive evidence that survival in these patients is improved by treatment with prednisolone alone or with combination therapy. At the same time, the risk of developing adverse reactions is higher than the likelihood of improving lung function.

The only drugs with proven effectiveness that exhibit an antifibrosing effect in this disease are pirfenidone (Esbriet) and nintedanib (Vargatef). They attenuate fibroblast proliferation and fibrosis progression. Other drugs have shown their effectiveness in animal experiments - cyproheptadine and ketanserin suppressed collagen synthesis and prevented the deposition of fibrotic masses in lung tissue.

Attempts are being made to influence pulmonary fibrosis with drugs that have enzymatic activity. Thus, Longidase is used in suppositories (containing the enzyme testicular hyaluronidase) as monotherapy or as part of complex treatment. Research has proven that this drug does not act on normal connective tissue, but destroys altered tissue in the area of ​​fibrosis.

When administered rectally, the drug penetrates all organs and tissues. In pulmonology and phthisiology, 1 suppository is used every 2-3 days; 10-20 injections are recommended. If necessary, you can repeat the course after three months, and then switch to long-term (3-4 months) maintenance treatment - 1 suppository once a week.

The basic treatment of all bronchopulmonary diseases accompanied by shortness of breath (COPD, bronchial asthma) is bronchodilators, since bronchial obstruction occurs with pneumosclerosis.

Taking bronchodilators reduces the severity of shortness of breath and increases exercise tolerance. Bronchodilators of various groups are used: beta-2 agonists, M-anticholinergics and methylxanthines. From the group of M-anticholinergics, the most commonly used are: ipratropium bromide (Atrovent, Ipratropium-native, Ipratropium Air) and tiotropium bromide (Spiriva, Tiotropium-native).

Beta-2 agonists act quickly and improve well-being in the short term, but resistance develops with long-term use. Therefore, it is recommended to take a break from use, after which the bronchodilator effect of this group of drugs is restored. If these two groups of drugs are insufficiently effective, methylxanthines (Diaphylline, Euphylline, Theophylline and prolonged-release drugs) are added to treatment. They strengthen the work of the respiratory muscles and reduce pulmonary hypertension.

The effectiveness of combined treatment with indacaterol and glycopyrronium bromide in slowing the development of fibrosis in COPD has been noted. This combination blocks the fibrotic response in the body that occurs in patients with COPD. The inhalation drug Ultibro Breezhaler contains a combination of these two substances, which quickly and for a long time (24 hours) cause relaxation of the bronchial muscles and provide a bronchodilator effect.

Mucolytics (mucoregulators, mucokinetics) are not indicated for all patients with bronchopulmonary diseases - only during exacerbation and bronchial obstruction due to poor sputum separation. If the sputum is purulent and its quantity increases, antibiotics are prescribed. General strengthening agents and vitamins are also indicated.

Considering the irreversibility of the process, treatment of pulmonary fibrosis with folk remedies is ineffective. Plant materials can be used as expectorants, mucolytics and restoratives in the complex treatment of patients.

The leading method of treating patients with malignant neoplasms, along with surgery and drugs, is radiation therapy. The damaging effect of ionizing radiation supplied to the tumor leads to radiation changes in healthy organs and tissues entering the irradiation zone. Radiation therapy for malignant breast tumors leads to radiation damage to the lungs (radiation pneumonitis, pneumonitis).

Changes in the lungs associated with irradiation are divided into early and late. Early radiation injuries that occur during the first 3 months after irradiation are characterized by damage to small vessels and capillaries with the development of overfilling of the vascular bed and an increase in capillary permeability. By

After 1 month, inflammatory infiltration occurs.

Radiation damage to the lungs is radiologically distinguished as follows:

I degree - preservation or slight increase in the number of elements of the pulmonary pattern, some thickening of individual elements, loss of clarity of their contours due to developing peribronchial and perivascular infiltration; II degree - a pronounced increase in the number of elements of the pulmonary pattern, distinct changes in its structure (strengthening, deformation); III degree - pronounced changes in the pulmonary pattern (deformation, fibrosis), multiple, of different sizes, focal shadows, a decrease in the volume of the lung or its share, up to pneumosclerosis.

Clinical manifestations of radiation damage to the lungs include shortness of breath, which may be limited or severe, up to acute respiratory failure, a nonproductive cough or cough with a small amount of sputum, and chest pain on the side of the injury. Hemoptysis is not a common symptom, but there are reports of massive hemoptysis even in the immediate period after radiation therapy. Fever is not necessary, but may be high.

