Atelectasis of lungs
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Description:
This morbid condition of all lung, its share or segment at which owing to disturbance of ventilation of an alveolus become airless and are fallen down. Obturation of a bronchial tube or a prelum of a lung are the reasons of an atelectasis. At obturation of a primary bronchus there is an atelectasis of all lung, at disturbance of passability of lobar or segmental bronchi — atelectases of the corresponding pulmonary shares or segments.
Symptoms of the Atelectasis of lungs:
The clinical picture depends on the volume of the pulmonary fabric which is switched off from ventilation and rate of the termination of ventilation. Manifestations of quickly arising atelectasis of all lung are clearest: there are short wind, pain on the party of defeat, pulse becomes frequent, the ABP decreases, cyanosis sometimes develops. The progressing respiratory insufficiency can lead to a lethal outcome. The chest wall on the party of an atelectasis considerably lags behind in the respiratory movements on comparison with the healthy party. At percussion of this area the stupid sound is defined, at auscultation are weakened or there are no respiratory noise. Heart is displaced towards an atelektazirovanny lung (this shift can be determined on localization of an apical beat, and also by percussion and auscultation of heart). The most reliable diagnostic method of an atelectasis is X-ray inspection of a thorax at which the dense airless shadow in a lung is found.
Slowly developing atelectasis can proceed asymptomatically, however quite often in an atelectasis zone at slow, gradual closing of a gleam of a bronchial tube there is an inflammatory process — atelectatic pneumonia which can be complicated by abscessing. Further, in process of subsiding of inflammatory process, connecting fabric develops, sclerous changes progress. Respiratory function of an affected area of a lung at the same time is lost. If the atelectasis comes sharply, within a short period of time, bronchial tubes are filled dense and, as a rule, with sterile slime. Inflammatory and sclerous changes in such cases are usually minimum, and after elimination of the reason of an atelectasis pulmonary fabric can become air again.
Reasons of the Atelectasis of lungs:
Depending on the reason and the mechanism of development distinguish the inborn and acquired atelectasis. Aspiration of amniotic waters or blood is the most frequent reason of an inborn atelectasis of a lung at newborns. The acquired atelectasis usually arises in bronchial tube obturation cases a foreign body, a viscous phlegm, blood, emetic masses, a tumor. Less often the acquired atelectasis can be caused by ruptures of bronchial tubes at various injuries, cicatricial narrowing of bronchial tubes as a result of injuries or the postponed tuberculosis, and also a prelum of bronchial tubes from the outside various intrathoracic tumors and the increased lymph nodes. At fall or a prelum of a lung as a result of accumulation of air or liquid in a pleural cavity there is a compression atelectasis of a lung.
Treatment of the Atelectasis of lungs:
Treatment is directed to recovery of bronchial passability and ventilation of a lung. The patient has to lie on a healthy side to stimulate drainage. For the purpose of recovery of bronchial passability at obturation of bronchial tubes foreign bodys or liquid masses (a phlegm, blood) apply a bronkhoskopiya. In not hard cases it is possible to try to remove a phlegm and blood with expectoration or by means of the catheter entered into a bronchial tube through a nose or a mouth. Essential value at this procedure has the cough stimulated by irritation of a mucous membrane of bronchial tubes. At the atelectases caused by a cicatricial stenosis of bronchial tubes, intrathoracic tumors, cysts, as a rule, make an operative measure. In cases of the compression atelectasis caused by a lung prelum at exudative pleurisy or pheumothorax pleurocenteses and drainage of a pleural cavity with aspiration of liquid and air are effective. Prescription of antibiotics is shown.