On physical examination, the symptoms of radiation damage to the lungs are minimal: hard breathing, scattered dry rales. Sometimes moist rales, pleural friction noise, and dullness of percussion sound over the irradiation zone in the presence of pleurisy are heard. In case of severe lung damage - tachypnea - acrocyanosis. The main complications of radiation pneumonitis are secondary pulmonary fibrosis, cor pulmonale and severe respiratory failure.

disturbances of vascular permeability and blood flow in the microvasculature; disorders of the coagulation and fibrinolytic systems; infiltration and inflammation of the lung tissue with the development of hypoxia, which causes damage to the pulmonary parenchyma, bronchial tree, and blood vessels of the lung in the irradiation zone and leads to the formation of local fibrosis, a decrease in bronchial patency and pneumatization of the lung.

In the prevention and treatment of radiation damage to the lungs (pulmonitis, pneumonitis), the following procedures can be used:

Electro- and phonophoresis Inhalation therapy with various medications Alternating magnetic field Massage Breathing exercises

Analyzing the effectiveness of various methods of restorative treatment, we came to the conclusion that for any type of radiation damage to the lungs with a predominance of restrictive changes, it is better to use a combination of a magnetic field with inhalations, and for more severe obstructive disorders - only magnetic therapy in certain modes.

Individual rehabilitation programs should be drawn up taking into account:

features of the malignant tumor, antitumor treatment performed, existing complications.

In rehabilitation, only those types of physiotherapy are used that do not affect the patient’s existing malignant neoplasm.

Central Clinic of the Literary Fund,

G. Moscow, st. 1ya Aeroportovskaya, 5

Examination of patients

Before starting treatment, it is necessary to conduct a thorough diagnosis to exclude other pathologies (cancer, various tumors). Therefore, the following types of research will be required:

X-ray of the lungs; electrocardiography; computer, magnetic resonance imaging; Ultrasound of the heart; study of blood gas composition; study of external respiration function; physical examination (listening to the heart and lungs as well as percussion); general clinical tests; examination of sputum to exclude tuberculosis.

If necessary, you can undergo bronchoscopy. In addition, the attending physician must necessarily identify the patient’s previous respiratory diseases, as well as the presence of any chronic pathologies, the patient’s living and working conditions (negative professional factors).

In the process of treating pulmonary fibrosis, the main factor is the elimination of the immediate cause of the disease with medications or the implementation of the correct measures to maintain therapy.

If pulmonary fibrosis develops against the background of another disease, the doctor initially prescribes a course of treatment aimed at eliminating the primary pathology.

Unfortunately, there is simply no single approach in this case. A specialist can prescribe a course of treatment only after a comprehensive diagnosis.

How to treat pulmonary fibrosis? As practice has shown, treating this disease with traditional medicine recipes often does not give a lasting, long-term result.

Traditional methods only allow you to get rid of unpleasant symptoms in the treatment of pulmonary fibrosis, but do not cure it.

If the root cause of the disease is pneumonia, the doctor will initially prescribe treatment with antibacterial agents. In most cases, the combined effects of drug treatment and physical therapy help cure pneumofibrosis.

The peculiarity of the treatment of this disease is that it should be carried out until the patient’s final recovery. Why is this necessary? Otherwise, there is a risk of relapse of the disease in a much more complex form.

However, even after complete recovery, the patient must be under constant supervision of a pulmonologist for at least 1 year.

If pulmonary fibrosis has not progressed to an acute form, resorting to hospital treatment is completely unnecessary. However, at home the patient is prescribed strict bed rest, due to which the sputum disappears much faster.

It should be noted that none of the methods of treating pulmonary fibrosis can give a 100% guarantee that the disease will completely recede without the development of complications.

The thing is that the cells that produce connective tissue do not disappear on their own, therefore the disease can reappear at any time.

Regime and diet

If the patient has a high temperature, he is advised to go to bed; if his condition improves a little, he will be given semi-bed rest, then general rest.

It is recommended that in the room where a patient with pulmonary fibrosis lies, the air temperature should be 18-20 ° C and it must be ventilated. Such a patient is advised to walk in the fresh air as much as possible..

A diet for pulmonary fibrosis should be aimed at accelerating immunobiological and oxidative processes in the patient’s weakened body, increasing repair in the lungs, reducing protein loss with sputum, improving hematopoiesis and the functioning of the cardiovascular system.

Taking into account the general condition of the patient, the specialist can prescribe a diet of 15 or 11 tables, the diet of which should consist of dishes with the required content of carbohydrates, proteins and fats.

However, the menu should be replete with products that contain calcium, vitamin A, B vitamins, ascorbic acid, potassium salts, folic acid and copper.

Breathing exercises

In case of pulmonary fibrosis, breathing exercises contribute to a noticeable improvement in respiratory function.

Below are some easy-to-follow but quite effective exercises for treating this disease:

Take as deep breaths as possible, take short pauses, and then slowly exhale the air. This exercise must be repeated 15-20 times. Lying on your back, perform deep exhalations and inhalations, while exhaling as deeply as possible, you can even help by pressing your hands on the diaphragm. This unique breathing exercise - inflating balloons - has proven to be quite effective, as it perfectly trains the lungs. Insert the tube into a pot of water. Try to blow out as much air as possible in just one pass. It is recommended to repeat this procedure 10-12 times. Place your legs as wide as possible, bend forward with your arms on different sides, while bending, exhale and draw in your stomach as much as possible. It is recommended to repeat this exercise 15-20 times, increasing the number of approaches daily. Raise your arms up and inhale deeply, and as you exhale, lower your arms with the sound “hu.” Why is it necessary to make such a sound? This technique allows you to get rid of oxygen in the lungs. Exhale as much as possible, while simultaneously pressing your arms and legs towards the entire body.

You can also do a light jog or a simple walk in the park.. Hardening exercises and swimming have proven to be very effective for pulmonary fibrosis.

Preventive actions

Prevention of pulmonary fibrosis includes measures that reduce the risk of developing the disease.
In industries with an increased risk of exposure to chemical compounds on the body, safety, labor protection and rest rules must be strictly observed. People whose professional activities involve risks are recommended to undergo annual treatment in a dispensary, in a mountainous area or near the sea.

Also It is important to exclude household factors - smoking, inhalation of vapors of chemical liquids (chlorine). Once a year you need to undergo fluorography and clinical examination (preventive examination by doctors).

If a person leads a healthy and active lifestyle, then the risk of disease is reduced many times over.

Pneumofibrosis is a severe lung disease with an unfavorable outcome. It is dangerous to human life and cannot be completely cured. If the pathology is not detected in a timely manner, the maximum life expectancy will not exceed 5 years. If the patient's condition is extremely severe, maintenance therapy will delay death by 3-5 months.

Etiological factors

You need to know not only what pulmonary fibrosis is, but also why it develops. The following reasons for the formation of this pathology are identified:

• hypoxia of lung tissue;
• circulatory disorders;
• difficulty in lymphatic drainage;
• chronic obstructive diseases (bronchitis);
• pneumonia;
• inhalation of dust and gases;
• inhalation of vapors of alkalis, acids and toxic compounds;
• vasculitis;
• tuberculosis;
• syphilis;
• fungal diseases.

The development of pulmonary fibrosis is caused by oxygen starvation of the tissue, against the background of which fibroblasts are activated. These are cells that contribute to the production of collagen and the growth of connective tissue. The risk group includes frequently ill people, smokers, people who come into contact with flour, dust, coal, cement, asbestos, metal, wood, and talc.

They often develop chronic dust bronchitis. Against the background of inflammatory diseases, sputum stagnates and plugs form. In the absence of therapeutic measures, this leads to fibrosis. Less commonly, diffuse pneumofibrosis develops due to exposure to high doses of ionizing radiation or medication (antiarrhythmic and antitumor drugs). Local (hilar) fibrosis most often forms after tuberculosis.

Development of pneumofibrosis in adults and children

Pneumofibrosis of the lungs is a chronic disease in which rough connective tissue grows in the lungs. Lung tissue loses its elasticity, which causes difficulty in the passage of air. Pneumosclerosis and fibrosis are not independent pathologies. Most often this is a consequence of other lung diseases (bronchitis, pneumonia).

Pneumofibrosis is of the following types:

• one-sided and two-sided;
• diffuse and focal;
• infectious and non-infectious origin.

There are 3 types of fibrosis depending on the severity of changes in interstitial tissue:

• pneumofibrosis;
• cirrhosis;
• sclerosis.

With pneumofibrosis, areas of normal tissue alternate with connective tissue. Depending on the etiological factor, post-radiation, post-pneumonic, dust, focal, infectious and idiopathic pneumofibrosis are distinguished. In the latter case, the exact cause of lung damage has not been established. Diffuse fibrosis occurs most severely when the organ decreases in volume. This pathology mainly affects adults.

Provoking reasons

Pneumofibrosis is not considered a separate disease, but a concomitant symptom or complication of other diseases. This condition can be caused by chronic inflammatory processes or the ingress of toxins into the mucous membrane of the respiratory tract. According to statistics, diffuse pneumofibrosis most often accompanies one of the following pathologies:

One of the most likely mechanisms for the development of pulmonary fibrosis is hypoxia, or insufficient blood supply to lung tissue. With a lack of oxygen, the alveoli become less elastic, and fibroblast cells are activated. These cells produce collagen in large quantities, which underlies the formation of connective tissue.

Symptoms

Symptoms of pulmonary fibrosis depend on the stage and subtype of the disease. However, it is possible to identify general factors that indicate pulmonary fibrosis:

• shortness of breath, which intensifies as the disease progresses;
• severe dry cough;
• bluish skin color;
• weakness, weight loss;
• changes in body temperature;
• soft tissue hypertrophy.

In more severe forms, swelling of the neck veins may occur.

It is worth noting that the presence of such symptoms does not mean that it is pulmonary fibrosis. To make an accurate diagnosis, you need to undergo a series of instrumental and laboratory tests. Please also take into account that the focal form does not manifest itself in any way, which complicates the diagnostic process.

Surgical treatment

In some people, the development of local pulmonary fibrosis occurs asymptomatically, or the signs are mild, and the patient does not consider them a reason to seek qualified medical help. In such cases, the disease is usually discovered by chance during a routine examination. A doctor can use bronchoscopy, CT or MRI to determine whether a patient needs surgery.

Surgical treatment is prescribed in rare cases. Its implementation is considered appropriate if a secondary infection is attached to the source of inflammation, that is, areas of pulmonary fibrosis begin to fester. In this case, the surgeon removes part of the lung - the tissue affected by the disease.

Causes of the disease

The causes of pulmonary fibrosis can be:

• smoking;
• acute and chronic respiratory tract infections;
• tuberculosis;
• bronchial asthma;
• chest injuries;
• irradiation;
• polluted air (most often in production);
• genetic characteristics (absence in the body of one of the liver enzymes that act as a protector of bronchopulmonary tissues).

Tobacco smoking is one of the main causes of chronic pulmonary obstruction.

The presence of several causes at the same time greatly increases the likelihood of progression and worsens the prognosis.

Prevention

In order not to have to drink bitter decoctions according to folk recipes, it is worth making every effort to prevent the disease. For preventive purposes, you can use the following:

• completely stop smoking;
• play sports, increase physical activity;
• use respirators and follow safety precautions (if necessary for the type of activity);
• practice breathing exercises;
• If initial symptoms occur, consult a doctor immediately.

In any case, with the clinical picture described above, you should not take any pills that are given at the pharmacy or start looking for a problem on the Internet. Contact a pulmonologist.

Treatment

In order to treat local pulmonary fibrosis and its other forms, there are many ways. However, when a pathology is discovered accidentally as part of a preventive examination, and it occurs without symptoms, then treatment is not prescribed. Restoration is possible using folk remedies.

The doctor indicates the need for antibacterial therapy in the following cases:

• when local minor lesions in the lung area are identified after inflammation or destructive algorithms;
• if the disease develops against the background of regularly occurring infectious processes.

In addition to antibacterial therapy, anti-inflammatory components are indicated, as well as physiotherapeutic procedures that optimize sputum production.

In a situation where the disease has developed due to the entry of aggressive particles into the pulmonary area (this can be not only dust, but also toxic components), treatment is aimed at eliminating them. That is, it is necessary to exclude minimal contacts with poisonous particles, dust and other harmful pollutants, which cannot be compensated for with folk remedies.

In some cases, it becomes necessary for a specialist to prescribe complex treatment for respiratory failure. This will help alleviate the patient’s condition with pulmonary fibrosis, but will not provide 100% recovery.

Syndrome of increased airiness of lung tissue(pulmonary emphysema) is a condition of the lungs characterized by pathological expansion of the air spaces located distal to the terminal bronchioles.

Complaints: mixed shortness of breath, which initially occurs only with significant physical exertion, then the amount of physical activity causing shortness of breath decreases, and, finally, shortness of breath can be bothersome at rest.

Chest examination: barrel-shaped chest, raised shoulders, short neck, in men - a decrease in the distance between the thyroid cartilage and the manubrium of the sternum, bulging of the sternum, an increase in the epigastric angle, widening and bulging of the intercostal spaces, their retraction during inspiration, smoothness or bulging of the supraclavicular fossa, shallow breathing, participation in breathing of auxiliary muscles (on inspiration, the sternocleidomastoid and scalene muscles are tensed, on exhalation, the serratus anterior and abdominal muscles are tensed). As they exhale, patients cover their mouths, puffing out their cheeks (puff). There is a limitation in chest excursion during breathing.

Palpation of the chest: chest rigidity and diffuse weakening of voice tremors are determined.

Percussion of the lungs: box sound, drooping of the lower border of the lungs, decreased mobility of the lower edge of the lungs, increased height of the apexes of the lungs, expansion of Kroenig's fields, decrease in size or disappearance of absolute dullness of the heart.

Auscultation of the lungs: weakened vesicular breathing (“cotton” breathing) is diagnosed.

Laboratory diagnosis of pulmonary emphysema.

Complete blood count: possible erythrocytosis and increased hemoglobin content, decreased ESR.

Biochemical blood test: with primary pulmonary emphysema, there may be a decrease in the level of α -1-antitrypsin (normal 27-74 µmol/l).

X-ray examination of the lungs. Signs of pulmonary emphysema.

Increased transparency of the lung fields.

Rarefaction and depletion of the pulmonary pattern.

Low position of the diaphragm and a decrease in its excursion.

Flattening of the diaphragm and increasing costophrenic angles.

Approaching the horizontal position of the posterior segments of the ribs and widening the intercostal spaces.

Expansion of the retrosternal space.

“Small”, “drip”, “hanging” heart.

Pulmonary function test: decrease in vital capacity; increase in residual lung volume (RLV); decrease in maximum pulmonary ventilation (MVV).

13. Types of pulmonary emphysema, development mechanism

Emphysema is a condition of the lungs characterized by pathological expansion of the air spaces located distal to the terminal bronchioles.

Types of pulmonary emphysema.

Non-obstructive emphysema (no obstruction of terminal bronchioles):

a) compensatory (vicarious) pulmonary emphysema - a consequence of replacement hyperextension of lung tissue, which develops as a result of a decrease in the respiratory surface of neighboring areas of the lungs - (lung resection, atelectasis, pneumonia, etc.;

b) senile – a consequence of age-related decrease in the elasticity of the alveoli.

Obstructive emphysema:

a) functional pulmonary emphysema (acute bloating of the lungs) develops with sudden valvular obstruction of the bronchi (attacks of bronchial asthma, foreign body aspiration, etc.), transient, disappears when the cause that caused it is eliminated;

b) chronic substantial pulmonary emphysema, in which destruction of the alveolar walls is noted (true pulmonary emphysema):

Primary – not associated with previous lung diseases (eg hereditary defect of α -1-antitrypsin);

Secondary – develops as a result of diseases of the lungs and bronchi (COPD, bronchial asthma, tuberculosis, pneumoconiosis, etc.).

Mechanisms of development of pulmonary emphysema.

Primary emphysema develops without previous lung disease. It develops with hereditary deficiency of α-1-antitrypsin, with changes in surfactant, in glassblowers, trumpeters, and singers.

In most cases, pulmonary emphysema is secondary. The main role in the development of secondary pulmonary emphysema is played by obstruction of the small airways in COPD and bronchial asthma. During inhalation, the walls of the bronchi, altered by inflammation, stretch, the bronchi expand, and air fills the alveoli and expands them. When you exhale, the lung tissue contracts, compressing the terminal bronchioles. Alveolar air does not have time to evacuate, and part of it remains in the “alveolar trap”. With subsequent breaths, everything repeats. The alveoli are overstretched with air, causing acute swelling of the lungs. Then degenerative-destructive changes in the walls of the alveoli occur and chronic pulmonary emphysema develops. The consequence of true pulmonary emphysema is expansion of the chest, a decrease in its respiratory excursions, impaired ventilation of the lungs and gas exchange in them, respiratory failure, and cor pulmonale.

Clinic and diagnosis of pulmonary emphysema (see question 12)

Severity of emphysema

Idegree– mild pulmonary emphysema.

The lower border of the lungs is not changed. The mobility of the lower edge of the lungs is reduced to 4 cm. Absolute dullness of the heart is not determined.

IIdegree– moderate emphysema.

The lower border of the lungs is shifted down by 1 rib. The mobility of the lower edge of the lungs is reduced to 2 cm. Insignificant participation of auxiliary respiratory muscles in the act of breathing.

IIIdegree– pronounced pulmonary emphysema.

The lower border of the lungs is shifted down by 2 ribs. There is no mobility of the lower edges of the lungs. The participation of auxiliary muscles in the act of breathing is clearly expressed. The lower edge of the liver is below the costal arch.

The concept of respiratory failure and the reasons for its development

Respiratory failure- this is a pathological condition of the body in which either the maintenance of the normal gas composition of arterial blood is not ensured, or it is achieved due to the operation of the external respiration apparatus, which reduces the functional capabilities of the body.

The following types of respiratory dysfunction are distinguished.

Ventilation disorders are a violation of gas exchange between external and alveolar air.

Parenchymal disorders caused by pathological changes in the lung parenchyma.

2.1. Restrictive disorders are caused by a decrease in the respiratory surface of the lungs or a decrease in their extensibility.

2.2. Diffusion disorders - a violation of the diffusion of oxygen and CO 2 through the wall of the alveoli and pulmonary capillaries.

2.3. Perfusion or circulatory disorders are a violation of the absorption of oxygen from the blood from the alveoli and the release of CO 2 from it into the alveoli due to a discrepancy between the intensity of alveolar ventilation and pulmonary blood flow.

The variety of acute inflammatory processes that occur in the respiratory organs of young children creates certain difficulties in recognizing them in the first hours and days of the disease. Moreover, it is extremely important to conduct an initial x-ray examination of the child in the early stages, observing the required technical rules for performing x-rays and always taking into account the status and age.

When assessing the radiograph, signs of immaturity of the chest skeleton and, accordingly, the anatomical formation of the bronchopulmonary structures are taken into account. X-ray diagnosis of acute inflammatory processes in young children is based on primary and secondary, or indirect, signs. Primary signs include changes in the vascular pattern and the appearance of additional shadows, and secondary signs include symptoms of impaired bronchial obstruction.

The onset of an acute inflammatory process in the bronchopulmonary structures is accompanied by hyperemia and blood filling. On an x-ray, this condition is manifested by the appearance of vascular shadows in the peripheral zones of the lungs, characterized in a healthy child by the absence of any structures. As a result, an excessive vascular pattern appears, and as a result of its summation, there are a large number of vascular shadows per unit area, which enriches the entire vascular pattern. This symptom is detected in the early stages of the disease and can be regarded as an early phase of the disease. Primary signs also include the appearance of one or two-sided additional shadows, characterized by varying prevalence, shape, size, intensity, nature of contours, etc.

Secondary symptoms are associated with anatomical and functional immaturity of the airways and impaired bronchial obstruction. Symptoms of bronchial obstruction in young children are found in various acute respiratory diseases, but manifest themselves differently depending on the type of obstruction. The inflammatory process in the bronchi is primarily expressed in hyperemia and swelling of the mucous membrane. With the appearance of signs of endobronchitis, the lumen of the bronchus and, accordingly, the volume of inhaled air passing through the bronchus decrease. As a result, less air enters the area of ​​the lung ventilated by this bronchus. X-ray areas of the lung with reduced pneumatization or hypoventilation are determined by comparing them with the corresponding areas of the opposite lung, as well as determining differences in airiness with adjacent areas of the lung. Identification of such areas is easier if they are the same size as the segment or larger. The vascular pattern under conditions of hypoventilation is less differentiated and more condensed.

Rice. 63. X-ray in direct projection. Lobular swelling. On the left, at the level of the root head and cardiac shadow, an area of ​​increased pneumatization is identified, resulting from swelling of several lobules with scalloped contours.

Another variant of bronchial obstruction is caused by the formation of a valve, or valve, mechanism. The valve can be an edematous fold of the mucous membrane or a mucus plug formed as a result of hypersecretion of mucus. In this case, there is a free flow of air at the moment of inhalation, but the presence of a valve mechanism in the bronchus prevents complete exhalation. In the area of ​​the lung ventilated by this bronchus, increased transparency appears, which should be considered as localized swelling. Radiologically, the symptom of bloating is determined by increased transparency compared to other areas of the lung, the disappearance of small vascular structures and thinning of larger ones.

The valve mechanism is more often observed in the lobular bronchi or in the superior bronchus that ventilates a group of lobules. In these conditions, the swollen lobules on the radiograph correspond to a limited area of ​​​​increased transparency, contrasting with the adjacent lung tissue. Its contours are rounded, scalloped, reflecting the stretched walls of the lobules. Inside such a lobular swelling, thin intersecting lines can sometimes be traced, corresponding to the interlobular septa. The sizes of lobular swellings are different - from 1 to 2 cm g and are directly dependent on the age of the child (Fig. 63).

The same pathogenetic mechanism underlies the obstructive syndrome observed with bronchiolitis in young children, which is sometimes mistaken for an asthmatic component.

Another variant of bronchial obstruction is complete obstruction of the bronchial lumen, ending with the resorption of air in the ventilated area and the formation of atelectasis in it [Vladykina M.I., 1971]. In young children, obstruction is observed mainly at the level of small bronchi, as a result of which small areas of the lung are excluded from breathing, and radiographically, atelectasis has a disc-shaped or lamellar shape, its length is IV2-2 cm or more. The direction of atelectasis can be different - from horizontal to vertical, which depends on the location of the segment and the direction of the obstructed bronchus. The width of disc-shaped atelectasis varies from 1-2 to 5-8 mm, and depending on its width, the clarity of the contours changes: the narrower the shadow of atelectasis, the clearer its boundaries are, and vice versa. The nature of its shadow also depends on the width of the discoid atelectasis: with a minimum width of atelectasis, its shadow is homogeneous, and as it increases, it becomes less homogeneous. When inhaling, the shadow of atelectasis moves simultaneously with the lung, therefore, during a repeated x-ray examination, depending on the depth of the child’s inspiration and the preservation of atelectasis, its shadow may move to a rib or intercostal space. The mechanism of formation of such atelectasis can be different: not only mechanical blockage of the bronchus, but also primary damage to the surfactant, bronchiolospasm of a reflex nature, as well as compression of the lung from the outside - collapse (Fig. 64) [Esipova I.K., 1976].

With obstruction at the level of lobular and terminal bronchioles, lobular atelectasis is formed, which is radiologically displayed in the form of small punctate formations. Lobular atelectasis is of theoretical rather than practical importance, and only in differential diagnosis should one bear in mind their low prevalence, small size (I-1.5 mm), as well as the clinical picture of the disease.

Among the secondary signs, the symptom of interstitial emphysema is also important, observed mainly at an early age and associated with the development of a destructive process in the alveolar tissue and/or in the bronchial system. This symptom appears on an x-ray in the form of a chain of gas bubbles located along the vessels and bronchi. The continuous supply of air can lead to its penetration into the mediastinum through the hilum of the lung, where there is no pleural cover, resulting in the formation of pneumomediastinum.

In addition to secondary radiological signs indicating a violation of bronchial obstruction, in some conditions young children experience a symptom of general swelling of the lungs. The development of this symptom is also based on morphological and functional immaturity.

Rice. 64. X-ray in direct projection. Disc-shaped atelectasis in the upper lobes. The vascular pattern is changed, uneven pneumatization of both lungs.

General swelling of the lungs can be a sign of toxicosis in severe cases of the disease or one of the main symptoms of bronchiolitis in children in the first months of life, and although the clinical signs of this condition are quite clearly expressed, x-ray examination allows not only to confirm the presence of swelling, but also to determine its degree. Clinically observed at this time, inspiratory dyspnea, promoting deepening of inhalation and shortening of exhalation, leads to overfilling of the alveoli with air.

General swelling is accompanied by an expansion of the borders of the lungs, which on radiographs is characterized by the appearance of a second, light, contour on the shadow of the mediastinum, which indicates an increase in the medial borders of the lungs. A high degree of swelling is determined by the closure of the medial borders, contrasting with a denser shadow of the mediastinum. At the same time, the apexes of the lungs extend beyond the first rib. The swollen basal regions of the lungs change the position of the diaphragm. Pushed downward, it takes the shape of a cone, and since the diaphragm is compressed by swollen lungs and intestinal loops containing an increased amount of air, movement is even more limited. If the listed signs are present, one should take into account the expansion of the outer boundaries of the lungs, which manifests itself

Rice. 65. X-ray in direct projection. General bloating. The medial borders of the lungs form a second, light contour on the shadow of the mediastinum, the zerchushki of the lungs protrude beyond the 1st rib, the outer contours of the lungs! roll into the intercostal spaces. The anterior ends of the ribs are located higher than the posterior ones. Diaphragm at the level of the VII ribs. The vascular pattern is poor.

Protrusion of the lungs into wide intercostal spaces (Fig. 65).

On a radiograph in the lateral projection, the anterior chest wall, due to its compliance, bends forward and the retrosternal space becomes wide, its transparency increases until the structural elements in this area disappear. At the same time, the position of the ribs changes, the anterior segments of which are located higher than the posterior ones. With a low position of the diaphragm, the size of the heart shadow noticeably decreases. Lung distension has a negative effect on the function of the heart muscle, which is manifested in disruption of not only local blood flow, but also in the peripheral parts of the pulmonary circulation [Khura A.I., 1965].

Changes in hemodynamics in the capillary network at the level of the alveoli occur with an increase in intra-alveolar pressure, which is accompanied by bloating. In narrowed capillaries, blood flow slows down, hypoxemia occurs, completing a vicious circle.

With hemodynamic disturbances and lung inflation, changes in the vascular pattern occur. With acute bloating in young children, the appearance of small vascular shadows on a radiograph becomes less noticeable, and large ones become thinner. General swelling of the lungs is characteristic of young children and is transient in nature. With the elimination of the causes of bloating, the physiological properties of the alveolar tissue are restored and the air content in the lungs is accordingly equalized. Lung bloating in young children is fundamentally different from a condition such as emphysema, since bloating quickly appears and disappears and is not associated with destructive changes in the walls of the alveoli observed with emphysema.

The presented pathogenetic mechanisms are observed in the first months of a child’s life, but by the age of one year and older, as all structures improve, the conditions for their manifestation are eliminated and at the same time radiological signs disappear.

The problem of acute respiratory diseases in childhood remains one of the main ones in pediatric practice to this day. The diversity of the microbial landscape, their associations, the prevalence of viral infection, and the combination of viruses and bacteria create difficulties in the diagnosis and treatment of pathological processes in the bronchopulmonary system. The registered repeated diseases and the antibacterial therapy carried out at the same time are alarming in terms of sensitization of the child’s body. In recent years, the increase in allergic mood, which manifests itself differently and has similarities with other respiratory diseases, has caused concern. Certain difficulties arise as a result of the emergence of new destructive forms, previously unknown or rarely observed. As a result of x-ray study of these forms in comparison with clinical data, x-ray examination is of paramount importance in recognizing destructive pneumonia and it should be noted that the course of destructive pneumonia, due to their early diagnosis, has noticeably changed towards reducing complications and shortening the duration of the disease. This was facilitated by the use of bronchoscopy, performed for diagnostic and therapeutic purposes, as well as timely and targeted treatment with antibiotics.

It can be said that in overcoming many complications encountered in the process of studying and diagnosing respiratory diseases in children, the leading role belongs to x-ray examination.

If, as a result of an x-ray examination of the chest organs, any signs of a pathological process are determined that are not detected by physical examination methods or, conversely, there is no x-ray confirmation of clinical symptoms, the question of the advantage of only one method cannot be decided. It is necessary to understand the reasons for the discrepancy and give a unified clinical and radiological conclusion.

X-ray examination is not limited only to confirming the clinically suspected pathological process, but first of all determines its x-ray morphological nature, prevalence, complications that arise, as well as the effectiveness of the treatment and, finally, resolution of the process. In the study, first of all, age-related patterns of development of the respiratory organs are provided as the basis on which the pathological process is formed. This is necessary because the period of newborns and early childhood is characterized by some forms of the disease that are not found in other age groups, just as not all diseases of older age are observed at an early age.

A number of other factors should be taken into account, such as the perinatal period, previous diseases, including genetically determined, metabolic and immunological diseases, the state of the nervous and cardiovascular systems. It should be noted that with age, the importance of some of them is lost, while others may increase.

Reduced airiness or alveolar consolidation of lung tissue, signs familiar to all radiologists, imply increased density and complete obliteration of the alveolar air spaces of the lungs without significant volume loss in the affected segment. Against the background of alveolar consolidation, the vascular pattern is not visualized with classical radiography. Against the background of alveolar consolidation, the air bronchogram sign is often determined. This sign also does not have high specificity in itself, and is found in a wide range of lung pathologies.

Pathology

Causes

The decrease in airiness is caused by the presence of pathological contents in the terminal airways, causing an increase in the absorption of x-ray radiation by the lung tissue:

• transudate, e.g. secondary pulmonary edema in heart failure
• pus, e.g. bacterial pneumonia
• blood, e.g. pulmonary hemorrhage
• cells, e.g. adenocarcinoma in situ
• protein, eg. alveolar proteinosis
• fat, e.g. lipoid pneumonia
• gastric contents, e.g. aspiration pneumonia

Differential diagnosis

• chronic eosinophilic pneumonia
• bronchioloalveolar carcinoma (obsolete term)